Medicare - Original
Original Medicare (Paper card with red/white/blue strip at the top of card)
HCCC has opted-out of Medicare and does not have any counselors in network with Original Medicare. However, you can send Medicare a request for medical payment. By submitting Form 1490s and a receipt provided by HCCC, you may be eligible for out of network benefits from Medicare and receive significant reimbursement for your sessions.
HOW TO SUBMIT FORM 1490s
* Select a fully licensed counselor from HCCC ( Do not select an associate counselor: LPC-A, LMFT-A, or LCSW-A)
* Pay the self-pay rate of $185 (Includes the $25.00 self pay discount)
* Ask our team for your reciept
* Print the Form 1490s from the link below (Or request we email you the form)
* Fill out page 1, 2 and 3 of the form. (The additional pages are instructions and addresseses)
* When asked your reason for submitting this claim, select: "The provider or supplier is unable to file a claim for the Medicare Covered Services"
* Mail to the Texas address listed on the form
* You may be eligible for out of network benefits from Medicare and receive significant reimbursement for your sessions
Note: Medicare claims must be filed no later than 12 months (or 1 full calendar year) after the date when the services were provided unless an exception applies. If a claim isn't filed within this time, Medicare won't pay its share.
TIP: When filing out of network benefits, most clients mail receipts every few months... not every time they are seen.
⤓ Download Form 1490s (English)
