General Information about Insurance

I am fortunate to be a provider for each of the plans listed below. Please contact your insurance carrier/managed care organization directly to confirm whether Dr. McGarry is a covered provider for your plan.

Covered Insurance Plans

• Aetna


• Amerigroup (Medicaid/Peachcare Provider)


• Blue Cross - Blue Shield of Georgia PPO, FEP


• Cenpatico/Peach State Health Plan (Medicaid/Peachcare Provider)


• Cigna PPO and HMO/ CIGNA Behavioral Health


• Choice Behavioral Health / Tricare / Champus


• Magellan Behavioral Health / GreenSpring / MBC


• Medicaid/Peachcare of Georgia


• Medicare


• PHCS Private Healthcare Systems PPO and MHSP


• Preferred Plan of Georgia


• Principal PPO and HMO / Southcare


• United Healthcare / United Behavioral Health (UBH) PPO and HMO


• ValueOptions


• WellCare Behavioral Health


• Wellpoint Behavioral Healthcare

Types of Insurance

The array of insurance plans is confusing and wide. Some plans "carve out" mental health benefits to be administered by a different company than the one that handles medical benefits. The major types of plans include:

Indemnity Insurance

This type of plan typically does not require pre-authorization and is limited only by a dollar amount maximum per year (which equates to a specified number of visits). After paying a deductible, you are able to use as many visits an necessary up to the annual maximum, paying a copayment each visit

Health Maintenance Organization (HMO)

This form has contract with providers who form a panel from whom you can select. In some instances, you need to get a referral from your primary care doctor before making an appointment. There is usually a maximum dollar amount / number of sessions, and the managed care company will evaluate the number authorized based upon medical necessity.

Preferred Provider Organization (PPO)

These plans allow more choice of who you can see. You may pay a slightly higher copayment or a greater deductible to see someone who is not on the list of providers contracted with the company. Point of Service (POS) plans are similar, as are Exclusive Provider Organizations (EPO). Pre-authorization of care is often not required and benefits are frequently not managed.

Self-Insurance

This plan involves a company setting up their own health insurance in-house to pay mental health and/or medical costs for their workers.

Medical Necessity

Managed care companies are asked by insurance companies to distinguish between, "medically necessary," and "growth-oriented" therapy. Insurance will pay only for those sessions determined to be medically necessary even if you have more sessions left in your benefits for that year.

"Self-pay" (versus insurance-reimbursed) sessions beyond those authorized as medically necessary can be arranged by speaking to me if you desire to continue for growth-oriented therapy after your authorized sessions are used.