Using Alma’s Cost Estimator Tool

Overview

At Alma, we know how many factors go into searching for a therapist. For most people, the biggest thing to consider is cost - how much will I have to pay for mental health care? Our goal is to help alleviate the stress of navigating your insurance and benefits, so that you can focus on finding the right fit. To do so, Alma has partnered with several insurance companies to help you access affordable mental health care. 

If you are insured through Aetna, Cigna, Oxford or UnitedHealthcare (UHC), you can use Alma’s cost estimator tool to check how much you can expect to pay for therapy. Learn more about this tool below, or try it yourself.

How it works

Using Alma’s Cost Estimator Tool

  • Step 1: Navigate to Alma’s cost estimator tool
  • Step 2: Follow the instructions on the page and select See cost estimate
    • In order to get you a cost estimate, we need your first and last name, date of birth, and member ID. Alma does not save the information that you input in this form.
  • Step 3: View your cost estimate. Please note that everyone’s results look different based on their coverage, whether or not their deductible applies, and several other factors. Read more about interpreting your results.
  • Step 4: Select “search for in-network care” to see a list of providers who accept your insurance. Or, learn more about how to pay for therapy without insurance coverage.

Note: If you choose to move forward with an Alma provider, our team will double check your benefits for you so that you know exactly how much you’ll have to pay per session.

Interpreting your results

Because everybody’s health insurance is different, there are several factors that go into determining your payment responsibility for mental healthcare. Below are the most common scenarios that you might encounter when using Alma’s cost estimator tool.

Scenario 1

If your results show that you have in-network coverage with deductible* remaining it means that you have to pay for sessions in full before your insurance kicks in.

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For example: if you’ve already contributed $543 towards your $1,000 deductible, that means you will have to pay 100% of your provider’s contracted rate** until you pay the remaining $457 towards your deductible. 

Once you hit your deductible, you will only be expected to pay either a fixed rate (copay) or a percentage of your provider’s contracted rate (coinsurance) per session. You should see your expected cost per session in the format of a copay or coinsurance on the results page.

*A deductible is an amount of money you have to pay out-of-pocket before your benefits kick in

**The contracted rate, or the amount of money that providers charge per session, is determined by several factors like the state they’re licensed in, their degree (e.g., Masters, PhD, etc.) and the type of care they offer (e.g., talk therapy, medication management, etc.). Most Alma providers have a rate that falls between $130-$380 per session.

Scenario 2

If your results show that you have in-network coverage and your deductible doesn’t apply it means that you have either paid your full deductible or your insurance coverage kicks in prior to paying your deductible off, which is great news!

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If this is the case for you, you should see your expected cost per session in the format of a copay or coinsurance. For example, if your copay is $25, you will only be responsible for paying that amount per session with an in-network provider. 

If your coinsurance is 10%, that means you have to pay 10% of the cost of the session. To break this down a bit further - let’s say the provider you want to work with typically charges $150 per session. With your 10% coinsurance, you would only have to pay $15 per session.

Scenario 3

If your results show that we are not able to determine your coverage right now - don’t worry just yet. You’re seeing this because Alma needs to manually check your benefits, and we can’t do that until you’ve selected a provider to work with. The reason we do a manual check after you’ve identified a provider is because the more information we have, the more accurate your cost estimate will be. 

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That said, we recommend using Alma’s directory to search for a provider who accepts your insurance. Once you find the right fit and decide to move forward, you can expect to receive an email from Alma with your payment responsibility per session. You also have the option to call your insurance provider using the number found on your member card to get a cost estimate earlier in the process.

Scenario 4

If you see a screen that says this tool does not support your insurance yet, you still may be able to find a provider who accepts your insurance. If you see this message after inputting your information, it’s likely because Alma does not have a partnership with your insurance company, so we are not able to verify your coverage. 

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That said, many of our providers accept additional insurance plans independently from Alma. We recommend selecting Search for in-network care which will bring you to our provider directory where you can browse through providers and schedule consultation calls. 

If you choose to move forward with a provider, it’s important that you confirm that they accept your insurance. Alternatively, paying for therapy out-of-pocket is always an option. Learn more.

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