Insurance and Payment Information for Applegate Counseling
We accept all forms of payment, including private pay, individual/group insurance coverage, as well as PacificSource Medicare and Medicaid. If your insurance plan is not listed below, talk with us directly to see what we can do to serve your needs.
Insurance Plans Accepted
- Aetna Medicare
- Oregon Health Plan/Open Card
- PacificSource Health Plans
- PacificSource Community Solutions
- PacificSource Medicare
- Providence Health Plan
- Regence Blue Cross/Blue Shield
- Regence Blue Cross/Blue Shield Medicare
- Trillium Community Health Plan
- UnitedHealthcare Medicare
Please call to check if you have questions about your insurance.
Private Pay Sessions
Private pay sessions are discounted to $100. You can ask about our sliding scale if cost is a concern. Additional fees may be charged for additional services such as document requests, court appearances and advocacy work.
Rights and Protections Against Surprise Medical Bills
What is "balance billing" (sometimes called "surprise billing")?
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain service at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.
You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact: The Oregon Board of Licensed Professional Counselors and Therapists: (503) 378-5499 or firstname.lastname@example.org
Learn more about your rights under Federal Law
Learn more about your rights under the state of Oregon
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For emergencies call the Whitebird Crisis Line at (800) 422-7558 or 911 or visit your nearest hospital.
1997 Garden Ave
Eugene, OR 97403