How Insurance Works When Seeing a Therapist

Insurance does cover the cost of seeing a therapist but there are a few things you should know and ask about.

Does your therapist take your insurance?

Many therapists are only credentialed with certain insurance companies; some due to their choice and some due to the insurance not accepting more providers.

If you have out of network benefits, your insurance may still pay, so ask your insurance provider to see if you have that benefit.

Are there many providers that accept your insurance?

Our agency accepts BCBS CareFirst, Medicaid (state insurance), and Tricare. Check with your insurance plan to see how many mental health providers accept your insurance in the area.

When looking up mental health providers on Psychology Today, look at their site to see what insurance they accept or if they will accept a sliding fee.

When you renew your insurance, make sure your provider accepts the insurance you are getting and if you are paying out of pocket, consider changing your insurance to one that your provider accepts.

What is your deductible? 

When choosing insurance plans, you are often deciding whether to pay a higher monthly fee with a lower deductible or a lower monthly fee with a higher deductible.  This is important when seeing a therapist.  If you have a high deductible, you will have to meet that cost prior to having insurance pay for the sessions.  This deductible goes toward any medical care that you receive and a mental health provider is a medical expense.  The insurance company does lower the full fee cost of seeing there therapist if your therapist is credentialed through them, because they have an agreement for a set fee.  However, the fee can still be high per session until your deductible is met.

Many pay the fees initially at the beginning of the year for mental health providers and other healthcare providers but toward the middle or end of the year, have met the deductible and no longer have to worry about that fee.  Be aware that at the beginning of the year, you may see higher charges to see your mental health providers as the deductible is reset each year.

What are your co-pays?

Your co-pay should be listed on your card under specialty provider. If not, you can easily look that up on-line or call to ask your insurance company about your co-pay. Many have co-pays until the deductible is met and thereafter don’t but it’s very individual. Your provider may be able to look this up for you but you should really call on your own to make sure that you understand your insurance.

Do you have a Health Savings Account (HSA)?

If you have this plan at work, they take a certain amount of your pay every pay cycle and often give you a credit card to use. This money is taken before it’s taxed and you can use it for health care costs. You may use this card to pay for your deductibles and co-pays.

I hope this information is useful.  Please let us know if we can answer any questions.

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