Paying For Therapy: Insurance

Trying to figure out how to pay for therapy services can sometimes be overwhelming and lead to prolonged care. Below are a few ways you can use your insurance benefits to help pay for services.

Medical insurance can be used to pay for therapy sessions but individuals have a hard time understanding how they can use their benefits and what is covered. All insurance plans are different, which means payment responsibilities differ. During open enrollment, it is important to pay attention to what is covered under each plan, not just the overall price you pay per month. Below are a few questions to consider when selecting a plan regarding therapy:

1. Are therapy sessions covered?

2. What is my payment responsibility per session?

3. Are in-person and virtual sessions covered?

4. Is family and/or couples therapy covered?

5. Is there a limited number of sessions I can have per calendar year?

6. Do I need prior authorization?

7. What is my deductible? (I will explain this below)

Asking these questions will give you clarification on your payment responsibility and lessen the chances of a surprise bill.

What is a Deductible? 

A deductible is the amount you are responsible for paying out of pocket before your insurance benefits kick in. For example, if you have a $1,000 Deductible, that means you must pay for $1,000 worth of medical services before insurance will cover all or some services. Please be aware there are waivers to the deductible, which means some services are covered even before your deductible is met. If you have a Deductible, is it important to ask if therapy services are covered before you meet your Deductible?

Out of Network Benefits 

If you find a therapist who does not take your insurance, you can still use your insurance benefits, if you have Out of Network Benefits. Out of Network Benefits allow you to be reimbursed up to the allowable amount for therapy sessions.  The allowable amount is what an insurance company is willing to cover via their reimbursement rates. Please be aware this may not cover the full cost of what your provider may charge. Please contact your insurance company to find out more details on this process

Finding out this information can sometimes be overwhelming but it is essential to help you get the mental health care you need. If you have more questions about using insurance to book an appointment with Contemporary Healing Spaces, CLICK HERE to book a FREE 15-minute consultation.