Private and Group Insurance

Private insurance, group health companies, and managed care organizations each bring along their own set of challenges for funding. Our program over the years has established informal working relationships with several private and group insurance companies. We do not currently maintain any in-network contracts with these healthcare companies.

Home and community programs are not a covered benefit under most insurance policies. However, some policies will consider benefit substitution for home and community services when specific client and program status conditions are met. There are also situations whereby our office can explore setting up a letter of agreement for service authorization with the funding company on a case-by-case basis. Reimbursement will often be negotiated per in-network payment terms. Our goal is to maximize benefit coverage through obtained authorization and minimize out of pocket financial responsibility to the client and family.