Insurance Issues

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Since obtaining licensure in 2005, most insurance companies have accepted onto their panels mental health counselors and the other professions licensed with us.  Unfortunately there are still some companies that will not accept us, and we believe that an ongoing effort to communicate with them, to educate them about our professions, and to file complaints with them (if necessary) will get us closer to acceptance.

Please contact us with the names of the insurance companies that have not accepted you onto their panels and the reasons you were given for the rejection.  We will post that info here with instructions on the next steps that can be taken.
Ongoing Issues:

BC/BS of Western NY - Like Excellus, BC/BS of Western NY also does not accept LMHC's or LMFT's.  Unlike Excellus, LMHC's who inquired were told that LMHC's are "not qualified."  LMHC's and LMFT's in the catchment area are urged to apply to become providers and then file a complaint with the company when they are turned down.

GHI - NYMHCA members report that GHI does not accept LMHC's even though they did so in the past.  More information about this is needed.

Independent Health - This company operates primarily in Western NY and still does not accept LMHC's.  Please contact us with any information that will help us in our efforts to convince the company to open their panels to LMHC's.

NYS Empire Plan - Currently LMHC's and LMFT's are only reimbursable as out of network providers.  A NYMHCA member was told that it was because we are not Medicare reimbursable.  Someone else was told that it was because LMHC's did not have Civil Service titles. We are still exploring this issue.

Medicaid - None of the Mental Health Practitioners can obtain private Medicaid numbers which would allow them to accept clients with "straight" Medicaid.  In the coming months the only Medicaid coverage will be for Medicaid managed care, and the mental health practitioners should be eligible for reimbursement because the companies that will accept Medicaid customers already accept us.

Medicare  - The effort to get LMHC's and LMFT's into Medicare law as providers has been going on for many years.  The national counseling organizations have worked collaboratively with the AAMFT (American Association of Marriage and Family Therapists) to have our professions included in legislation, that when passed and signed into law would include us as providers.  There are currently a few bills in Congress that include our professions and are being actively lobbied for.  For information on what you can do to help, visit the websites of your national professional organizations as well as our  Additional Professional Issues page. Alerts to take action will be posted on this website as they come up.

TRICARE - The changing requirements for LMHC's who want to be in network with Tricare are confusing.  Click here for current and future requirements.

Univera - This company operate primarily in Western NY and still does not accept LMHC's.  Please contact us with any information that will help us in our efforts to convince the company to open their panels to LMHC's.

Workmens' Compensation  - Mental Health Practitioners are not currently on the list of approved providers for this program.  It is our understanding that social workers have just gotten onto the list.  More information is needed on this issue.
Here are two documents that can help you to lodge a complaint with an insurance company:
 To lodge a complaint against an insurance company with the former NYS  Insurance Commission, send your complaint to:

 NYS Department of Financial Services
 Consumer Assistance Unit
 One Commerce Plaza
 Albany, NY 12257
 Att:  Superintendent Benjamin Lawsky

 Please make sure that your complaint ONLY states the issues YOU are having  with an insurance company and does not mention NYMHCA.