What should I ask when I call my insurance company?

Learning about your insurance coverage can be an intimidating task if you’re unsure of what to ask. We’ve compiled this list of questions to make it easier to discuss and understand your coverage with your insurance company.

First, you’ll want to have your insurance card ready before calling. After making the call, here are some questions you may want to ask:

Do I have psychological services coverage?

• If the answer is yes, ask:

  • How many hours per session can I claim?

  • How many hours per week can I claim?

  • What is the total dollar amount of my coverage yearly?

  • What is the total amount per day I can claim for a single service?

  • What designation does the provider need to have for me to be covered? E.g. Registered Psychologist, Provisional Psychologist, Registered Clinical Social Worker, Canadian Certified Counsellor?

  • If relevant what are the specific services included in my coverage? E.g. Psychology individual visit? Psychological assessment? Family therapy? Couples therapy? Etc.

If you’re interested in Ketamine-assisted Psychotherapy, ask about the following:

Do I have prescription coverage?

• If the answer is yes, ask:

  • Is Ketamine covered under my plan?

    • If yes: What forms of ketamine are covered? i.e. oral (lozenges), intramuscular etc.

  • What percentage or maximum dollar amount can I claim for prescriptions?

Does my coverage cover a specific date range and if so, what is it?

• What is the effective/renewal date for my coverage?