Continue Care Beyond Your EAP Benefits

EAPs are designed for short-term mental health support. Based on your care goals, you and your Alma provider may decide to keep working together after your EAP benefit ends. This article covers your payment options for continuing care.

In-Network Care

If you have insurance through Aetna, Optum, Cigna, or one of Alma's in-network regional health plans, you may be in-network with Alma's Insurance Program. See the full list: Insurances Partnered With Alma.

If your plan is in-network, you pay a copay or coinsurance for your ongoing Alma sessions, based on your insurance benefits.

Verify Your Eligibility Before Your EAP Ends

While you are still using your EAP benefits, you can get an early cost estimate using Alma's cost estimator tool. Alma cannot formally verify your health plan eligibility through the Alma Portal until you finish using your EAP benefits.

You can also call the number on the back of your insurance card to ask whether your benefits are in-network with Alma's Insurance Program.

Once you finish using your eligible EAP sessions, your provider enters your insurance details into the Alma Portal, either on your behalf, or by emailing you a link to upload the information yourself. This link stays valid for 7 days.

Alma generally needs one business day to verify your insurance details. Alma emails you and your provider with:

Your health plan status (in-network or out-of-network).
Your payment responsibility for Alma sessions.

Alma uses this eligibility check to create invoices for your future sessions with your provider.

Out-of-Network Care

If Alma finds that your health plan is not in-network with Alma's Insurance Program, or you check the list above and see that your plan is not managed by one of Alma's network partners, Alma cannot file insurance claims for your sessions.

Instead, after your EAP benefits end, your provider begins invoicing you at their private rate. Discuss this rate with your provider so you are both clear on payment expectations going forward.

Becoming a private-pay client does not mean you lose all coverage for your Alma visits. Your health plan may offer out-of-network reimbursement for part of your session costs. Call the number on the back of your insurance card to ask:

Whether you are eligible for out-of-network coverage.
What documentation you need to submit for reimbursement.

Insurance companies generally require detailed invoices and superbills — monthly statements of the invoices you paid to your provider — to process reimbursement. You submit this documentation directly to your health plan.

Receive Care Without Insurance

If you do not currently have insurance coverage, discuss private-pay rates directly with your provider. Session costs vary by therapist, based on their services, training, and location.

Some providers offer a sliding scale, which prices care based on your specific financial situation. Talking to your provider about payment options is a good next step toward continuing care beyond your EAP benefits.

For more ways to make care affordable after your EAP ends, see: How to Pay for Therapy Without Insurance Coverage.

Frequently Asked Questions

Can I keep seeing my Alma provider after my EAP benefits end?

Yes. Depending on your coverage, you can continue care through in-network insurance, out-of-network reimbursement, or a private-pay rate you agree on with your provider.

Can I check if my insurance is in-network with Alma before I finish my EAP benefits?

Yes. Use Alma's cost estimator tool for a preliminary quote, or call the number on the back of your insurance card to ask about your network status directly.

What if my insurance is out-of-network with Alma?

Your provider invoices you at their private rate. You may still be able to get partial reimbursement from your health plan using invoices and superbills you submit directly.

What if I do not have insurance at all?

Discuss a private-pay rate with your provider. Some providers offer a sliding scale based on your financial situation.