Continuing care beyond your EAP benefits

Employee assistance programs (EAPs) were designed for short-term interventions to support mental health. However, based on your care goals, you and your Alma provider may also decide to keep working together after your EAP benefit terms are complete. 

If you choose to continue with your current Alma provider, you have several options to pay for sessions:

In-network care

If you have insurance through Aetna, Optum, Cigna, or one of our in-network regional health plans, you may be in-network with Alma's Insurance Program. You can find a list of the health plans we work with here: Insurances partnered with Alma

In this case, you would be able to pay a copay or coinsurance for your ongoing Alma sessions, as determined by your insurance benefits. 

Eligibility verification

While you are still using EAP benefits, if you want to get an early estimate of how much your Alma sessions will cost, you can use our cost estimator tool on the Alma website. Please note that Alma will not be able to formally verify your health plan eligibility through the Alma portal until your EAP benefits are complete. 
You can also call the phone number on the back of your health insurance card to ask whether your benefits are in-network with Alma's Insurance Program. For more instructions, read: Can I check if my insurance is in-network with Alma before I finish my EAP benefits?  

Once you finish using your eligible EAP sessions, your provider can enter your insurance details into the portal for a more detailed and nuanced eligibility check of your health plan. They can either add your insurance information to the portal on your behalf, or they can email you a link to upload the information directly yourself. This link will stay valid for 7 days.
Generally, the Alma team needs one business day to verify your insurance details. We will send you and your provider an email that includes your

  • health plan status (e.g., in-network or out-of-network)
  • payment responsibility for Alma sessions

We will use the information in this eligibility check to create invoices for your future Alma sessions with your provider. 

Out-of-network care

If the Alma team finds that your health plan is not in-network with Alma's Insurance Program, or if you review this list of in-network health plans and see that your health plan is not managed by one of our network partners, then Alma will not be able to file insurance claims for your Alma sessions.

Instead, after your EAP benefits end, your provider will begin creating invoices for you at their private rate. You should discuss these rates with your provider, so that you are both clear on expectations for payment following your EAP services. 

That said, becoming a private-pay client does not mean that you won't get any coverage for your Alma visits! Instead, your health plan benefits may include out-of-network reimbursement for a portion of your session costs. You can reach out to the phone number on the back of your insurance card to ask:

  • whether you are eligible for any out-of-network coverage, and
  • what you will need to submit as documentation tp apply for reimbursement.

Generally, your insurance company will require detailed invoices and superbills (i.e., monthly statements of all of the invoices you paid to a provider) to reimburse your expenses. You can submit this documentation directly to your health plan for processing. 

Receiving care without insurance

If you do not currently have insurance coverage, you can discuss private pay rates directly with your provider. Session costs differ from therapist to therapist depending on services, training, and location.

Some providers may also be able to offer sliding scale, which is care priced for each client's specific financial situation. Talking to your provider about payment options is a helpful next step to establishing a longer-term care relationship beyond your EAP benefits.

If you are interested in options to explore more affordable mental health care after your EAP ends, you can review: How to pay for therapy without insurance coverage.

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