This article explains how Tava verifies a member's insurance, which services are covered by insurance, and how member payments are handled after a session. It also describes what happens when a member has a high deductible health plan (HDHP), including when and how the member may be charged.
Eligibility Check
During sign‑up, care navigators or members may add their insurance information. Tava runs a near real‑time eligibility check with the plan to confirm that the member is active, and to retrieve key coverage details. If verification is delayed or temporarily unavailable, members can continue through the intake process and they will be notified by email once verification is complete.
Plan Acceptance
For a complete list of insurance plans accepted at Tava, see this article. When insurance is added, our provider matching algorithm automatically shows in‑network therapists who accept that plan. If a care navigator would like to see out of network provider options, they can remove this filter.
What insurance covers at Tava
Health insurance at Tava covers individual therapy sessions with licensed providers. Insurance often does not cover couples or family therapy sessions through Tava. Many providers offer couples and family therapy as cash‑pay services, and members can choose those options if they wish to pay out of pocket or if their sponsored benefit specifically includes it.
After insurance processes a claim
After each session, Tava submits a claim to the insurance plan for the contracted (allowed) amount. The plan adjudicates the claim and determines whether the member owes a copay, coinsurance, or deductible amount. When the plan’s determination is returned, Tava charges the card on file for the member’s responsibility and emails a receipt. Processing times vary by plan.
If a member has a High Deductible Health Plan (HDHP)
Members with an HDHP typically pay the full contracted (allowed) amount for covered services until their annual deductible is met. Here is what they can expect:
- Before the deductible is met: The insurance plan will apply the session charge to the deductible. The member will be responsible for up to the plan’s allowed amount for that visit. Tava charges the member’s card on file once the plan confirms the applied amount.
- After the deductible is met: The plan will apply the member’s copay or coinsurance according to the policy. Tava charges only that member share.
- After the out‑of‑pocket maximum is met: The plan typically covers eligible services at 100%, and the member should not owe additional amounts for covered individual therapy sessions. Members can usually use HSA/FSA funds for eligible session charges, subject to their account rules. HSA/FSA cards cannot be used for late cancellation or no‑show fees.