Is therapy always covered by your health insurance? The answer isn't that simple
Are you thinking about going to see a therapist? Good for you — finding someone to talk about your stress, anxiety, or depression is a huge act of self care. Therapy is sort of like working out. It’s good for you, and everyone should find a way to do it that works for them.
But if the form of therapy that works for you is one-on-one, in-person counseling with a licensed therapist, things can get expensive.
Which is why it’s even more frustrating that therapy isn’t always covered by insurance.
There are a few reasons for this, and before you start complaining about politics and health care bills, know that therapy was often not always covered by insurance, no matter who was in office. The Affordable Care Act, known as Obamacare, only expanded protections for people who needed mental health services.
The new health care bill that is up for debate right now under President Trump’s administration would take away some protections for patients, meaning that insurance companies wouldn’t have to cover your mental health needs if it didn’t want to.
Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, insurers weren’t allowed to deny coverage to patients who needed mental health care. So if you had health insurance, there was likely some coverage for you when it came to seeing a therapist in your network or prescriptions for mental health issues.
But here’s the annoying thing about finding a therapist, even if you have an insurance plan that covers counseling:
Around 30 percent of therapists don’t take insurance anyway.
It’s hard enough to figure out in your insurance policy exactly what kind of mental health care is covered and how. And if you plan on using insurance to pay for therapy, then you usually have to track a therapist down that’s in your network, is accepting new patients, and has availability on a schedule that works for you.
To then find out that you might have to pay anywhere from $75-250 an hour to get therapy is a huge blow. It’s also why many people choose to not go to therapy in the first place. It can be an expensive hassle, added to any stress and anxiety you might already have.
But don’t fret! Therapists aren’t greedy (or most of them aren’t, at least).
Here’s how insurance works at the most basic level.
When you use your insurance at a doctor or therapist, the insurance company reimburses them for the costs of your service. Many therapists claim that the reimbursements from most insurance companies are high enough to recoup their costs—usually about 10-20 percent.
That’s very similar to what your primary care doctor gets, but a primary care doctor can see so many more patients a day to make it worth it. A psychologist or therapist spends more time with a single patient, so sometimes the numbers just don’t add up.
If you have insurance that covers therapy, most therapists will ask you to pay their fee out of pocket each week. Then you can ask for a receipt and file a claim with your insurance company to get reimbursed directly from them. It’s a hassle, sure, but eventually you can get your money back.
Otherwise, you just have to pay out of pocket. Fortunately, most therapists understand the financial burden on their patients. There are a few ways to make it work for you.
Ask for a sliding scale.
Most therapists will offer patients a sliding scale fee. Don’t be afraid to ask, no matter what your income is! If you tell your therapist that you’d like to work with them, you might be able to get your rate down per hour. You can find therapists who do this through this Psychology Today locator, or just ask outright. It’s worth a shot.
Find low cost or free options.
Find alternative options.
Need therapy? Well, there’s an app for that, too, now. It might not be the same as talking to someone face to face every week, but there are subscriptions available that are less than a hundred bucks a week. It’s worth a shot if you want to get started on a better you.
If you’re feeling really low and need someone right this very minute to talk to, you can always call the Suicide Prevention Hotline at 1-800-273-8255. Good luck and take care!