Quick answer
Yes, Priority Health covers outpatient therapy as a behavioral health benefit on most plans. What you pay depends on your specific plan’s copay, coinsurance, and deductible rather than on the carrier itself. Peace Of Mind Therapy accepts Priority Health at our Berkley and Oak Park offices and for virtual sessions across Michigan. To confirm your benefits, call Priority Health’s Behavioral Health Department at 800.673.8043.
If you have Priority Health and you have been searching for a therapist in Metro Detroit, you have probably run into a frustrating pattern. Plenty of practices in Oakland County list Blue Cross. Fewer say anything about Priority Health, which leaves you guessing whether your card will be accepted before you have even described what you are dealing with.
We accept Priority Health. This post covers what that actually means for your wallet, how to verify your benefits in about five minutes, and what to do if the answers you get are confusing.
Key takeaways
- Priority Health includes outpatient behavioral health on most plans, covering therapy with licensed counselors, social workers, and psychologists.
- Your plan type determines your cost, not the Priority Health logo. Commercial, individual, Medicare, and Medicaid plans all behave differently.
- Priority Health has a dedicated Behavioral Health Department at 800.673.8043, which is faster than general customer service for therapy questions.
- Telehealth coverage can differ from in office coverage, so ask about it specifically.
- Peace Of Mind Therapy accepts Priority Health at both offices and for virtual sessions statewide.
Does Priority Health cover therapy?
On most plans, yes. Priority Health treats outpatient mental health counseling as a behavioral health benefit, and its network includes psychologists, licensed professional counselors, licensed master social workers, psychiatrists, and other clinician types. You can read the carrier’s own overview on the Priority Health behavioral health page.
What coverage does not mean is free. Covered means Priority Health pays a share of the negotiated rate and you pay the rest through a copay, coinsurance, or your deductible. Which of those applies is a function of your plan, and that distinction is where most of the confusion around insurance and therapy comes from.
Why your plan matters more than your carrier
“Do you take Priority Health?” feels like a yes or no question. The more useful question is “what does my Priority Health plan pay for outpatient therapy?”
Priority Health administers commercial employer plans, individual MyPriority plans, Medicare plans, and Medicaid. Two people can both hand us a Priority Health card and owe very different amounts, because a high deductible employer plan and a plan with a flat therapy copay are not the same product.
Your cost will land in one of three structures:
Copay
A flat amount per session. Predictable, easy to budget, and the same every week regardless of the underlying session rate.
Coinsurance
A percentage of the negotiated rate. If your plan sets coinsurance at 20 percent, you pay 20 percent and Priority Health covers the remainder.
Deductible
If your deductible has not been met, you may owe the full negotiated rate until it is. This is why clients are sometimes shocked in January. Deductibles reset with the calendar year, so the same session that cost $30 in December can cost substantially more in February. Nothing changed except the year.
How to verify your Priority Health therapy benefits
This takes about five minutes and saves a great deal of aggravation later. You have two good routes.
Call the Behavioral Health Department directly
Priority Health staffs a Behavioral Health Department at 800.673.8043 (TTY 711). Use this instead of the general customer service line. The staff there work in mental health benefits specifically, so you will not spend the call being transferred.
Ask these questions and write down the answers:
- Is outpatient mental health counseling covered under my plan?
- Do I have a copay for therapy sessions, and how much is it?
- Do I have coinsurance, and what percentage do I pay?
- Do I have a deductible, and has it been met this year?
- Is prior authorization required before I begin outpatient therapy?
- Do I need a referral from my primary care doctor?
- Are telehealth sessions covered the same as in office visits?
- Is there a limit on the number of sessions per year?
Ask for a reference number for the call. If a billing question comes up months later, having that number turns a dispute into a lookup.
Use the Find a Doctor tool
Priority Health’s Find a Behavioral Health Provider tool lets you search in network clinicians by location and coverage type. You can use it without logging in, though you will need to enter your location and plan type. For behavioral health searches the carrier recommends starting with the Advanced Search option and filtering by specialty, since the general search does not separate clinician types well.
One practical caution about directories generally: they go stale. Provider network lists across the industry are notoriously out of date, so a phone call to the practice is always worth making even when the directory looks definitive. Call us at (248) 397-4705 and we will tell you directly.
Prior authorization and referrals
Requirements vary by plan, which is why “is prior authorization required” is on the question list above rather than answered here. Some plans require authorization for certain levels of care, some require a referral from your primary care doctor, and many require neither for routine outpatient therapy.
The reason to ask before your first session rather than after is simple: if authorization was required and nobody obtained it, the claim can be denied and the cost can land on you. Five minutes on the phone prevents that entirely. Priority Health outlines its coverage categories on the mental health services page, though your plan documents are the authority for your situation.
