GEHA Insurance Coverage for Depression Therapy and Treatment in South Florida

How Do Professionals Diagnose Depression?

Diagnosing depression is a multi-step process and typically involves a discussion of your symptoms through an interview, a mental health evaluation, and the process of reviewing diagnostic criteria. While the process of receiving a depression diagnosis will vary from one treatment center or program to the next, it generally begins with an assessment. 

You will meet with a mental health professional to discuss your medical history, including any mental health disorders that may run in your family. They will ask questions about your mood, energy levels, quality of sleep, and appetite. They may use a standardized checklist to compare your symptoms with the criteria detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

Your mental health provider will complete a mental health assessment to gauge the severity and frequency of your symptoms. In some cases, symptoms similar to depression can present in physical ailments, such as a thyroid issue. A physical examination may be completed to rule out other possibilities. If your care team determines a diagnosis of a depressive disorder, you will be referred to a treatment program that will include a combination of talk therapy, skill-building, and medication management. 

Does Health Insurance Cover Depression Therapy?

Yes, health insurance companies typically offer some level of support for mental health treatment, including therapy for depression. The full extent of coverage will depend on the details of your insurance policy, including details related to factors like your copay, deductible, premiums, exclusions, and any required prior authorizations. 

You can read your insurance policy in full to understand the extent to which your insurance will support your mental health treatment, or you can contact us for help verifying your insurance details. 

Is Depression Testing Covered by Health Insurance?

In many cases, insurance will cover some portion of your testing, but it is not a guarantee. In order to be diagnosed with depression, one of the initial required steps is to undergo a mental health assessment/evaluation. A mental health professional will ask you a series of questions to get a sense of your symptoms and determine a diagnosis. 

Some mental health facilities will often include the initial assessment as part of the treatment. Some mental health centers, like Sylvia Brafman, even offer a complimentary mental health assessment with no obligation to undergo treatment. Reach out to us at 877-958-9212 to learn more.

GEHA’s Brands, Services, and Products Explained

While GEHA covers a wide range of mental health services, there are different levels of plans, and the extent of your coverage will depend on which one you have. Understanding the differences between these product lines and supported services ensures you receive the best care for your needs. 

• Standard Option (FEHB Plan): These GEHA mental health services include treatments in the form of therapy or counseling. They can also include medication management. This standard plan provides access to a network of mental health professionals, including Sylvia Brafman, and provides you access to a base level of quality care.
• High Option (FEHB Plan): This plan provides more comprehensive coverage for specialized mental health care, such as intensive outpatient or inpatient treatments. Sylvia Brafman’s services may be covered with this plan, ensuring that you receive the quality care you need for more severe issues.
• GEHA’s HSA (Health Savings Account) Option: With an HSA, GEHA members can take advantage of high-deductible health plans in conjunction with a tax-advantaged savings account. This flexibility can help manage mental health-related expenses, including those received at Sylvia Brafman.
• GEHA’s Preventive Care Coverage: GEHA’s preventive care services offer coverage for evaluations or screenings that can help to catch potential mental health issues earlier. For a proactive approach to your mental health care, Sylvia Brafman is happy to guide you through these preventive care screenings and assessments. 
• Telehealth Services: Telehealthcare options are available through GEHA, allowing you to access counseling and therapy from the comfort of your home. If you’re interested in Sylvia Brafman’s psychiatric services but cannot attend in person, this remote option may be the solution.

GEHA Coverage for Depression Therapy in South Florida

Does GEHA cover depression therapy in South Florida? The short answer is yes, but with the caveat that the details will vary based on your plan specifics. In general, mental health services, including depression treatment, will be covered on some level through GEHA, but you may have coverage limits, required copays, or need prior authorization to seek these services. 

If you are seeking traditional therapy in an outpatient setting, that will be covered by the standard plan, while the high-level plan typically covers inpatient care. If you are seeking mental health services for depression treatment at Sylvia Brafman and have questions about depression treatment costs or depression support pricing, reach out to us for help clarifying your plan’s details.

GEHA Coverage for Inpatient Depression Treatment

Inpatient or residential treatment for depression provides consistent, 24/7 comprehensive care. Inpatient treatment will require you to live at the mental health facility, where you will focus on your depression recovery full-time. Inpatient recovery will consist of individual and group therapy, skill-building, and medication management if deemed appropriate. 

GEHA plans, particularly the high-option FEHB plan, typically offer some level of coverage for inpatient/residential treatment for depression. This may depend on a number of factors, including your plan details, diagnosis, and medical necessity. Reach out to your insurance company or to us for help understanding the details of your GEHA plan.

GEHA Coverage for Depression PHP

A Partial Hospitalization Program (PHP) is a step down from residential care. You’ll spend the majority of the day in treatment for five to seven days each week, but you won’t reside at the facility. You’ll return home at the conclusion of each therapy session. This is an excellent option if you want comprehensive care but require some flexibility. 

