Out-of-Network Reimbursement Explained

Insurance terms can be confusing. Here’s a simple breakdown of how out-of-network benefits work for ABA therapy.

What does "Out-of-Network" mean?

It means the provider doesn't have a contract with your insurance company. However, many PPO plans have "out-of-network benefits" that pay for a large portion of the cost after you meet a deductible.

The Deductible

This is the amount you pay out-of-pocket before your insurance starts chipping in. Once this is met, your plan usually covers a percentage (e.g., 60%, 70%, or 80%) of the "allowed amount."

Coinsurance

This is your share of the cost after the deductible. If your plan covers 80%, your coinsurance is the remaining 20%.

How We Help

At Mint, we handle the complexity for you. We verify your benefits upfront so you know exactly what to expect. We also submit claims on your behalf so you don't have to deal with the paperwork.