The insurance benefits call
A word-for-word script for understanding your coverage
Before you dial
Have these in front of you. The call goes faster and you sound like someone who knows the drill.
The opening line
"Hi, I'd like to understand my mental health and behavioral health benefits. Can you help me with that, or transfer me to someone who can?"
The five questions that matter
Ask these in order. Write the answers in the blanks.
"Do I need a referral from my primary care doctor to see a psychiatrist or be evaluated?"
"Is pre-authorization required for an evaluation or for psychiatric care?"
"What is my copay or coinsurance for a behavioral health visit, in-network and out-of-network?"
"Do I have a deductible, and how much of it have I met this year?"
"Can you send me a list of in-network providers who are taking new patients?" (More on this in the directory script.)
Capture every call
You will call more than once, and reps contradict each other. Log it.
| Date | Rep name | Reference # | What they told me |
|---|---|---|---|
If you get a confusing answer
"I want to make sure I have this right. Can you say that one more time, slowly, so I can write it down exactly?"
Then read it back. If two reps tell you two different things, that contradiction is useful, note both, with names and reference numbers.
Haze to Health is not a medical or mental-health provider. We do not diagnose, treat, or prescribe. This is educational and organizational information only, not medical, legal, or psychological advice. Only a licensed professional can evaluate or diagnose ADHD or any other condition.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline), any time, free and confidential.