Frequently Asked Questions About Insurance and Payment

Regeneration Psychiatry

How does health insurance work in the U.S.?

In the United States, most people get health insurance from their employer. This is called “private insurance companies” and these policies often cover their spouse and children. People 65 years old and older are covered by insurance provided by the federal government called “Medicare.” People who are low-income often get health insurance provided by their state, this is called “Medicaid” (In California, this is called Medi-Cal).

What insurances do you take?

We take regular Medicare. We only take certain types of Medicare Advantage. We do not take Medicaid/Medi-Cal. For an updated list of private insurance insurances we take, please look at this list: https://www.regenerationpsych.com/fees

Why do I need to bring a form of payment to the visit when I have insurance?

Even if you have health insurance, many policies have co-pays and deductibles, meaning you will need to pay a proportion of the cost of your treatment. What proportion depends on your plan and you can look it up in your policy documents or by calling your insurance company.

What does “co-pay” mean?

Co-pay means a set amount that you need to pay each time you see the doctor. Often this amount is between $10-70. You can look up your co-pay by looking at your policy documents or calling your insurance company.

What does “co-insurance” mean?

Co-insurance is a set percentage of the total cost of your treatment that you will need to pay each time. This is less common for private insurance and you might not have this as part of your plan. You can look up your co-insurance by looking at your policy documents or calling your insurance company.

What does “deductible” mean?

Deductible is a set amount that you are responsible for paying before your health insurance will start paying for your care. Some people have no deductible, though this is rare. Most deductibles are $500-$5000 depending on the terms of your insurance policy. Cheaper plans tend to have higher deductibles and more expensive plans have lower deductibles.

Are there any out-of-pocket costs to seeing a doctor at Regeneration Psychiatry?

If you are using insurance, you will be responsible for paying for your co-pay, co-insurance, or deductible. This is why we collect your payment information at your first visit. It is your responsibility to understand your insurance plan and your deductible. When we are notified by your insurance company that you are responsible for payment, we will send you a notification and billing statement. You will have 5 days to notify us if something is incorrect before you are charged.

If you are paying out of pocket, we will charge you our cash-rate for any treatment you receive. We can provide a superbill at your request and it is your responsibility to submit the claim for reimbursement with your insurance company.

How does Medicare work?

Medicare is a health insurance provided by the U.S. federal government for people over the age of 65 and those who are disabled. With regular Medicare, you can see any provider of your choosing who takes Medicare. You have to pay a yearly deductible and 20% coinsurance unless you have a Medicare Supplement Insurance policy.

What is Medicare Advantage?

Medicare Advantage plans are insurance plans sold by private insurance companies as a replacement for regular medicare. These plans often limit which doctors you can see. Our practice only sees certain Medicare Advantage plans.

What is Medicare Supplement insurance?

Medicare Supplement plans are additional health insurance plans that Medicare patients can buy that will usually pay for their 20% coinsurance and sometimes their deductible. We take all Medicare Supplement insurance plans.

What is the difference between primary and secondary insurance?

Primary insurance is the health plan that will pay for your treatment first. Any leftover costs will be transferred to your secondary insurance. Please call your insurance company to verify which insurance plan is your primary vs secondary. We can only take your insurance if your primary plan is in-network.

What is a "Good Faith Estimate"?

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

Other FAQs:

How is a psychiatrist different than a therapist?

A psychiatrist is an MD, or Doctor of Medicine. To become a psychiatrist, an individual needs to complete an undergraduate degree and 4 years of medical school as well as at least 4 years of residency (or on-the-job training). Some psychiatrists have further training in order to specialize to treat children and adolescents or addictions. A psychiatrist is not only knowledgeable about psychiatric conditions, but is also familiar with medical conditions and how these can contribute to psychiatric issues. A psychiatrist can prescribe medications while a therapist cannot. A therapist usually has a degree in clinical psychology, social work, marriage and family therapy, or mental health counseling. A therapist will not have completed medical school or finished a rigorous residency. A therapist cannot prescribe medications.