Paying for care
Insurance, HSA/FSA and paying for in-home recovery coaching
Paying for care is one of the first things families ask me about, and it should be. Coaching can be private pay, or covered by insurance through a single case agreement. Most families use a mix. Here is every way we help, and what we can’t promise.
Kathryn, founderFour ways families make it work
- 1
HSA or FSA
With a letter of medical necessity, part of coaching may be paid from your HSA or FSA. We give you itemized invoices to make it easy.
- 2
Insurance for the clinical team
Our licensed clinicians, or yours, can often bill insurance, in or out of network, so insurance carries its share.
- 3
A single case agreement
For some plans, we can ask your insurer to cover a set block of coaching hours for your family. It’s a request, not a promise.
- 4
A plan that steps down
Hours go down as recovery gets stronger, so cost goes down too. See example plans.
What kind of health plan do you have?
It changes what’s possible. Not sure? Look at your insurance card, or ask HR if your employer’s plan is “self-funded.”
Often self-funded
Your employer may be able to say yes.
Many large employers pay claims with their own money. That gives HR and the plan more room to approve an exception for in-home care. These are often the best odds.
What we’d do together
- Ask HR: “Is our plan self-funded?”
- We help you request a plan exception or SCA
- Your clinician sends a letter of medical necessity
- HSA/FSA covers what the plan doesn’t
Usually fully insured
We can ask your insurer for an SCA.
Your insurance company decides. Many exclude in-home support, but some approve a set block of hours when there’s no in-network option. We’ll ask with you.
What we’d do together
- We check your benefits with you
- We request a single case agreement
- Your clinician writes a letter
- Use HSA/FSA for the rest
Not covered today
Medicaid doesn’t pay for our coaching yet.
We’ll be honest so you don’t waste time. Let’s talk about a shorter, lighter plan, and other Colorado programs we trust.
What we’d do together
- Free call to talk about options
- A lighter plan
- Referrals to Medicaid-covered programs
That’s normal
We’ll figure it out together.
Send us a photo of the front and back of your card on the call, or just tell us the company name. We’ll walk you through it.
What we’d do together
- Book a free call
- Tell us your insurance company
- We explain your options in plain words
HSA and FSA
Using your HSA or FSA, step by step
The IRS lets HSA and FSA money pay for care that’s mainly to treat an illness, and eating disorders, other mental health disorders and substance use disorders count. Meal support, recovery coaching and coping support can qualify. Errands and driving usually don’t, so we list them separately.
Tick each step as you finish it. 0 of 4 done.
You’re ready to use your HSA or FSA.
We’ll send itemized invoices from your first week. Let’s talk about your plan.
Schedule a free consultSingle case agreements
How we ask your insurance to cover coaching
A single case agreement (SCA) is a one-time contract between your insurance plan and a provider, for one person. Plans use them when they don’t have the care you need in network. Here’s how it works with us.
1. We check your plan
Who your insurer is, and whether the plan is self-funded or fully insured.
2. Your clinician writes a letter
Your doctor or therapist explains why support at home is needed.
3. We send the request
With our licensed clinicians, we ask for a set number of coaching hours.
4. You know before you pay
We tell you what was approved and what’s left, in writing, before coaching starts.
The honest part
Many plans don’t cover in-home coaching, and an SCA can be denied. It’s still worth asking, and we’ll do the paperwork with you. If it’s denied, HSA/FSA and a step-down plan still help.
Questions about cost
Don’t see yours? Ask us directly.
Are you in network with my insurance?
We work with insurance through single case agreements: we ask your plan to cover a set block of coaching hours for your family. Our clinicians may also be able to bill your plan.
Is a single case agreement guaranteed?
No. Your plan decides. Many plans exclude in-home support. We’ll still help you ask, and tell you the answer in writing before you pay.
Can I use my HSA or FSA?
Often yes, for the treatment part of coaching, with a letter of medical necessity. Your administrator makes the final call.
What does the free call cover?
Your situation, whether we are a good fit, and every way to pay for it, including your insurance and HSA/FSA. No pressure.
This page is general information, not tax or insurance advice. Coverage depends on your plan. Check with your plan or HSA/FSA administrator.