Payment

Paying for Therapy: Insurance, Out of Network, Out of Pocket, and Scheduling

What does the cost of therapy include? You’re not just paying for 53 to 60 minutes of therapy. I work outside our scheduled appointment to plan, research, and design your course of treatment.

A typical course of treatment is about 6 to 12 months, but can be 3 months or more than a year. It will depend on what you need. That’s something we discuss collaboratively.

Many of us have high deductible insurance plans, which means we are paying out of pocket either way. This means we also have HSA accounts, which are usually matched or employer funded. So, that’s some free money for therapy.

Therapy is a commitment you make. It is an investment that costs us time, energy, and money. The goal is to improve your overall mental health, ability to function and ability to succeed. A little time and money invested in therapy today can help you for the rest of your life.

Quick example for what it looks like if I do not accept your insurance and you’re paying cash, here’s an example of your options (keep in mind, rates are negotiable) -

  1. Come weekly at $150 per session - about $600 per month.

  2. Come every-other-week at $150 per session - about $300 per month.

    These are estimates and may differ from your actual cost.

I will provide you with “superbills” monthly, which you send to your insurance company. If you have out of network benefits, you may get a percentage back. You should check with your insurance on whether you have OON and, if you do, how much do they reimburse you.

Some info about insurance and mental health:

The average rate for an hour of therapy provided by a licensed clinical psychotherapist in the United States is $155. How many insurance companies match this rate? Not one of them.

In fact, most pay a much lower rate. The lowest rates being those of Cigna, Husky. Anthem has increased rates recently, however they often ask for client records and search for reasons to ask for money back, which is why I’m not in network.

Why tell you all this? Imagine your employer told you that there was no cost of living increase for years and years. Would you take that job?

Mental health providers are some of the most underpaid Healthcare workers in our nation and insurance reimbursement rates have not increased to match those of other healthcare specialties.

Everything is negotiable to a degree.

I do take some insurance, but mostly I am a cash for service therapist. I say mostly because I am not in network with Anthem BC/BS or Cigna and most people in CT have an Anthem health insurance policy. If you want a male therapist who takes Anthem, contact me and I can connect you to one of my colleagues.

Information on insurance, payments, and cost of therapy:

If I don’t take your insurance, don’t worry. You may have out of network benefits.

I currently take Optum (Connecticare, United Health or United Behavioral Health, Oxford, etc…) and Aetna.

For people who have an insurance I am not in-network with (Cigna, Anthem), payment is simple. You pay our agreed upon rate out of pocket and I provide you with superbills monthly. These are specific receipts for services that you submit to your insurer and IF you have Out of Network benefits, they should pay you a percentage.

The link floating to the right is for Reimbursify, which is a service to help people paying for therapy out of pocket, to see if you are eligible receive some money from out of network benefits in your plan. There is a fee involved, so read carefully. I can set you up to receive superbills from Simple Practice monthly and you can submit them through Reimbursify.