Counseling and Psychological Services

Health Insurance Resources

Getting Started

Here’s what you need to know to get started:

  • SCSU Medical Clinic and Counseling and Psychological Services (CAPS) provides quality integrated care for the students of St. Cloud State University so they can have a cost-effective, easily accessible way to get medical and mental health care.
  • Studies show that good physical and mental health positively impact student success!
  • Our individual counseling and assessment services are billed directly to student health insurance providers. Group therapy and psychoeducational seminars are free. Initial Consultation appointments are also free.
  • Our counselors are licensed Mental Health Professionals. Members of the CAPS team including Office Support staff will assist students with navigating insurance and payment options.
  • We are encouraging students to verify coverage by calling the customer service number on the back of your insurance card. Every plan is different and the insurance customer service can answer questions about coverage/costs associated with co-payment or deductibles.
  • We will explore options for students who do not have health insurance including connecting you to a Navigator who will help you get signed up for health insurance.

We are continuously improving how we provide excellent services for our students. This includes utilizing an Electronic Health Record (EHR) system, which we share with the Medical Clinic. Both clinics use the client “portal” for communication, paperwork requests, and other important information related to your healthcare. The portal is located at myhealthservices.stcloudstate.edu. Using this portal requires a University email address.

All Huskies should monitor their St. Cloud State email account for messages on appointments, forms to complete, and other important information.

If you have any questions or would like to make an appointment, please call the counseling center at 320-308-3171. You can request an appointment through the website too. We look forward to helping you on your path to wellness!

Health Insurance 101

Project Care

Project Care

Mid-Minnesota Legal Aid
110 6th Avenue South, Suite 200
St. Cloud, MN 56301
Phone: 320-253.0121

Getting Health Insurance is Fast, Easy, and Affordable

Project Care’s team of Navigators will explain your options, help you find the best coverage for and your family, and assist you through every step of the enrollment process.

How Project Care Helps:

  • Provides free face to face application and enrollment assistance.
  • Help with all healthcare programs renewals.
  • Staffed by a team of certified Navigators.
  • Appointments available in multiple locations in Minnesota.

Affordable Coverage Options through MNsure:

  1. Medical Assistance (MA)
    Covers adults with little or no income, many children and pregnant women. Has no monthly premiums
  2. MinnesotaCare
    Covers people with slightly higher incomes who do not have access to affordable health insurance through work. Low monthly premiums based on income and family size.
  3. Advance Premium Tax Credits (APTC)
    Provides a subsidy to lower the cost of premiums for private insurance plans offered through the MNsure Marketplace. The amount of the tax credit is based on income and family size.

How to Determine if Services are Paid by Your Health Insurance

  • On the back of your health insurance card, there should be a telephone number for members to call, sometimes referred to as Member Services.
  • When you call that telephone number, they will ask for demographic information so that they can locate your policy information. They may ask your name, birth date, member number (on front of the card), etc.
  • When they have located your policy, inform them that you are a student at St. Cloud State University, you are seeking services at St. Cloud State University Counseling & Psychological Services, and you would like to know if the service is going to be covered. (see Questions to Consider below)
  • You might want to make a note of who you spoke with, what they tell you, and/or they may offer to give you a reference or call number.
  • If you need assistance with the information that you are given, one of our office staff members in Counseling & Psychological Services (320-308-3171) or the Medical Clinic (320-308-3193) can assist you.

Questions to Consider Asking When Calling Insurance Plan

  • Ask for a “Summary of Benefits and Coverage.” They may direct you to a web site or email you this information. This will tell you if and how much of the services will be paid by your insurance plan.
  • Is the Counseling & Psychological Services clinician that I am seeing at St. Cloud State a network provider or out-of-network provider? The name of the clinician may be needed in addition to the facility.
  • Is there any cost-sharing amount with outpatient mental health services?
  • Do outpatient mental health services require preauthorization?

Common Terms Used When Navigating Health Insurance

Insured: The individual (you) whose health is covered by the insurance plan or policy.

Insurer: The company responsible for paying claims (your insurance plan or policy).

Provider: The facility (clinic, hospital, etc.) or the licensed professional (doctor, psychologist, social worker, etc.) employed by the facility, who provides health care or mental health services.

Summary of Benefits and Coverage: A document that outlines what services are covered and not covered, and cost-sharing amounts.

Covered Service: A healthcare, mental health, or behavioral health visit that is paid, partially or fully, by a health insurance plan.

Non-Covered Service: A healthcare, mental health, or behavioral health visit that is not paid by a health insurance plan and will be 100% the responsibility of the insured (you).

Cost-Sharing Amount: The insured’s (your) share of costs for services that the insurance plan covers that must be paid out of the insured’s own pocket (sometimes called “out-of-pocket costs”). Some examples of cost sharing are copayments, deductibles, and coinsurance.

Copayment: A form of cost sharing in a health insurance plan that requires an insured person (you) to pay a fixed dollar amount (for example $25) when a medical service is received.

Deductible: A fixed dollar amount during the benefit period - usually a year - that an insured person (you) pays before the insurer (your health insurance plan) starts to make payments for covered medical services. Plans may have both per individual and family deductibles. Deductibles are usually set at rounded amounts (such as $500 or $1,000).

Coinsurance: A form of cost sharing in a health insurance plan that requires an insured person (you) to pay a stated percentage (for example 20%) of covered medical expenses after the deductible amount, if any, was paid.

Network: The facilities, providers and suppliers a health insurer or plan has contracted with to provide health care or mental health services.

Network Provider: A provider who has a contract with a health insurer or plan who has agreed to provide services to members of that plan. Since insurance plans have negotiated lower rates with network providers, the insured (you) will pay less if using a provider in the network. Also called preferred provider or participating provider.

Out-of-network Provider: A provider who doesn’t have a contract with a health insurer or plan to provide services. If an insurance plan covers out-of-network services, the insured (you) will usually pay more to see an out-of-network provider than a preferred provider. Some health insurers or plans will not cover any out-of-network services, or cost sharing amounts will be higher. May also be called non-preferred or non-participating.

Allowed Amount: This is the maximum payment the plan will pay for a covered health care service. May also be called eligible expense, payment allowance, or negotiated rate. When the insured uses a network provider, the negotiated rate or allowed amount is used for payment.

Preauthorization: A decision by a health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment (DME) is medically necessary. Sometimes called prior authorization, prior approval or precertification. A health insurer or plan may require preauthorization for certain services before insureds receive them, except in an emergency. Preauthorization isn’t a promise a health insurer or plan will cover the cost.

Referral: An official notice from a qualified provider to an insurer that recommends specialist treatment for an insured.

Maximum out-of-pocket expense: The maximum dollar amount the insured is required to pay out of pocket during a year. Until this maximum is met, the insurer (health plan) and the insured (you) shares in the cost of covered expenses. After the maximum is reached, the insured (health plan) pays all covered expenses, often up to a lifetime maximum.

Lifetime maximum: The maximum dollar amount the insured may receive under a health insurance policy or plan. Once a lifetime maximum is reached, the insurance plan will no longer pay for covered services.