Some individuals may put off seeking a therapist due to uncertainties about their insurance. If you relate, you're not alone. Struggling to afford coverage or confusion about insurance aren't uncommon. However, there are several options for insurance and low-cost therapy you can investigate.
In some instances, health insurance coverage options are available for therapy. Major health insurance providers like Blue Cross Blue Shield may cover all forms of therapy, including telehealth, as a part of their behavioral health services. In cases where treatment isn't covered by insurance, other affordable options are often available.
Understanding the options available to you, learning about insurance, and finding low-cost therapy can help you decide on the type of therapy that works for you.
Understanding the law behind health insurance coverage: The Mental Health Parity Act of 2008
According to the Mental Health Parity Act, health insurance coverage providers must provide mental health insurance benefits that are "equal to or better than medical coverage." Insurance companies must charge comparable co-pays for insured people who visit medical and mental health providers. In addition, the act states that co-pays should be equal to the company's standard co-pay and not more or less than the equivalent medical standard they cover.
This act made it more reachable for some people to receive insurance coverage for mental healthcare. However, insurance company documents can be confusing, and many plans don't cover telehealth therapy, which four in ten Americans have been using since 2021.
The law requires employers with over 50 employees to provide health insurance coverage, including mental health coverage, under the Federal Parity Act. Those who receive health insurance from their workplace may have different coverage options. Look at the benefits information your human resources department provided to you to reach out to the insurance company.
Does health insurance cover online therapy?
Online therapy insurance coverage is a mental health benefit that operates similarly to medical healthcare coverage. However, not all insurance plans offer full or affordable coverage. To understand your plan's policies, visit the provider's website or speak with an insurance representative by phone regarding your concerns about what you may be asked to pay.
Your health insurance provider can help you discover what online therapy services your insurance plan covers, your out-of-pocket expenses, and your co-pay per therapy visit. Some online therapy options may be covered by insurance, while others won't. Online therapy platforms might not be able to charge for insurance, but your insurance plan may be able to offer reimbursement, depending on their policies.
What does online therapy insurance cover?
The services covered by telehealth insurance plans may be outlined in the benefits section of your health insurance policy. In some cases, your online therapy benefits may be limited or outside of what your insurance can cover, as it may be classified differently on billing forms than traditional in-office therapy.
Online therapy insurance may cover similar durations and forms of therapy as in-person therapy sessions. However, the services your insurance provider covers may be first evaluated to deem that they're medically necessary. Therapists who accept insurance are asked to enter a medical code with a diagnosis during billing to get reimbursed for support. Your therapist can go through this process and your diagnosis with you.
It is up to the therapist's discretion and not the insurance company to decide whether they will accept insurance. Some therapists work with multiple insurance panels, whereas others may not work with any. Some providers don't accept insurance as payment due to complicated reimbursement processes and extended wait times for receiving payment for services.
How does insurance cover therapy?
When therapy is covered by insurance, the mental health portion of your coverage plan can operate similarly to a medical insurance policy. If you choose an out-of-network therapy provider, you may be required to pay more for the service. If you choose an in-network therapist, you might have a co-pay or be fully covered, depending on your plan.
Once you've selected your provider, contacted their office, and requested an appointment, the therapist may have you send in your insurance policy information to pre-authorize payment for services and to determine if your policy covers the services they offer. Insurance processing is often done before your first appointment. If the office doesn't request pre-authorization of insurance benefits to confirm what services your plan will cover, you can ask for it or contact your mental health insurance provider before your appointment to avoid having to pay out-of-pocket.
Some health insurance providers indirectly cover online therapy. While they may not cover therapy services and allow you to make a co-payment, they may allow full or partial reimbursement of your online sessions. The insurance provider policies determine the amount of reimbursement provided for services online. After paying for a session with your therapist, you can ask them for a "superbill" and send it to your insurance company for reimbursement. Other documents might be requested.
What are my options if I have no health insurance coverage for mental health services?
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How to find mental health support with no insurance coverage
Therapy costs, not knowing what insurance will cover, and a lack of insurance are among several reasons people who want to see a therapist struggle to find support. People living with a mental health challenge and a low income may believe that no affordable therapy options are available. However, affordable, low-cost, and free therapy options might be possible through a few avenues, including but not limited to the following.
Public health clinics
Clients may be able to find free or sliding-scale therapy services at local public health clinics. These clinics offer low-cost services to those with a low income, disability, or inability to pay. If you live in a large city, you may have several public health clinics to choose from.
Community organizations
Some individuals might find free or low-cost therapy at local community organizations like spiritual centers or places of worship, non-profit organizations, or adult education centers. These organizations may sometimes pair with therapist volunteers to provide temporary or short-term crisis services or case management to those who cannot afford therapy.
