How to use your health insurance to cover therapy costs
If you have health insurance, there is a good chance that your policy will cover at least part of the cost of therapy sessions. The first step is to check your insurance policy to see if mental health services are covered. If they are, you should find out what your co-pay or deductible is for each session. Once you have this information, you can search for a therapist who is in your insurance network. You can usually find a list of in-network providers on your insurance company’s website or by calling the customer service number on your insurance card. When you make your first appointment with a therapist, be sure to let them know that you have insurance and ask if they accept your plan. At the end of each session, you will need to pay your co-pay or the full cost of the session if you have not yet met your deductible. Your therapist will then bill your insurance company for the remainder of the cost.
What if I want to work with an out of network provider?
Many therapists are not in network with insurance companies for various reasons. Because of this, the therapist you want to work with might not be covered in network by your insurance plan. So does that mean you can’t use your benefits for therapy?
Not exactly.
Many plans cover out of network services to some degree. This means that they will reimburse their customers a certain percentage of the amount the customer paid for their therapy services (or any other out of network health service). If your insurance company covers out of network services, then you can see whoever you want to see as your therapist and submit your receipts later for reimbursement.
Getting reimbursed for out of network therapy sessions by your insurance company requires a few steps:
First, make sure that your insurance plan covers out of network providers.
Then, ask your therapist for a superbill, which is a document that includes all the necessary details about your therapy session, such as the date of service and the type of service provided.
Next, submit the superbill to your insurance company with a claim form. You may need to fill out some personal information, such as your name and policy number. It's important to keep records of all these documents, as well as any communication with your insurance company, to ensure you can track your progress and follow up if necessary.
Finally, be patient, as processing times for out of network claims may take longer. While getting reimbursed for out of network therapy sessions can be a bit of a process, it's worth it if it means you can receive the care you need to improve your mental health.
What can I do if my insurance company doesn’t offer out of network reimbursement
Sometimes insurance plans don’t cover any out of network services at all. When this happens you can either appeal to them to cover your therapy sessions out of network or you can ask your preferred therapist if they have any sliding scale spots to make therapy more affordable to you.
Filing an appeal
If you find yourself in a situation where you need to see an out-of-network therapist but your insurance company won't cover the visit, there is still hope. The first step is to gather all the necessary information, including copies of your insurance policy, receipts from previous therapy sessions, and any correspondence between you and your insurance company. Once you have all the information, you should write a letter of appeal explaining why you need to see an out-of-network therapist and why you believe your insurance should cover the cost. Be sure to include any relevant documentation or medical records that support your appeal. Finally, you should submit your appeal to your insurance company and wait for their response. Remember to be patient and persistent - filing an appeal can sometimes be a long and frustrating process, but it is worth it to get the help you need and to get your money’s worth from the insurance company.
Asking for sliding scale
If you are seeking counseling but are worried about the costs, it is important to talk to your therapist about a sliding scale payment option. When you are choosing a therapist, don't be afraid to ask about the fees and inquire if they offer a sliding scale rate. You can explain that you have limited finances, and you want to ensure that you can receive the support you need while staying within your budget. You might also ask if there are any other payment and financing options available to accommodate your financial situation. Remember, therapists understand that not everyone can afford their full fees, and they will often work with you to create a payment plan that fits your needs.
Sometimes the therapist is unable to offer a sliding scale rate due to already having several spots on their caseload taken by sliding scale patients. If this is the case they can often refer you to another therapist who is able to offer sliding scale rates.
With open communication and honesty, you can work together to find a solution that makes therapy affordable while still getting the help you need.
Working with the therapists at A Better Life Therapy
The therapists at A Better Life therapy are out of network providers. Many of our clients receive reimbursement through their insurance for out of network costs of use their HSA/FSA accounts to cover services.
If you want to know whether or not you have out of network coverage you can use this benefits checker. If you don’t see your therapists name, just choose any name as it will still give you the information on your out of network coverage!
To schedule an appointment email info@abetterlifetherapy.com or using our online scheduling system to pick the best time and therapist for you!