I recommend that you contact your insurance prior to starting therapy to inquire about your behavioral health benefits, whether or not you need pre-authorization or referral, your co-pays or deductible, and if you have other provisions or limitations to your particular policy.
For some people it makes sense to use health insurance for psychotherapy, especially if it allows them access to services they otherwise wouldn’t be able to afford. Insurance companies can sometime pay for a portion or all your therapy, based on your policy. Other people decide that the flexibility afforded by paying privately is worth the extra cost.You will be asked to provide written authorization for your therapist to communicate with your insurer. The insurance company is entitled to some personal information about your situation and treatment plan, and a written record is kept of your sessions.
You will be given a mental health diagnosis by your therapist (such as depression, PTSD, adjustment disorder, etc.) in order to prove "medical necessity". If you don’t meet the criteria for the diagnosis, your insurer may not pay for your therapy. You should know that some people do fall into diagnostic categories, especially when they experience significant stress in their lives, but some do not. Many people are seeking therapy even if they do not exhibit significant distress; however they use therapy as a tool for self-enhancement and self-growth. Being a medical insurance, the insurers only support therapy that is deemed medically necessary.
Your insurer controls the length of therapy and sometimes the models of therapy they accept.
I suggest that you consider your options based on your specific circumstances and the purpose of your therapy. Ultimately, it is your decision and it is usually a balance of needs, privacy, and cost.
I am a provider for the following insurance plans: Blue Cross Blue Shield (BCBS) and Allways, and the Optum Network including HPHP Out of pocket fees:
55-minute intake session: $150
50-minute psychotherapy session: $120
four, 15 minute telehealth pack: $150
90-minute group therapy session: $50
Those with other insurance plans that offer out-of-network benefits may be able to receive some reimbursement for sessions. Some questions you could ask your insurance company:
Do I have out-of-network benefits for mental health coverage?
If so, what percentage is covered?
Do I have a deductible? What is it and how much of it have I met?
What is the co-pay for a session if I see an out-of-network provider?
How do I submit a request for reimbursement?
My office hours are Mondays, Tuesdays, Thursdays and Fridays from 9a-3p (last client).