Your employer
Some individuals receive therapy coverage through their job. Ask your employer whether they have health coverage and whether it includes mental health. Check your policy documents or contact a specialist for support if you have an employee benefit plan.
Your university
Students at specific universities might have health services included in their tuition or offered at a low cost. If there is a campus mental health or medical clinic, visit them to ask them how you might be able to use the school's health services for therapy.
Online platforms
If you're considering free or low-cost therapy options online, use a search engine to search for options in your area. You may be able to find free peer-led advice sites. However, note that these websites do not replace the advice of a licensed therapist.
While the national average for attending traditional in-office therapy can range from $100 to $200 a session, some online platforms offer more affordable services without insurance coverage. For example, platforms like MyTherapist offer sessions with psychologists, licensed clinical social workers, and professional counselors ranging from $65 to $90 a week, billed monthly.
How to address insurance-related setbacks
Before you choose a plan, consulting your insurer and knowing what they do and don't cover can be vital. Consult your insurer's website to ask them about the specific therapist or type of therapy you'd like to try. On the site, you may also discover what therapeutic modalities they cover, co-pay costs, and which therapists accept your plan in your state.
Insurance claims can sometimes come up with errors, rejections, high out-of-pocket costs, or other challenges. When dealing with an insurance company, your permanent medical record may record the health treatment you've received in the past. Companies that undergo audits to prevent fraud may go through specific personal details. They might flag your claims or ask you or your therapist to submit further information in these cases.
In addition, an insurance company may decline your therapist's claim for payment due to not deeming it a "medical necessity." If a therapist leaves out a diagnostic code, treats a couple or family, or offers specialty services like equine therapy, your insurance provider may deny the coverage. Some session lengths, therapeutic modalities, or formats might be considered non-medically necessary to an insurance company.
If you face these challenges or find that the services you need aren't covered, you might consider speaking to a provider online or through another avenue. Low-cost or sliding-scale providers in your area may also be available to discuss your options.
If you're interested in trying online therapy through online platforms like BetterHelp or MyTherapist, you may be unsure where to start. To get started, you can complete a questionnaire about your preferences for a provider. Once matched in as little as 48 hours, you can choose between phone, video, or chat sessions weekly and participate in messaging with your therapist. These flexible options may give you a sense of control over your online counseling process.
Research shows that online treatment is effective, too. One review of 17 studies found that online treatment could be more effective than traditional in-person counseling for those living with depression, for instance. Another study confirmed that online therapy was often more cost-effective for clients than face-to-face options in their area.
Takeaway
Understanding the ins and outs of insurance may help you make an informed decision about the care you can receive. If you have mental health insurance, contact your health insurance provider to verify what services they can reimburse. If you do not have health insurance, you can start by trying a local health clinic, non-profit, or sliding-scale therapist. You may also opt for online therapy if it is more cost-effective for you. Know that you're not alone, and financial insecurity may not completely bar the possibility of receiving support.
Frequently Asked Questions (FAQs)
Below are several frequently asked questions about the cost of therapy with insurance and online.
How much does it cost to see a therapist for mental health treatment with insurance?
Co-pays for therapy may cost between $20 to $50 or more, depending on your insurance policy. However, without insurance, the costs range from $100 to $200, increasing if the session is specialized or a form of marriage or couples therapy. Each therapist may charge a different rate within your area, so talk to providers you're interested in to learn more about their insurance coverage and out-of-pocket costs.
Mental health professionals often charge clients hourly or per session. Certain factors can affect insurance costs or whether the session is covered. These factors include your location, health insurance provider, and the number of sessions you book. If you don't have insurance, some therapists offer a sliding-scale therapy option. Sliding-scale rates can vary widely, depending on a therapist's practice policies and your needs.
Note that specialty therapies like animal-assisted therapy, art therapy, massage therapy, couples therapy, group therapy, anger management classes, and other forms of counseling may cost more than traditional therapy due to their unique nature, the supplies required, or the demand. In addition, insurance companies may not cover these services.
Is paying for therapy worth it?
Therapy is highly effective for a range of mental health conditions and symptoms. In addition, you don't need a mental illness to see a therapist. Science shows a significant body-mind connection, showcasing how caring for your mental health can improve your physical health and vice versa.
Some people have preconceived myths or misconceptions in their minds about therapy. However, therapy is unique. There are over 400 therapeutic modalities clients can take part in, and each therapist takes a unique and specialized approach, depending on their education, passions, and expertise. Consulting with multiple therapists before settling on a specialist can help you find someone who fits.
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