Health insurance can be confusing, and it can be difficult to know exactly what your plan covers. Even those with good insurance might be hesitant to seek health services when you are unsure what will or will not be covered.
Does health insurance cover the cost of therapy? The short answer is: it depends. Most plans in the United States cover mental health similarly to how they cover other medical costs, meaning that sessions could be billed with a co-pay or go toward your deductible.
What Kind of Insurance Plan Do You Have?
Most insurance plans either have a co-pay or deductible. A co-pay means you pay a set amount for each appointment, and your insurance covers the rest. A deductible plan means that you pay all your medical expenses up to a certain amount, at which time insurance starts covering a specific percent of your costs.
If your plan has a deductible, you will want to know how much each session will cost you before your insurance coverage starts. Most therapists post information about their rates on their website, but your insurance plan might have a negotiated rate with in-network providers. This means that your rate per session is discounted. Companies vary on what plans they offer and what services they cover. Since many people are insured through their employer, you might not get to choose which insurance company covers you and your family.
The cost of therapy varies significantly, with many providers in the United States charging between $65 to $200 per session. The cost depends on your location, the therapist’s training, and any specialized care you might need.
Usually, your insurance card lists which type of plan you have, but you can get this information from the company’s website or by calling the customer service phone number on your card. You can learn more about insurance here.
At Lakewood Child and Family Counseling for Adults…
We do have some Therapists who can bill your group medical insurance or health insurance plan, if needed. Not all therapists here can bill insurance. Not all therapist here can bill the same insurance plans, so if your plan changes, please update us immediately to avoid a billing nightmare and a private pay balance due. Please note, not all health plans pay for all types of therapy services.
Please call your plan directly and inquire about your covered services.
For a deeper dive into medical insurance and mental health click here and see what CMS.gov has to say.
You may want to learn more about your Therapy EOB or What’s an explanation of benefits is.
An explanation of benefits (EOB) shows you the total charges for your visit. An explanation of benefits isn’t a bill.
It helps you understand how much your health plan covers, and what you’ll pay when you get a bill from your provider.
Just know, insurance can be tricky to understand!
We are here to help explain the process if you get stuck. Usually, your best 1st step is calling your insurance plan directly to see what they have agreed to cover for Therapy. They make the rules for your costs and your fees, not the Therapist/ provider.
We’re in this insurance loop together, so let’s work together to get your needs met.