Do You Take My Insurance?

Do You Take My Insurance?
Hello! Thank you for selecting Milestones Counseling Center PLLC for your mental health services. Before we collect more detailed information, we’ll start by asking you to select your insurance company and plan. This quick step helps us make sure you’re starting on the right path, so you don’t spend time filling out all the intake paperwork only to find out we aren’t in-network. Once you select your plan, we’ll guide you through the rest of the intake.
Your Name*

First NameLast Name
Your Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Would You Like To Receive Our Newsletter?

Our newsletter contains information on MCC events, clinician interviews, mental health tips, therapy openings, etc. Would you like to be added?
YesNo
How did you hear about us?*

InsuranceEAPFacebookGooglePrevious/Current ClientZocdocPsychology TodayCommunity Event (Parade, Trick or Treat Trail, Country Christmas)Mental Health FairSaw the Sign in Front of the OfficeOther
From the options below, please select the type of insurance that you have.

Private Insurance (Through a job or the marketplace)Medicare (Including any supplement plans)Medicaid (Obtained through the State of Illinois)I Do Not Have Insurance and With to Self-Pay
Private Insurance
Select the company and plan type

Aetna PPOBlue Cross Blue Shield PPOBlue Cross Blue Shield HMOCignaUnited Healthcare/ OptumSomething Else/I'm Not Sure
Aetna PPO

We accept your insurance! Michelle, Emily, Patricia, Miguel, & Marcus can accept your insurance.
Blue Cross Blue Shield PPO

We accept your insurance! All of our therapists and Masters Level Clinicial Interns can accept your insurance.
Cigna

We accept your insurance! All of our therapists and Masters Level Clinicial Interns can accept your insurance.
United HealthCare/ Optum

We accept your insurance! Michelle, Emily, & Marcus can accept your insurance.
Medicare
Unfortunately, we do not accept Medicare at this time. This includes all Medicare supplement plans and Medicare Advantage plans. We apologize for any inconvenience and appreciate your understanding. You're always welcome to call our office, and we’ll gladly offer referrals to help you find the support you need.
Medicaid
Select your insurance plan

Aetna Better HealthBlue Cross Community HealthCounty CareMeridianMolinaYouthCare Health Choice IllinoisSomething Else
We’re currently in the process of becoming a contracted provider with your insurance company. While timelines can vary, this could take some time — or be finalized sooner than expected.If you’d like, we can add you to our waitlist, and you’ll be among the first to be contacted once we’re officially in-network with your plan.

I want to be added to the waitlist.I do NOT want to be added to the waitlist.
CountyCare Health Plan

At this time, we’re not in-network with your insurance plan. We understand this can be disappointing and are happy to offer referral options if needed. Please don’t hesitate to reach out with any questions.
We Accept Your Insurance!

You’re almost there! Please submit this form to continue. You’ll be taken to a second form where we’ll gather a bit more information. Once that’s complete, you’ll be able to schedule your intake appointment with one of our Master’s Level Clinical Interns. During that intake session, you and the intern will work together to determine the best clinician match for your ongoing care. For your initial appointment, please schedule with Dawn, Kyle, Courtney, or Imroz. Thank you! We look forward to working with you!
Let’s Take a Closer Look at Your Insurance

Before completing any paperwork, please take a moment to call our office at 708-880-7747 to confirm whether we accept your insurance. Some insurance plans have multiple names or companies associated with them. This quick call can save you time and ensure you're on the right path from the start. We’re happy to help!
Let's Get You on Our Waitlist
What is your relationship to the client?

SelfSpouse/PartnerParentLegal GuardianOther
Enter the Name of the Client

First NameLast Name
Client's Date of Birth

MonthDayYear
Date
Client's Age
Client's Phone Number (Guardian for a Minor)
Type of Session

IndividualCouplesFamilyOther
Telehealth, In-Office, or Hybrid

TelehealthIn-Office (Crete, IL)Hybrid (Some sessions in the office and others via telehealth)
Upload a picture of the front and back of your insurance card.

Cancelof
Do you have EAP benefits you would like to use?

YesNoI Don't Know
Very briefly, why are you interested in therapy now? What is going on?
Do you have a clinician preference?

MichelleEmilyPatriciaMarcusMiguelKyleDawnCourtney (Available in September)Imroz (Available in September)No preferenceOther
MCC has a training program for future therapists. These interns are in their final stages of their Master's program and have been chosen from a competitive field of applicants. They receive weekly supervision and training. Are you open to working with one of our interns?

YesNoMaybe
YOU ARE NOT DONE YET!!!!

Once you submit this form you will be taken to the appropriate intake forms. Once those are submitted you'll be directed to Simple Practice to schedule an appointment.
Provide Your Insurance Info

We’ll collect the rest of your insurance information, including a photo of your card.

Tell Us About You

You’ll share some basic details about yourself and what brings you to therapy. You'll also upload pictures of an ID for the client and their legal guardian, if under 18.

Sign Required Consent Forms

You’ll review and sign the documents needed to begin therapy services.

Schedule Your Appointment

Once everything is complete, you’ll choose a time for your first session.

If you need to take a break, you can stop at any time and your results will be saved for 30 days.
Click SUBMIT below and you will be directed to the NEXT STEP.
Thank You for Your Interest in MCC.

If you’ve joined our waitlist, please know we haven’t forgotten about you. We’ll be in touch as soon as we’re able to begin accepting your insurance and move forward with scheduling.
Thank You for Your Interest in MCC.

If we aren’t able to accept your insurance at this time, we understand how frustrating that can be. You're always welcome to call our office, and we’ll gladly offer referrals to help you find the support you need.
Don’t forget to click Submit so we know to follow up if needed.
We Accept Self-Pay Clients.

Please answer the question below to move onto the appropriate intake paperwork.
In order to direct you to the correct intake paperwork, please select the statement below that best describes your relationship to the client.

I am 18 and older and I am seeking services for myself.I am 12-17 years old and I am seeking services for myself.I am the parent/guardian of a youth aged 6-11 who is in need of services.I am the parent/guardian of a youth aged 12-17 who is in need of services.Other
For Youth Ages 12 & Up

Important Note About Intake Paperwork- Due to privacy and consent laws, both the youth and their parent or guardian are required to complete separate sets of intake paperwork. This ensures we have the proper permissions to provide care and that the youth’s voice is included in the process. Thank you for your cooperation!
Adults, Legal Guardians, and Youth Age 12-17 Are Required to Complete Their Own Paperwork

If you do not fit in these categories but feel that you should be completing the paperwork for someone else, please contact the office at 708-880-7747 before completing the paperwork.
Should be Empty:

Do You Take My Insurance?

Would You Like To Receive Our Newsletter?

Private Insurance

Aetna PPO

Blue Cross Blue Shield PPO

Cigna

United HealthCare/ Optum

Medicare

Medicaid

CountyCare Health Plan

We Accept Your Insurance!

Let’s Take a Closer Look at Your Insurance

Let's Get You on Our Waitlist

YOU ARE NOT DONE YET!!!!

Click SUBMIT below and you will be directed to the NEXT STEP.

Thank You for Your Interest in MCC.

Thank You for Your Interest in MCC.

Don’t forget to click Submit so we know to follow up if needed.

We Accept Self-Pay Clients.

For Youth Ages 12 & Up

Adults, Legal Guardians, and Youth Age 12-17 Are Required to Complete Their Own Paperwork