Dr. Schild accepts a limited number of Medicare clients. If you have Medicare and you would like to use your insurance benefits for psychotherapy, please read the following information carefully. Medicare is a wonderful, yet complicated program and I encourage you to visit the Medicare websites (www.medicare.gov and www.cms.gov), and learn more about yours rights and responsibilities. Having Medicare benefits entitles you to see a mental health professional for a reduced fee; however, it does not mean that you have no financial obligation for your mental health services.
- If your only health insurance coverage is Medicare, then you are responsible for a percentage of the Medicare Allowable amount for each visit, which is usually 20%. For example, the copay for an hour session is generally $28.12. This is your co-pay that you are required to pay directly to Dr. Schild during each session. These amounts may vary depending on the services rendered and dependent on future changes in your Medicare benefits.
- At the beginning of each year, Medicare Part B, which covers outpatient mental health services, is requiring you to pay an annual deductible of $147. Each Medicare recipient must pay this deductible out of pocket before Medicare pays any subsequent claims. In other words, if you have not yet met your deductible, your cost for your initial visits will be substantially higher.
- If you have secondary or supplemental coverage though another insurance company, it may pay for all or part of your deductible. Medicare generally bills your secondary insurance automatically after the claim is processed, and the secondary insurers are generally obligated to cover any service that Medicare covers. To know the exact benefits of your supplemental insurance, please contact your insurance company directly. Contact information can generally be found on the back of your insurance card.
- Dr. Schild only accepts Medicare if it is your primary, and not your secondary insurance. Due to different billing procedures for Medicare as a secondary insurance, Dr. Schild is currently not able to accepts such an arrangement.
- At this time, Dr. Schild does not accept Medi-Cal (Medicaid) insurance. If you have Medi-Medi (i.e., both Medicare and Medicaid) and you would like to use your insurance benefits, you would be financially responsible for your copayments (see #1), which otherwise may have been covered by Medi-Cal. To find a mental health professional who accepts both insurances, please contact Medi-Cal directly. Some insurance information can be found on the Medi-Cal website at: www.medi-cal.ca.gov.
If you have any questions or concerns about your Medicare benefits, please visit the Medicare (www.medicare.gov) and the Centers for Medicare Services (CMS) websites (www.cms.gov), read the mail you receive from CMS such as EOB’s (Explanation of Benefits) and other letters, and contact Medicare with any concerns or questions you may have.
Professional Psychotherapy &
Sven Schild, PhD
Licensed Clinical Psychologist & Certified EMDR Clinician