Hello,

Starting this year, I am covered under 2 insurance plans, one under my employer and one under my wife's (as her dependent). My T is in network under my wife's plan and is not in network under my plan. My plan does not allow for out of network providers. I currently see my T 2x week. We have been discussing increasing that to 4x week (switching to more psychoanalysis). I am in the USA. I have a couple questions.

1. Where does continuity of care fall in terms of requiring an insurance to cover "out of network" level for someone when they are in the middle of a treatment program? Is there such a thing?

2. My wife's plan does allow for unlimited number of visits a year; however, when talking to someone in their behavioral health group, they said that standard of care is 1x wk. They said they do not review every case, just random audits and those cases flagged based on usage of service. I am worried that increasing my sessions would flag me for an audit and my T will have to provide details about my therapy in order to prove that it is "medically necessary". My T and I have not discussed formal diagnoses and I'm pretty certain I don't want to know her clinical thoughts about me. I am worried that they would only authorize 1x week sessions. Right now it is a struggle to go the 4 days without seeing her and often I use outside of session contact to stay connected to her.

3. If my T was to get in network under my plan or we got some other allowance, is it possible to send 2 visits to one insurance and 2 visits to the other rather than trying to get one to cover all 4 and the other pick up the difference? My T talked about primary and secondary insurances and such.
This confused me on if both insurances had to know what was being submitted to the other one or if legally we could split it like this. Again, this is to minimize either insurance from knowing how often I am seeing my T.

Thank you.