1.  How much coverage (in dollar amount or number of sessions) do you have remaining on your OUTPATIENT MENTAL HEALTH BENEFIT for this year? $ or sessions.

Also, what is your LIFE-TIME BENEFIT for OUTPATIENT MENTAL HEALTH? $

2.  Do you have a DEDUCTIBLE (that is, how much does your insurance company require you to pay before they begin to pay on your bill)?    No   Yes

If yes, fill in the $ amount. (Usually $50 - $250 and all medical care received in any year is credited towards this.)

3.  Do you have a CO-PAYMENT OR CO-PAY ( that is, do you pay a certain dollar amount or percentage of the fee for each service or session)?    No   Yes

If yes, fill in the $ amount or the % per session.

4.  Has your insurance company established a maximum fee per hour session that they will reimburse for?
No   Yes

If yes, fill in the $ amount.

5.  Does your insurance coverage include psychological testing if that were to be recommended for you?  No   Yes

If yes, fill in the $ amount per hour of testing.

6.  What type of mental health therapist does your insurance company recognize? (Some companies or HMO's have discriminatory clauses which arbitrary pay for the services of only certain practitioners). Check those below which apply.

A. Clinical (Certified) Social Worker, C.S.W. 
B. Masters of Social Work, M.S.W. 
C. Masters Degree Psychologist, M.A. (also Limited Licensed Psychologist) 
D. Doctoral Degree Psychologist, Ph.D., or Psy.D. (also Full Licensed Psychologist) 
E.  Psychiatrist, M.D.
F.  Physician, M.D.

7.  Are there any other restrictions or conditions which your insurance company places on obtaining outpatient mental health benefits? For example, are you penalized, by decrease coverage, if you choose your own provider, or if your provider is not on your HMO's panel?

8. Does your employer offer a MEDICAL SAVINGS ACCOUNT (MSA), also called "IRS Section 129 Plan"??  If so, you may be able to reduce you out of pocket costs by an additional 25 percent by utilizing it. Here's how you can get a 25 percent reduction in the cost of treatment, on as much as 2,500 worth of care (equivalent to an annual savings of as much as $625). This is done by using pre-tax dollars to pay for therapy. Here's how it works:

• Money Mechanics.At the beginning of the plan's annual open enrollment period, you ask your employer to reduce your salary by up to $208.33 per month, in order to pay for treatment. In any one year, for one covered person needing treatment, the combined deductions allowed under Section 129 and IRS Form 1040 cannot exceed $2,500. If a dependent also is eligible for this deduction, the combined annual total covered cannot exceed $5000, for a total maximum monthly salary deduction of $416.66. For income tax purposes, a person's taxable income would be computed on the basis of this deduction. You turn in receipts for your treatment every month to your employer. Your employer will then issue you a non-payroll check every month, reimbursing you for the amount you have had deducted from your payroll check, up to the full amount or for the full amount of the receipt, whichever is greater. This goes on until the annual maximum has been reached. You pay your therapist directly.
• Cautionary Notes.IRS regulations don't permit you to change your mind mid-year about participation in the plan. Once in, you are in to stay for the year, or you risk missing out on receiving reimbursements. It may sound complex, but in actuality, it isn't. Get your own tax advisor to send you material on Section 129 regulations so you can be better advised on its use.
• Broad Applications.Section 129 coverage is fairly broad. It covers such things as: hypnosis for the treatment of illness; treatment of alcoholism or addiction; membership fees in associations furnishing medical or clinical care; and psychiatric and psychotherapeutic care. Even day care for children under 13 is covered, so if you should conclude your therapy early, you can shift your covered expenses to other activities.