Medicare and Medicaid (AHCCCS)

🩺 Insurance, Medicare & Medicaid at Wily Wellness

At Wily Wellness, we do not bill insurance directly. [Why not?] This includes:

• Medicare (Original Medicare & Medicare Advantage)

• Medicaid, also called AHCCCS in Arizona

• All private insurance plans

We are a private pay practice, which means you pay for services at the time of your appointment. In some cases, you may be able to get reimbursed by your private insurance company.

💡 If You Have Private Insurance

We’ll provide a Superbill (a special kind of receipt). You can send this to your insurance company to request reimbursement for your care.

To make this easier, we work with Reimbursify, a service that helps patients get reimbursed by their insurance.
👉 You can download their app or use the blue button on the bottom right of our Fees page to check your eligibility.

Note: You cannot submit Superbills to Medicare or Medicaid directly.

🧠 What If You Have Medicare?

There are two kinds of Medicare, and the rules are different for each.

1️⃣ Original Medicare (Part B)

This is the red, white, and blue government-issued card.

• If you have Original Medicare and want ketamine treatment, you may see any provider at Wily Wellness. Ketamine treatment is not a covered service, so you are allowed to pay cash.

• If you have Original Medicare and want general psychiatric care (like therapy or medication management), you may only see Heather Carlisle, who has formally opted out of Medicare. Medicare requires that you sign a private contract agreeing to pay out of pocket and not seek reimbursement.

2️⃣ Medicare Advantage (Part C)

• This is a Medicare plan managed by a private insurance company (like United, Aetna, or Humana).

• Wily Wellness is out of network for all Medicare Advantage plans.

• You may choose to pay out of pocket, but we cannot guarantee reimbursement.

• We recommend contacting your insurance company to ask about their out-of-network policies. You may be able to submit a Superbill to the private insurance company.

• Ketamine treatment is not a covered service, so you are allowed to pay out of pocket for that.

Do you need help figuring out your Medicare type?

If you're not sure whether you have Original Medicare (Part B) or a Medicare Advantage plan, here are some tips:

• Original Medicare has a red, white, and blue card issued by the government.

• Medicare Advantage is a private insurance plan (like Aetna, United, or Humana) and has its own insurance card.

You can also call 1-800-MEDICARE or check your MyMedicare.gov account for details.

🛡️ What If You Have Medicaid (AHCCCS in Arizona)?

• We cannot provide psychiatric care to AHCCCS patients—even if you wish to pay privately.

• However, you can receive ketamine treatment at Wily Wellness, because it is not a covered service under Medicaid.

💬 Questions?

We know insurance can be confusing. If you’re unsure what kind of plan you have or whether our services are a fit for you, please don’t hesitate to call—we’re happy to help you understand your options (to the best of our ability 🤔)