How to Access Affordable Online Therapy with Insurance
Affordable Online Therapy with Insurance: Using Out-of-Network Benefits for your Private Pay Therapist
Hey y’all!
If you’re already paying out-of-pocket for therapy, kudos to you for supporting a private pay therapist and investing in your mental health. There are many benefits to seeing a private pay therapist versus one in-network, and freedom of choice is one of them. To access affordable online therapy with insurance, you can use out-of-network benefits to choose a therapist best suited to your needs instead of searching through in-network lists.
You may already be experiencing the mental health benefits of seeing a private pay therapist, but during these economic times, you might still need to save money on therapy. This is where maximizing your out-of-network benefits can be helpful. In health insurance, out-of-network super billing is a hidden gem. It’s not often discussed and can feel difficult to access if you’re unfamiliar with the process.
The process isn’t always easy, but luckily, I’ve done it myself for years and know how good it feels to get a nice deposit back into my account for all the money I’ve invested in my mental health. Shout out to the therapists who go to therapy!
Private Pay therapy can be immensely expensive, especially if you have long-term concerns. There’s a little-known way to use your out-of-network benefits to potentially receive money back for therapy. And I’ll teach you how!
Not every insurance plan offers out-of-network billing, but it’s worth exploring and maximizing if yours does.
Interested? I’ll walk you through the process below:
Step 2: Check your out-of-pocket cost. If your health insurance offers out-of-network benefits for mental health, check what percentage you are responsible for. I’ve typically seen between 20% - 50%. For example, if you are responsible for 20%, that means you will be reimbursed 80% of what you paid for therapy.
Example: If you pay $200 per session for therapy (the average rate in California), you will be reimbursed $160 per session!
Important note: This is the amount you would get reimbursed after you reach your deductible. You may have already reached your deductible if you’re six months into therapy and go weekly. If you’re asking, "WTF is a deductible?" follow along for step 3.
Step 4: Submit your superbills regularly. I suggest setting a monthly reminder in your calendar to submit your superbills. A superbill is a receipt of how much you’ve paid for therapy and includes the codes used for the services.
Here’s an example:
Step 1: Check your insurance plan. You can check your insurance benefits online to see if they include out-of-network benefits for mental health care. This is simple to do on your insurance website, or for California residents, you can check for free here. If you have Kaiser, unfortunately, they typically don’t offer out-of-network reimbursement for mental health services.
Step 3: Check your deductible. Your deductible is the amount you pay out of pocket before you receive a portion of your money back. For example, if your deductible is $1,500, you won’t be able to get reimbursed until you’ve spent $1,500 out of pocket (about 7 full-fee therapy sessions). After you’ve paid that amount, you can receive money back for health expenses afterward.
Important note: You still need to submit the claims for them to count! If you’re in therapy weekly, that’s about 2 months of sessions.
If this sounds ridiculous to you, I’m right there with you. Insurance is confusing AF and designed to overwhelm you so that you don’t take full advantage of it.
Luckily, for California residents, you can easily check your coverage and deductible by using this link.
Congrats! You made it through the obstacles of insurance hell. Now, how much could you potentially save on therapy?
Well, that depends on your coverage and insurance, but my husband was kind enough to create this awesome calculator to estimate how much you could potentially save on therapy based on your insurance coverage. Keep in mind that this is just an estimate, and you must check with your insurance to be aware of any loopholes or limitations.
Bonus tip: You can use your HSA or FSA funds for therapy. Yup! That’s pretax money you can use to cover your deductible. Hello, 30% off! When you’re planning for a full year of therapy, it’s helpful to put the amount of your deductible into your HSA account. (More on how to use an HSA in my next blog post.)
You can save $!
Since you pay $ ,
it will cost ~$ out of pocket for the year (assuming sessions).
You will need to submit superbill reimbursements every month to ensure you meet the $ deductible.
After the deductible is met, continue submitting superbills and you will be reimbursed ~$ per session.
This will amount to a total cost of $ and a total savings of !
FREQUENTLY ASKED QUESTIONS
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No. I, like many other private practice owners, do not take insurance. However, I can provide a superbill that clients can submit to their insurance for out-of-network reimbursement. I can also provide a guide that helps you inquire about your potential out-of-network benefits.
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The short answer is that our healthcare system significantly undervalues our work by limiting the number of sessions, requiring extensive paperwork, very little pay, and limited confidentiality for the client. Therefore, until the kinks in this system are worked out, I will not be taking insurance.
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I prefer to start with weekly sessions until we have reached the maintenance phase of therapy. Then, when clients feel ready, we discuss the option of biweekly sessions.
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Not currently.
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Simply put, expressive arts therapy uses various artistic modalities to facilitate a therapeutic healing process. This includes modalities such as visual art, music, movement/dance, writing, and poetry. You do not need to be an artist; you only need yourself and a few materials. I always check in before recommending the use of the arts, but I encourage clients to be open to the process. For example, you may write a poem in a session expressing your feelings. Sounds cool, huh?
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No, therapists are only licensed to see clients within the states that they are licensed. I am currently licensed in the state of California.
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No. Psychological assessments for children or adults are administered by a licensed psychologist. If you are looking for clinical assessments for school, I am not your person.
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I do not offer a sliding scale, but here are some options I do have available:
• I do accept Loveland Foundation vouchers which provide Black women and girls with vouchers to help cover the cost of therapy. Visit their website here.
• I keep 20% of my caseload for Black women who are students, parents, unemployed, or work in social service fields (non-profits, education, etc.) to receive therapy at half the cost.
• If you have a PPO insurance plan, you may be able to get partial reimbursement for the out-of-pocket costs of therapy. I can provide a superbill for you to submit to them for reimbursement.
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I use a HIPAA-compliant platform called Simple Practice to do all sessions. Before your appointment, a video link will be sent to your email to give you access to the video session. It's like Zoom for therapists. You can use the Simple Practice client portal to request or cancel appointments and access superbills and other documents.
“Good Faith Estimate for Health Care Items and Services” Under the No Surprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises
