Insurance
Presently, Dr. Simon is in-network with Aetna, Anthem Blue Cross, Cigna, Harvard Pilgrim, Medicare, MultiPlan/PHCS, Oxford, Tricare, UltraBenefits, United Healthcare, Wellcare, and Connectucut Medicaid/Husky. For commercial health insurers and Medicare a co-pay may be required for each visit. If you have health insurance other than the ones listed above, then you must contact your insurance company to inquire whether they pay for out-of-network providers.
Medicaid ("state insurance") is not an accepted health insurance for Telehealth services through TELEBUP LLC. Telebup LLC accepts Aetna, Anthem Blue Cross, Cigna, United Healthcare and several other commercial health insurance companies. In addition, Telebup LLC accepts only "straight federal government Medicare," the insurance with the cardboard/paper red, white and blue insurance card. Telebup LLC is not in-network with any Medicare managed care plan. It accepts only CMS Medicare payments directly through the U.S. Federal Govt. If you have a Medicare Part D plan for your medication insurance, that is OK.
If you have commercial health insurance through a company that Telebup LLC is in-network with, then we will assist you in contacting your insurance company to see if they will pay for some or all of our fees. To allow us to do this, please complete the following form and fax it to
1-860-786-1192:
Insurance information form
If your insurance company does not agree to pay for services, then you will be required to pay the fee in full at the time of each visit. We will notify your insurance company electronically how much money you paid for our non-covered fees, which may be applied to your deductible on your insurance plan.
Because of laws requiring payment for mental health and addictive disorders, many insurance companies will reimburse some of the money paid by the patient for treatment. However, this would be between you and your insurance company, and no guarantee of reimbursement or payment by an insurance is implied here. It is advised that you ask your insurance company about this beforehand.
Generally, most (if not all) insurance plans will pay for the cost of prescribed buprenorphine (Suboxone/Zubsolv/Bunavail) obtained at a pharmacy minus any required co-pay. In addition, most insurance companies will pay for the costs of laboratory tests such as urine toxicology to check for compliance with prescribed therapy and to rule out illicit drug use. However, some payers may have a limit as to how many urine drug tests they pay for. Since drug testing is mandatory while being prescribed buprenorphine, patients are advised to check with their insurance companies about this. Again, no guarantee of payment by any insurance company is implied here.
Fee for Service Rates
Out-of-pocket fees for services charged to patients as of May 2020 are as follows if there are not other contracted rates with your insurance company:
Initial consultation & evaluation, which generally lasts about 60-75 minutes is $280. For prescription of medications for opioid use disorder ("MOUD") a second visit for 'buprenorphine induction' may be required, which costs $250. Subsequent visits for medication management and brief counseling, generally lasting 25-30 minutes, are $150 per visit. Discounts are available for full payment at the beginning of each month.
For new buprenorphine (Suboxone/Zubsolv) patients, weekly visits are required until stabilization at no greater than a certain dose of buprenorphine. Therefore, total fees for the first month will be $280 + $250 + $150 + $150 + $150 = $980. After stabilization at no greater than a certain dose of buprenorphine, weekly visits may no longer be required. Eventually, appointments are generally continued every three weeks for stable patients in recovery. If you are covered by a health insurance company that Dr. Simon or Telebup LLC is in-network with, then the company will likely pay the majority of these fees and you may be responsible only for a co-payment for each visit. All co-pays are due at time of service by credit card, PayPal or other mechanisms. Again, you are advised to check about this with your health insurance company. For patients not covered by the insurance companies listed above that Dr. Simon or Telebup LLC is in-network with, then full payment is required at each visit. Those non-covered persons may agree to pay at the beginning of each month for the month's services at a discounted fee. If you pay for the first month up front the fee is discounted from $980 to $830 for that month. If you pay for subsequent weekly visits at the beginning of each monthly cycle the fee is discounted from $600 to $510 for the month. Once you are stable in your recovery the frequency of sessions is decreased, which will be less expensive.
Forms of Payment Accepted.
Credit cards (Amex, Discover, Mastercard, Visa), PayPal, and Stripe are accepted before or at the time of service.
Cancellation Policy
Except for a documented, legitimate emergency, if you do not show up for your scheduled therapy appointment, and you have not notified us at least 24 hours in advance, you will be required to pay for the cost of the missed session. Patients are prescribed future doses of medication at each scheduled appointment
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