Paying for therapy isn’t always as straightforward as using your health insurance. Even with insurance coverage, you might encounter unexpected costs like high deductibles, unanticipated out-of-pocket expenses, or limits on the number of sessions covered. For those without insurance, paying for therapy can feel even more daunting.
The good news is that there are many ways to make therapy more affordable and accessible. Whether you’re relying on insurance, using a health savings account, or paying out-of-pocket, we can help you navigate your options.
Paying for Therapy Through Insurance
Using insurance to pay for therapy can significantly reduce your out-of-pocket costs, but understanding how it works is key. Here’s what you need to know about using insurance to cover therapy:
In-network coverage
In-network therapists have agreements with insurance providers to offer services at set rates, which generally results in lower costs, predictable copays, and simplified billing. These therapists typically handle claims directly with your insurance company, making the process seamless.
For example, if your plan requires that you pay a $30 copay for mental health services, that will likely be the only cost you will pay out-of-pocket until your insurance deductible is met.
Out-of-network coverage
Therapists who are out of your insurance network are not contracted with your insurer, but you may still be able to get some coverage for their services. The specifics of how much is covered will vary depending on your specific health insurance plan.
Often with an out-of-network provider, you’ll pay the full session cost upfront and then submit a claim to your insurance provider for reimbursement. This process often involves requesting an itemized receipt, known as a superbill, from your therapist that includes all necessary details such as session dates, costs, and diagnosis codes.
Your health insurance plan may also have a separate deductible for in-network vs. out-of-network coverage.
Verifying insurance coverage
Before scheduling therapy sessions, it’s important to confirm your insurance benefits for mental health care. Consider taking some of the steps below to confirm your insurance coverage:
Read your benefits booklet: Look for details about mental health services, including coverage for therapy sessions, annual limits, and whether pre-authorization or a referral is required.
Call your insurance provider: Ask specific questions about in-network vs. out-of-network coverage, your deductible and copay amounts, the reimbursement process for out-of-network providers, and any limits on coverage (e.g., number of sessions).
Contact a therapist: Prospective therapists can also help you confirm your insurance coverage, if they are in-network with your health insurance provider, and other benefits.
Submitting a Superbill for Reimbursement
If your therapist is out-of-network, or if your therapist does not take insurance, but your insurance plan offers reimbursement for such services, you can use a superbill to recoup some of the costs.
A superbill is an itemized receipt provided by your therapist that includes all the necessary information for your insurance provider to process a claim. This document typically contains details like the therapist’s name, license information, session dates, fees, a diagnosis code (if applicable), and the type of service provided.
Once you have the superbill, log in to your insurance provider’s online portal or contact their claims department to find out how to submit it. Be sure to double-check your insurance company’s requirements for processing claims to avoid delays.
After submission, your insurer will review the claim and determine how much of the cost they’ll reimburse. This amount is based on your plan’s out-of-network reimbursement rate and whether you’ve met your deductible. Once approved, the reimbursement will typically be sent as a check or direct deposit to you, not to your therapist, so you’ll need to manage the payments to your provider yourself.
While the process of submitting a superbill may feel time-consuming, it’s a valuable way to offset therapy costs if in-network options aren’t available or if you’ve chosen a provider outside your insurer’s network.
Using an HSA/FSA Account
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are tax-advantaged accounts that can make therapy more affordable. These accounts allow you to set aside pre-tax money to pay for qualified medical expenses, including mental health services.
An HSA is typically paired with a high-deductible health insurance plan and offers long-term savings benefits since the funds roll over annually and can grow tax-free. An FSA, on the other hand, is usually offered by employers and has a “use-it-or-lose-it” policy, meaning you must spend the funds within the plan year or forfeit any remaining balance.
You can use your HSA or FSA to pay for therapy sessions, whether you’re paying out-of-pocket or covering copays for in-network care. These accounts can also cover other therapy-related expenses, such as deductibles, coinsurance, or even out-of-network costs. If you’re working with an out-of-network therapist and submitting a superbill, you can use your HSA or FSA to pay the upfront costs.
Paying Out-of-Pocket
For people without insurance coverage or those who choose not to use it for therapy, paying out-of-pocket is a straightforward option. While this approach can seem more expensive initially, it offers significant advantages, such as increased flexibility in choosing a therapist and privacy regarding your mental health records.
When you pay out-of-pocket, you aren’t limited to in-network providers. This opens up a wider range of therapists, including those who may specialize in specific issues or treatment methods that aren’t always covered by insurance. It also means there’s no need to worry about reimbursement processes or the restrictions that insurance companies may place on session limits or approved treatments.
If you’re concerned about cost, some therapists offer sliding scale fees based on your income, making therapy more accessible for people paying out-of-pocket. Others may provide package discounts for multiple sessions or lower rates for cash payments. If cost is a concern, don’t hesitate to discuss financial arrangements with your therapist—many are open to finding solutions that work within your budget.
At Westmoreland Psychotherapy Associates, we are in-network with the following health insurance plans:
Blue Cross/Blue Shield Commercial Plans
Highmark BC/BS Commercial Plans
UPMC Commercial Insurance Plans
United Healthcare/Optum Commercial Plans
Geisinger Health Plan Commercial Plans
Cigna/Evernorth Commercial Plans
Aetna Commercial Plans
Self-payment without insurance is also accepted
Whether you're using insurance, an HSA/FSA, or paying out-of-pocket, we're here to help you navigate your options. Reach out to us today to discuss payment methods, insurance coverage, or any questions you may have about starting therapy.