Telehealth coverage is worth asking about separately
Most plans now cover telehealth mental health visits, and coverage has broadly expanded in recent years. Broadly is not the same as universally. Some plans still treat virtual and in office visits differently, whether in the copay amount or in restrictions on which visits qualify.
We offer virtual therapy to clients anywhere in Michigan, and many of our clients move between formats depending on the week. If you expect to use telehealth even occasionally, make it a specific question during your benefits call rather than assuming it works identically. If you are weighing the two formats, our comparison of online therapy versus in person therapy covers the practical tradeoffs.
What if you get a confusing answer?
Insurance language is genuinely difficult, and getting a muddled answer on the phone is common rather than a sign you asked wrong.
If the representative cannot tell you whether outpatient therapy is covered, ask them to look up the specific benefit for outpatient behavioral health office visits. If you are told a number that contradicts what you expected, ask whether your deductible applies and whether it has been met. If you still cannot get clarity, call us. We help clients verify coverage regularly and we know which questions tend to unlock a straight answer.
One thing we will always be honest about: you are ultimately responsible for understanding your benefits, copays, deductibles, and coverage limits. We assist where we can, and your insurer is the authoritative source. Any practice that promises you a guaranteed cost without checking your plan is telling you something they cannot actually know.
Using Priority Health at Peace Of Mind Therapy
We accept Priority Health for therapy and counseling services at both of our Oakland County offices and for virtual sessions across Michigan.
POM Berkley
2301 12 Mile Rd, Berkley, MI 48072
On 12 Mile between Woodward Ave and Coolidge Highway, with a private lot, street parking, and a separate entrance and exit for privacy.
POM Oak Park
8750 W Nine Mile Rd, Oak Park, MI 48237
On 9 Mile Rd, minutes from downtown Ferndale, with a private parking lot.
Both offices accept the same plans, so choose whichever is the easier drive. We work with adults on anxiety, depression, trauma, grief, stress and burnout, relationship concerns, and life transitions, and we offer individual, couples, and family therapy. You can see the full list on our Therapy Services page, and every community we cover on our Communities Served page.
What if you do not have Priority Health?
We also accept Blue Cross Blue Shield and Blue Care Network, and we have a separate guide to using BCBS or BCN for therapy that follows the same structure as this one.
If your carrier is not on our list, private pay is available by cash, check, electronic payment, or card, with payment due at the time of service. Some clients with coverage choose private pay deliberately, to keep a diagnosis code out of their insurance record or to keep session frequency between themselves and their therapist rather than subject to a medical necessity review. We break down what that costs and when it makes sense in our guide to therapy costs in Metro Detroit.
Frequently asked questions
Does Priority Health cover therapy?
Yes, on most plans. Priority Health includes outpatient mental health counseling as a behavioral health benefit, with a network covering licensed counselors, social workers, psychologists, and psychiatrists. Your specific cost depends on your plan’s copay, coinsurance, and deductible.
Does Peace Of Mind Therapy accept Priority Health?
Yes. We accept Priority Health at our Berkley and Oak Park offices and for virtual sessions anywhere in Michigan.
How do I find a therapist who takes Priority Health in Oakland County?
Use the Priority Health Find a Doctor tool with an advanced search filtered by behavioral health specialty, or call the Behavioral Health Department at 800.673.8043. Directories can be out of date, so calling the practice directly is worth doing either way.
How much will I pay for therapy with Priority Health?
It depends on your plan. You may owe a flat copay, a coinsurance percentage, or the full negotiated rate until your deductible is met. Call 800.673.8043 and ask about your outpatient behavioral health benefit for an exact figure.
Does Priority Health cover online therapy?
Most plans cover telehealth mental health visits, but the terms can differ from in office visits. Ask specifically whether telehealth therapy is covered and at what rate.
Do I need a referral to start therapy with Priority Health?
Requirements vary by plan. Some plans require a referral or prior authorization, many do not for routine outpatient therapy. Confirm before your first session so a claim is not denied afterward.
Do you see children or teens?
Peace Of Mind Therapy works with adults. We do not currently provide therapy for children or adolescents, and we are glad to point families toward providers who specialize in that care.
Ready to start?
Call (248) 397-4705 or request an appointment online. Let us know you have Priority Health and whether you prefer in office or virtual sessions, and we will take it from there. You can also review our Insurances Accepted page or our FAQ for rates, session lengths, and what to expect at a first appointment.
If you are in immediate danger or need urgent support, call 911 or contact the 988 Suicide & Crisis Lifeline right away. Priority Health also offers 24/7 crisis support to members at 800.673.8043. This article is general information and not insurance or clinical advice for your specific plan or situation.