We are excited to share that some employers Modern Health partners with are now offering members and dependents age 18 and above extended therapy coverage through Modern Health, making long-term therapy more easily accessible through Health Plan Integration (HPI). If you use or have used your therapy sessions covered by your employer for the year, you may be able to continue therapy through Modern Health by paying a cost-share/copay, similar to what you pay with your elected health plan design (not including Kaiser).
If you are unsure that your employer is listed as a client under this plan, please feel free to reach out to your Benefits Team or our team directly via help@modernhealth.com.
Health Plan Integration (HPI) Eligibility
How do I know if I’m eligible for additional sessions through my health plan?
Once you book your final therapy session covered 100% by your employer, you will be prompted to enter your health plan information, which you can find on your insurance card. Modern Health will immediately verify your eligibility for extended therapy coverage through Modern Health and allow you to book additional sessions. You will also be informed of applicable co-pays, or deductibles, or coinsurance that you may be responsible for, as determined by your employer.
If you’d like to find out in advance of booking your last session if you’re eligible, you can reach out to help@modernhealth.com to see if your employer and current health plan qualifies.
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- Your plan is no longer active due to a lapse in coverage.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 was 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.
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, we won’t be able to submit claims to your health plan to continue sessions, but there may be other options available to you, and you are always able to continue seeing your provider by paying out of pocket. We recommend working with your provider to determine the best plan if you could benefit from additional sessions.
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?
Unfortunately we aren’t able to submit claims to Kaiser plans at this time. Due to this, please revert to the response above on alternative coverage policies.
Health Plan Integration Session Count
How many additional sessions will I have through my health plan?
This is different from plan to plan. Please reach out to your health plan to determine if there are any limits on the number of outpatient behavioral health office visits that you can have in a benefit year. Modern Health has some limited information on this, so you can also reach out to us at help@modernhealth.com for additional questions.
My visit was cancelled due to the eligibility check 48 hours before the session - what should I do?
If your visit was incorrectly cancelled, 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.