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  • Writer's pictureLauren Drago

Get Therapy! How to Use Your Health Insurance to Pay for Out of Network Counseling

Therapy is in high demand. The COVID-19 pandemic led to a big shift in the need for mental health counseling, and now, more than ever, it can be hard to impossible to get on a therapist's client roster.


Using a therapist who is paneled in with your health insurance is a common place to start looking. But what happens if those therapists are full, not a good fit, or not who you wish to work with?


What happens if the therapist you want to work with is an Out of Network (OON) provider ? An Out of Network provider is a therapist, like myself, who does not accept your insurance directly. Rather, you pay the therapist their fee out of pocket (HSAs can help with this), and get reimbursed afterward by your Health Insurance.


Seeing an OON provider can feel prohibitive for many, as therapy can feel like both a luxury expense while still also being absolutely essential to your well being. So what do you do? Put that Health Insurance to work if you can! I always encourage clients to do this, and many don't. If it makes the difference between you being able to afford quality therapy or not, or having a financial hit from doing so, you owe it to yourself to use your OON benefits/coverage.


How?


  1. Call your the number on the back of your health insurance card and ask what your coverage and reimbursement is for service code 90834. It will take 5 minutes, and you should hang up with clarity about how it works based on your individual plan. Recently I had a client tell me she had to stop seeing me because she and her partner had a savings goal to meet. After I encouraged her to reach out to her insurance she found out our sessions would be covered 70%. She was psyched to learn that she didn't have to stop getting the counseling she wants just because she had a new budget. All she has to do is send in the Superbills I provide her and voila! Insurance coverage!

  2. If you have a high deductible to meet first and you think it will never get met, in your superbills anyway. By doing so, you're chipping away at your deductible, putting your money spent on therapy to work for you. Then if you have unexpected medical expenses, you'll be ahead of the game by being closer to those expenses being covered.

  3. If you've had a lot of medical bills, now may be the best time to get therapy! Last year I had an unexpected trip to the emergency room. Blergh! But the positive side was I met my deductible with that visit alone. I'd been meaning to get to therapy, so conveniently I got in with someone and our work together was covered 90%. For $15 a session (my 10% responsibility) I did some great work with a therapist at a time I needed it the most. I hope these tips encourage you to look into the health insurance benefits you might be leaving on the table. It may make the difference for you between getting the support you need and feeling like it's out of reach and unaffordable. Mental health care now is more important than ever. Take the extra step and you'll find out if seeing an Out of Network provider is actually a much more accessible option than you knew!

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