How To Pay For Therapy
- Starting Therapy
- in-network providers, insurance payments for therapy, out-of-network providers, paying for therapy, private pay, using OON benefits for therapy
Psychotherapy is a field seeking to help individuals, couples, and families improve function in their daily lives. Looking into paying for this service can be a hassle, however exploring various options may save you money in the long run, find you suitable help to meet your unique needs, and invest in your growth. Because people have diverse financial abilities and diverse privacy needs there are several ways to access therapy. Options available include free counseling, paying using your insurance benefits (along with paying any applicable co-insurance or co-payment), or fully paying your therapist directly.
Some ways to find free professional counseling include seeing a pre-licensed intern or counseling graduate student, using an employee assistance program (EAP) at your job, finding a therapist or counseling organization who does pro bono work, or meeting a therapist under a sponsorship or scholarship program. If you need free counseling and are unsure where to start you can call your local mental health hotline to provide you a referral. Also, many licensed professionals may be able to guide you.
There are three ways to pay for therapy:
1. Private payments- direct payment via cash, card, or other accepted forms of payment. Paying for therapy services directly is the most secure and private option, however, it is usually the most expensive way to pay for care. There are some therapists who offer lower rates or an income-based sliding fee scale to those who qualify.
- One benefit of direct payments is there are no steps involved. You discuss fees with your therapist and pay according to your agreement.
- Another benefit of choosing direct pay is optimal confidentiality. There is no information shared with any third party beyond the clinical staff working your paperwork and any bank involved with the form of payment you use. The only exceptions to this are confidentiality exceptions which are applicable for anyone seeing a therapist (mandatory reporting for suspicion of abuse of a protected group, risk of physical harm to yourself or another, court order, or your signed waiver of confidentiality to another party).
- A third benefit of paying directly is more therapists are available to you. This expands your therapist search beyond waitlists with booked full therapists. Also, this enables you to work with specialists in your area of difficulty.
- A fourth benefit is receiving quality counseling care even while uninsured. If you do not have insurance or prefer not to use it, you can still find quality therapeutic care that helps you meet your needs efficiently. Many times private pay therapists can provide exceptional quality care because they don’t spend any time dealing with insurance companies. This provides them more time to focus on treatment and research. Private pay therapists also tend to specialize in certain mental health areas so your specified counseling needs would be met more acutely.
- Lastly, a great benefit is being free from managed care. Insurance companies have many requirements which typically include declaring a diagnosis, short-term treatment approaches that may limit approval for continued care, telehealth limitations or lack of coverage, insurance companies keeping a file of your clinical record, their ability to share your information with the national medical information databank, and changes to provider policies over time.
2. “In-network” benefits- payments are made to your therapist by your insurance provider. Paying for therapy services with your insurance is typically the most affordable way to cover the costs of your care, however, it is also the most involved. To use your insurance use the following steps:
- Contact your insurance provider to verify you have active mental health or behavioral health benefits.
- Ask your insurance provider how much of your healthcare costs they will cover, this avoids any surprises. Most often insurance companies do not cover your full therapy fee. It is important to understand your costs for co-insurance (the percentage of fees you are responsible to pay) or co-payment (the flat dollar amount you are responsible to pay).
- Ask your insurance provider if you have a deductible to meet before they will cover any healthcare costs. A deductible is an amount you need to spend before you can use your insurance benefits.
- Select a therapist who is “in-network” with your insurance company. You can do this by reviewing lists of in-network therapists with your insurance provider, or asking a therapist if they accept your insurance and are accepting new clients.
3. “Out-of-network” (OON) benefits- directly paying your therapist their full fee and being reimbursed by your insurance provider. This option gives you the best of both worlds (privacy of direct payments with unique care and the affordability of insurance payments), but it also involves your insurance company. Minimal information is shared with your insurance company (a receipt of your services) therefore your payments are often higher than they’d be if you chose in-network therapy care. How OON works is you pay your therapist full fee directly and request reimbursement from your insurance provider. Your insurance provider then reimburses you, per your benefits. Use the following steps to use your insurance with an OON therapist (this will be similar to steps for in-network insurance use):
- Contact your insurance provider to verify you have active out-of-network (OON) mental health or behavioral health benefits.
- Ask your insurance provider how much they reimburse for OON benefits and how they would like you to send such a claim. Most often your reimbursement will be a percentage of your therapist’s fee. Sometimes you may have a “deductible” which is a flat dollar amount you must spend in therapy costs before you are eligible for OON reimbursement.
- Fully pay your therapist directly and request your therapist provide you a detailed receipt (this is an invoice called a “superbill”).
- Send the superbill with your claim to your insurance company to be reimbursed for your therapy costs according to your benefits.
- Receive your reimbursement of costs. Usually, this comes in the form of a check from your insurance company.
by Brittany Black, M.S., LMFT
photo cred~ Fabian Black (@blankerwahnsinn)