How Insurance Works for Counseling

Starting counseling is a big step, and one of the most common questions people have is: “How does my insurance work with therapy?” The truth is, insurance can feel confusing—but it doesn’t have to be.

Most insurance plans help cover the cost of mental health counseling, but what you pay depends on a few key factors:

• Deductible – This is the amount you pay out of pocket before your insurance starts helping. If you haven’t met your deductible yet, you may be responsible for the full session cost. 
• Copay – A flat fee you pay per session (for example, $25 or $40). 
• Coinsurance – A percentage of the session cost you pay after your deductible is met (for example, 20%). 

Some plans also have an out-of-pocket maximum, which means once you’ve spent a certain amount for the year, your insurance may cover 100% of your sessions.

• In-network providers have agreements with your insurance company, which usually means lower costs for you. 
• Out-of-network providers may still be covered, but you may need to pay upfront and get reimbursed later, depending on your plan. 

The best way to understand your coverage is to check your benefits before your first appointment. Here are two easy ways to do that:

Ask to speak with a representative and say:

“I’d like to check my mental health outpatient benefits for counseling.”  

Here are helpful questions you can ask:

• Do I have coverage for outpatient mental health therapy? 
• What is my deductible, and has it been met? 
• What is my copay or coinsurance per session? 
• Do I need preauthorization before starting therapy? 
• Do I have out-of-network benefits? 

Most insurance companies have online member portals or apps where you can:

• View your deductible and out-of-pocket costs 
• Check if a provider is in-network 
• See a summary of your mental health benefits 

Insurance can feel overwhelming, but you don’t have to figure it out alone. Many counseling practices (including ours) can help verify your benefits and walk you through what to expect financially before you begin.Taking care of your mental health is important—and understanding your insurance is just one step toward getting the support you deserve.

We currently accept Blue Cross Blue Shield , Blue Care Network insurance, Priority Health, some United Healthcare plans, Medicare and Aetna.  Even though we do take insurance, it's the client's responsibility to know their benefits prior to their first session.