Mental Health Insurance Coverage

CAPS is organized to provide short term treatment in order to serve the greatest number of students. Students who need longer term treatment (or who prefer a private therapist) are referred to one of many community providers near campus. Students insured by Northwestern under AETNA should contact CAPS (847-491-2151) in order to get treatment authorized and receive referrals. More information can be obtained by visiting the AETNA Student Health website.

Students not insured by Northwestern should contact their insurance company and find out what will be payed for and what their financial responsibilities will be. The questions below will help in gathering important information about mental health insurance benefits, which will assist with making informed decisions about therapy.

  1. Does my plan cover mental health outpatient visits?
  2. Do I have to see someone on the provider list?
  3. If yes, where can I get a copy of the provider list for providers in Evanston/Chicago?
  4. Is there anything I need to do to have my counseling sessions covered by insurance, if I am living out of state?
  5. How does my coverage differ if I see a participating provider versus a provider "outside the network"?
  6. For how many sessions can I be seen?
  7. What is the percentage co-pay for sessions?
  8. Do I have a deductible that I have to satisfy? If yes, how much?
  9. Is there a pre-existing conditions clause for my plan? If yes, what is the length of time I have to wait prior to my insurance covering a pre-existing problem?
  10. What is the effective date of the plan?
  11. Do I have to fill out any paperwork or be pre-certified prior to seeing a therapist?

If you will be submitting claims:

  1. What information will you need from my therapist in order for my claims to be paid?
  2. Where do I send my claims?
  3. Approximately how long does it take to receive a reimbursement?

When you contact therapists, ask them if they are accepting clients who are insured by your insurance plan. Also find out if they will require you to pay for sessions when you are seen, or if they will bill your insurance company.