GEHA plans typically cover some level of PHP treatment for depression, but the specifics of that support depend on your plan, including prior authorization requirements, premiums, exclusions, deductibles, and copays. It is prudent to research the specifics of your insurance plan to understand the full scope of your coverage. If you get stuck, we at Sylvia Brafman are here to help you unravel it all.

GEHA Coverage for Depression IOP

An Intensive Outpatient Program (IOP) provides structured treatment in a supportive environment. Like a PHP, it does not require you to reside at the treatment facility and allows you more flexibility. In an IOP, you will attend treatment four to six days each week for several hours daily, returning to your daily obligations after completing each session. 

The policies offered by GEHA typically cover IOP treatment on some level, but the details depend on your coverage and what your insurance company deems medically necessary. Reach out to us to get a better sense of what your treatment fees for depression will be with a GEHA plan. 

GEHA Coverage for Depression Outpatient Programs (OP)

When you think of therapy, you are likely thinking of an outpatient therapy program. Outpatient programs for depression require only a small time investment, meeting once or twice a week for approximately an hour at a time. It is an excellent option for those who are doing mental health upkeep or whose issues require less intensive care. 

GEHA covers outpatient therapy, and the chances of your claim being approved with little pushback are high. The details of how much of your claim is covered may vary, but rest assured, you will not be responsible for paying the full price of your outpatient depression therapy. If you have additional questions about rates for depression therapy in Florida through GEHA, Sylvia Brafman is standing by to take your call. 

Reasons for GEHA Policyholders to Pursue Depression Therapy in Florida

You may be asking yourself, “Why would I seek affordable mental health services out-of-state in Florida when I can find it here where I live?” That is a valid question, and we hear you. It seems more convenient to stay near home, so what are the advantages of traveling for depression treatment?

It is no secret that Florida offers beautiful weather – It is known as the “Sunshine State” after all. The sun’s vitamin D can be significantly beneficial when treating depression. Sunshine has proven effective in reducing feelings of sadness and hopelessness. In addition, Florida’s beaches offer the opportunity for your treatment to feel more like a vacation – an opportunity to take a break from the stressors of your day-to-day life while working to improve your emotional wellness. 

Is Out-of-State Depression Therapy Covered by GEHA Insurance?

Ultimately, it depends on the specifics of your plan. If you are considering traveling out-of-state to seek budget-friendly depression support at Sylvia Brafman, you may be wondering, “Does GEHA cover depression therapy out-of-state?” Some plans will cover out-of-state treatment as long as the provider is in-network. Others will not cover any treatment out of state, regardless of their network status. 

To understand the full breadth of your GEHA plan, you can contact GEHA directly or contact us. We are happy to collaborate with you to help make sense of the intricacies of your GEHA policy and ensure you receive the affordable counseling for depression that you deserve. 

Major Depressive Disorder (MDD) Therapy

Major Depressive Disorder (MDD), or clinical depression, is the most common form of depression. This diagnosis is characterized by persistent feelings of sadness, hopelessness, and lack of interest in hobbies. Symptoms include moodiness, low energy, appetite or sleep changes, and thoughts of death or suicide. MDD can significantly impact daily life and requires treatment through psychotherapy and medication management.

Persistent Depressive Disorder (Dysthymia) Therapy

Persistent Depressive Disorder (PDD), also known as dysthymia, is a chronic depressed mood lasting for at least two years. While not as severe as MDD, it can still have negative impacts on your emotional wellbeing. Symptoms include low energy, appetite changes, sleep disturbances, and feelings of hopelessness accompanied by low mood. Treatment commonly involves therapy combined with medication.

Postpartum Depression (PPD) Therapy

Postpartum Depression (PPD) is related to hormonal changes affecting new mothers after giving birth. Symptoms include sadness, fatigue, hopelessness, and difficulty bonding with your new baby. PPD can interfere with your life as you adapt to parenting a new baby. Treatment typically involves therapy and sometimes medication to help manage your mood in the postpartum period.

Premenstrual Dysphoric Disorder (PMDD) Therapy

Premenstrual Dysphoric Disorder (PMDD) is a more severe version of premenstrual syndrome (PMS). Hormones associated with the menstrual cycle cause symptoms such as mood swings, irritability, depression, anxiety, low energy, and sleep disturbances during a woman’s luteal phase, just before menstruation. PMDD can significantly impact your life, and treatment regimens typically include talk therapy supplemented with medication and lifestyle changes.

Seasonal Affective Disorder (SAD)

SAD occurs during specific times of the year, usually in the winter when there is less sunlight. Symptoms include low energy, sleep disturbances, and a depressed mood that typically improves as the seasons change. Light therapy and counseling are common treatments.

Atypical Depression

Atypical depression is a subtype of depression where individuals may experience mood reactivity, weight gain, excessive sleep, and heightened sensitivity to rejection. Symptoms are often improved with therapy and medications, particularly Monoamine Oxidase Inhibitors (MAOIs) or Selective Serotonin Reuptake Inhibitors (SSRIs).