Therapists That Take EmblemHealth Insurance in New York

Yes, MMHC is in-network with EmblemHealth. Network status can differ from one clinician to another, so if a particular clinician is out-of-network for your plan, we match you with one who is in-network. We confirm your coverage in writing before your first session.

We verify coverage for members across EmblemHealth's plan families, including GHI and HIP. Because acceptance can depend on your exact plan, we confirm your coverage in about 5 minutes before your first session.

Yes. GHI (Group Health Incorporated) and HIP (Health Insurance Plan of Greater New York) are the two plan families EmblemHealth operates. A GHI therapist, a HIP therapist, and an EmblemHealth therapist all mean the same in-network care, and your member card names which plan you carry.

Yes. GHI is one of EmblemHealth's two plan families, and outpatient psychotherapy is a covered behavioral health benefit on GHI plans. Under the federal Mental Health Parity and Addiction Equity Act, any limit on therapy visits can be no stricter than the plan's limits on comparable medical care. New York employer group plans must also cover at least 20 outpatient mental health visits per year under Timothy's Law. Your copay and any plan rules depend on your specific plan, and we verify them before you start.

Most of our EmblemHealth clients pay between $0 and $25 per session. Your exact cost is your plan's copay, or coinsurance after your deductible, and it depends on your EmblemHealth plan and where you are in your plan year. Costs can shift after your deductible resets each January. We confirm your current cost at no charge and put a written estimate in your hands before you start.

Yes. Under New York Insurance Law section 3217-h, EmblemHealth cannot exclude a covered therapy service because it is delivered by telehealth (telehealth: therapy held over secure video from wherever you are), and your telehealth copay, coinsurance, or deductible must be at least as favorable as for the same service in person. Every MMHC session is a secure video session, so you can meet with your therapist from home, anywhere in New York State.

Yes. Our EmblemHealth therapists see members in Manhattan, Brooklyn, Queens, the Bronx, Staten Island, and across New York State by secure video. Distance is not a factor, so we match you on fit rather than location.

Yes. Because every session is telehealth, EmblemHealth members in Brooklyn, Staten Island, and every other New York borough and county see the same in-network therapists online, with no commute.

EmblemHealth behavioral health benefits are administered with Carelon Behavioral Health, reachable at 888-447-2526 (TTY 711). You can also call the number on the back of your member ID card, or let us verify your benefits for you at 212-960-8626.

Psychiatric care is generally part of EmblemHealth behavioral health benefits; confirm the specifics with your plan. MMHC provides psychotherapy and does not prescribe medication. If you need medication management, Carelon Behavioral Health at 888-447-2526 (TTY 711) can point you to in-network prescribers, and therapy at MMHC can run alongside that care.

It depends on your plan. Many EmblemHealth plans, including GHI plans, do not require a referral for outpatient therapy, while some HIP HMO plans route care through your primary care doctor. We confirm your plan's rule when we verify your benefits, and if a referral is needed we help you get one.

It depends on your plan. Some EmblemHealth plans require prior authorization for certain outpatient mental health services, and rules differ by plan family. Checking authorization and referral requirements is part of our standard benefits verification, so you know before your first session. Any session cap is confirmed at the same time; under federal parity law, behavioral health limits can be no stricter than comparable medical limits.

We handle it with you rather than handing you a bill. If a claim is denied, we review the reason with EmblemHealth and refile when it is a coding or authorization issue. If your EmblemHealth coverage lapses or changes mid-treatment, we re-verify your benefits and talk through your options, including our self-pay rate, before your next session, so you are never surprised by a cost you did not agree to.

Most health-plan deductibles reset on January 1. If your EmblemHealth plan applies a deductible to outpatient therapy, your per-session cost can change at the start of the plan year until the deductible is met again. Ask us to re-run your 5-minute benefits check at renewal and we confirm your updated number in writing.

You rematch. Tell us what felt off and we connect you with a better-matched therapist. Your progress and goals carry over, so you do not restart intake.

Call 212-960-8626 or fill out the contact form. We verify your EmblemHealth coverage, copay, and network status in about 5 minutes and put your estimated cost in writing. You can also call the number on the back of your member card or Carelon Behavioral Health at 888-447-2526.