• beelievepediatric

Insurance Insider

National Open Enrollment season starts November 1st! Insurance is a wonderful thing, but deciphering the ins and outs of insurance can be frustrating. Our insurance and billing team has provided some insight for understanding your policy and getting the coverage your family needs!

Insurance plans are individualized to you! Make sure to ask questions and get something that is exactly what your family needs.

Recommendations for you to get the most out of Open Enrollment.

  1. READ YOUR POLICY. There might be updates that your business or insurance company puts in place that changes the current plan you have. What you have this year might not necessarily be the same plan that you have moving forward.

  2. GET ON THE PHONE. Call and ask someone about plans, coverage, and upcoming changes; not everything is always available to view online.

  3. ASK THESE QUESTIONS, our insurance team recommends calling and asking these 4 questions:

  • Are there exceptions for specific diagnoses? Having your diagnosis codes on hand before calling is key as certain diagnoses can increase or eliminate the visit limit regulation.

  • Do therapies have a visit limit? - Is there a hard or soft max? Does the limit combine disciplines?

  • Does your plan have therapy exclusions? (VERY important for Speech Therapy)

  • Do different tiers have different options for various diagnoses? This is especially important when thinking about therapy and how many sessions/ visits they can have.


Things to be aware of when choosing or changing your insurance plan:

  • Therapist recommendations aren’t the same as your policy’s visit allowances.

  • What an office accepts is not the same as being in network.

  • For example, Beelieve is not in network with Aetna Commercial, but we can accept an Aetna Commercial plan if you have out-of-network benefits. If you do not see your insurance company listed on our insurance page, please call to inquire about out of network benefits!

  • Know your child’s diagnosis codes and treatment codes before you call your insurance company. Sometimes, this can help your company find the best plan for you!


It might be a good idea to change insurance companies or have a secondary company to assist with coverage if you have restrictions on your visit limit that prevent your kiddo from getting the services they require. To make sure you’re covered, check your deductible, out of pocket, and max visits; when you’re looking at services like therapy or assistive devices, this is vital!!




If you are a current client at Beelieve and have questions about your policy or want more information on your insurance codes before contacting your company, reach out to our insurance team! They cannot legally recommend an insurance company, but they can help you ask the right questions to find the best policy for your family!

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