Overview
Modern Health now offers extended care coverage via Health Plan Integration (HPI) for members and their adult and minor dependents. Extended care coverage allows eligible members to access therapy sessions, beyond the sessions covered by their employer. Additionally, extended care coverage allows eligible members to access psychiatry and medication management (PAMM) sessions.
Please note, that extended care is not available to all Modern Health members. In order to access extended care coverage for therapy using Modern Health's Health Plan Integration, your employer must offer Health Plan Integration. In order to access psychiatry and medication management, your employer must offer psychiatry and medication management. For extended care coverage for both therapy and psychiatry and medication management, you must be on your employer's eligible health plan. Kaiser plans are currently not supported.
To learn more about our psychiatry and medication management (PAMM) offering, please navigate to our Psychiatry & Medication Management article.
To learn more about member payments for extended care, please navigate to our Payment Overview article.
For additional questions, please reach out to help@modernhealth.com. We'd be happy to assist!
About Health Plan Integration
Health Plan Integration (HPI) makes it easier and more affordable to continue care through Modern Health.
With HPI, once you’ve used all of your employer-covered therapy sessions, you may be able to keep seeing a Modern Health therapist using your health plan coverage. Some employers also utilize HPI to offer access to psychiatry and medication management (PAMM).
HPI visits are billed through your health plan and may require a cost-share payment, as determined by your employer.
Health Plan Integration (HPI) Eligibility
What are the eligibility requirements for HPI?
- Your employer: They must offer HPI through Modern Health.Your location: HPI is currently available only to US-based members on eligible plans.
- Your health plan: You must be enrolled in an employer-sponsored health plan that’s compatible with HPI (for example, some Kaiser plans are not supported).
- For PAMM: Your employer must offer PAMM in addition to HPI, and you must be 18 or older.
- Your location: HPI is currently available only to US-based members.
How do I know if I’m eligible for HPI?
Once you book your final employer-covered therapy session, you will be prompted to enter your health plan information in your member portal. Modern Health will then verify your eligibility for extended care coverage. If you are eligible, you will be able to begin booking HPI sessions.
How can I check my eligibility for HPI prior to reaching my final covered therapy session?
Mobile
- Beginning on your Modern Health account home page, navigate to the "Settings" tab of the app
- Under "Your Account", select "Health Plan Details"
- Select "Update your health plan details"
- Follow the prompts on the screen to input your health plan details
- After you have provided your health plan information, we will confirm your eligibility status for HPI
Desktop
- Beginning on your Modern Health account home page, navigate to your account drop-down menu in the right-hand corner and select "Settings"
- Scroll down to the bottom of the page where you will see a box labeled "Your health plan details"
- Select "Review your coverage", then "Update your health plan details"
- Follow the prompts on the screen to input your health plan details
- After you have provided your health plan information, we will confirm your eligibility status for HPI
After submitting my insurance information, I was notified that I was not eligible. How come?
Your eligibility may be denied for two reasons:
- Your plan is no longer active due to a lapse in coverage. If this is the case, you’ll need to reach out to your employer and/or health plan to reinstate coverage.
- Different information was submitted in the eligibility form than what the health plan has on file. Please confirm that all information submitted on the eligibility form is accurate. If it is accurate, then you’ll need to reach out to the health plan to make sure they also have the correct information on file.
For additional assistance, please reach out to our team at help@modernhealth.com.
How do I know if my adult and minor dependents are eligible for additional sessions through my health plan?
Once your dependents book their final employer-covered therapy session, you can check if they’re eligible for HPI.
- At the bottom of your member portal homepage, you will see the option to “Add your health plan details… Your dependents may also be eligible for HPI, which can be checked in Family Care.”
- Once you click into that page, you will be prompted with a screen that asks, “Is [your dependent’s name] covered under [your insurance] with [your employer]”?
- After you click Yes, you will be asked to fill out the required fields in order to check your dependent’s eligibility.
- If eligible, you will see “[Your dependent] is eligible for additional therapy!” and be able to book a session for them.
I’m not on my employer’s plan - what options do I have available for continued coverage?
If you aren’t on your employer's plan, you will not be able to access extended care with HPI. We recommend working with your provider directly to determine the best path forward. They may recommend continuing care outside of the Modern Health platform until your employer-covered sessions renew.
Modern Health also provides you access to:
- Mental health, professional, and financial coaching sessions
- Unlimited meditations, audio series, and interactive programs
- Unlimited Circles — community-based workshops & support sessions
What if I’m on a Kaiser plan?
If you are on a Kaiser plan, you will not be able to access extended care with HPI. Due to this, please revert to the response above on alternative coverage policies.
My visit was canceled due to the eligibility check 48 hours before the session - what should I do?
If your visit was incorrectly canceled, this is likely due to one of two reasons:
- Your plan is no longer active due to a lapse in coverage. If this is the case, you’ll need to reach out to your employer and/or health plan to reinstate coverage.
- Different information was submitted in the eligibility form than what the health plan has on file. If any information that your health plan has on file has recently changed, you’ll need to update that information in our system as well. If the health plan has incorrect information on file, you’ll need to contact them to update this.You can also reach out to our team to receive additional support and help to get the visit rescheduled.
Note: Please note that access to certain features and services depends on the benefit package selected by your company.