How to find a therapist who takes your insurance

14 minutes Written by Mental Health Match

Everything you need to know to easily find a therapist who is part of your insurance network. 

It’s not just you. Finding a therapist you click with can be difficult —let alone understanding the maze of health insurance rules and coverage. You can find great therapists, though, including ones who match with the payment and insurance options that are best for you. Continue reading to see the most common questions people have about finding therapists and navigating insurance. Quit wondering and worrying—we’ve got the answers you need.

Does insurance cover therapy?

The short answer is: sometimes.

Depending on the type of insurance plan you have, and even what state you live in, your coverage may differ. Carefully review your insurance provider’s materials (including their website and informational materials you likely received when you subscribed) to see if outpatient mental and behavioral health are listed areas of coverage.

If so, then your insurance most likely covers therapy under some circumstances, but there are large differences among insurance programs, and important variables for you to consider before determining that your insurance provides access to the care you need.

If your insurance does cover mental health therapy, then you’ll see two terms you need to know to understand your coverage: co-pay and deductible.

What is a co-pay?

Sometimes insurance covers the vast majority of mental health care on behalf of a user, except for a regular charge referred to as a “co-pay.” Co-pays are a small charge (usually $30 or less) that a therapist or other health provider charges to a client immediately before or after an appointment. These are very common. You pay the co-pay to your counselor or therapist; your insurance pays the rest.

What is a deductible?

Most insurance programs indicate that their coverage begins only after the recipient has “met a deductible,” a minimum amount of health expenses that you must pay before the insurance begins paying its portion of additional expenses. For example, if you have a $1500 deductible that resets each January 1, you may be responsible to pay for healthcare you receive at the beginning of the year, until those charges total $1500. Pay close attention to the conditions of your deductible—sometimes only certain types of health interventions (behavioral health, dental appointments, surgery, emergency care, mental health) count towards meeting a deductible. Sometimes mental health care is excluded from the deductible, meaning you get benefits immediately. Other times, you must meet your deductible before your insurance starts to pay for therapy. 

What types of therapy are covered by insurance?

Most American healthcare plans (including all of the ones available to individuals on the insurance marketplace) must provide benefits in at least three main areas, as described at healthcare.gov:

  • Behavioral health treatment, such as psychotherapy and counseling
  • Mental and behavioral health inpatient services
  • Substance use disorder (commonly known as substance abuse) treatment

Your insurance plan might offer coverage in more areas than are required, but even if the mental health care category you’re looking for is accounted for, there are other variables to consider, especially the amount of coverage. Your plan’s coverage may even differ by state, and your out-of-pocket cost may be affected by variables like the deductible, co-pay, and appointment frequency. Just because your plan offers some benefit doesn’t mean it will cover the majority of your therapy costs.

Furthermore, most insurers cover only proven, common therapies such as Cognitive Behavioral Therapy (CBT). Newer therapies such as Eye Movement Desensitization and Reprocessing (EMDR) or biofeedback may not be covered by your insurance plan. 

Couples therapy and family therapy are rarely covered by insurance unless you are inviting others into a single therapy session as part of your individual therapy. 

Does my insurance cover online therapy?

There are lots of reasons you might choose online therapy that takes insurance. Your prefered therapist may not be close enough to visit in person, or you may find it easier to open up to someone by connecting virtually.

When it comes to coverage, insurance providers typically don’t draw a distinction between remote and in-person therapy, but the convenience of online therapy may be too good to be true if your preferred therapist is out of network or or out of state.

During the COVID-19 pandemic, all insurers began paying for telehealth visits, where before, many of them would only allow virtual healthcare visits in certain situations. Now, most insurers have made those changes permanent, and there are a number of bills across the US that would do the same. It is likely that your insurance plan covers online therapy, but you should always double-check to be sure. 

What is the best online therapy that takes insurance? 

Nearly all therapists now offer online therapy, so you can go directly to the therapist who best meets your needs. Going directly to an independent therapist helps you build a strong relationship with your therapist while also making sure you can choose the therapist who is best for you. 

Large and well-funded companies that employ lots of therapists may seem like an appealing prospect, but keep in mind that these companies reached their size by making lots of money off of the fees and percentages they charge therapists and clients. As long as you’re putting in the work to find a great therapist, we recommend finding an independent therapist (or a therapist in a small group practice), and skipping the big companies with sketchy records. Check out this article about online therapy companies if you want to know if such a company is right for you. 

Why do people say it’s so hard to find a therapist who takes insurance?

It might be easy to identify whether or not a therapist accepts insurance, but the information you need lies behind more than this simple yes-or-no question.

The therapist you prefer might accept your insurance, but that coverage may not meet your needs—and you might not be entitled to that coverage for reasons including your location or the type of therapy you are getting. 

On the other hand, the therapist you prefer might not accept your insurance, but might still be a viable option if you can’t or don’t want to use your insurance for your mental health needs. 

Given the complexity of the choice ahead of you, we’ve broken down some of the variables you may wish to consider before assuming that using insurance to pay for therapy is best for you.

What are out-of-network benefits?

If your preferred therapist does not have a relationship to your insurance provider, then they are understood to be “out-of-network.” Sometimes insurance plans cover out-of-network providers for things like emergency visits, but only rarely do they offer any coverage for out-of-network therapists. 

Many therapists say they are “out-of-network” for various insurance plans, which simply means they do not accept that insurance. Depending on your insurance, you may still have benefits to help you see those therapists, but such benefits are rare and very limited. Most of the time, you won’t get any help from your insurance plan to see out-of-network therapists. At best, your insurance may pay just a part of your therapy bill. 

Proceed carefully if you plan to use out-of-network benefits. It may be prudent to request a good faith estimate to align your expectations. And plan to handle all the paperwork yourself; therapists who are not “in-network” may need to use a form that itemizes the provided services known as a “superbill.

Should I use insurance for therapy?

Choosing to use mental health services is a deeply personal decision, much like choosing how to pay for it. Even if you can use insurance to pay for therapy, there are reasons you may prefer to pay out of pocket.

Reasons why you should use insurance to pay for therapy

It may seem intuitive that using insurance to pay for therapy is your best option—and, in many cases, it is! If you’re able to confidently determine that 

  1. an in-network therapist… 
  2. who you feel good about…
  3. offers the mental health services you need…
  4. and your insurance plan covers enough of the cost of your appointments…
  5. at the frequency you desire… 
  6. and you feel comfortable receiving a mental health diagnosis…

then you’re a good candidate for using insurance to pay for therapy. The last point is important – to use your health insurance to pay for insurance, you must get a diagnosis of a mental health issue that becomes part of your record with your health insurance company. 

Reasons why you might want to pay out-of-pocket instead of using your insurance

In order to understand why you might choose not to use insurance to pay for mental health services even if you can, let’s look at the flipside of the conditions listed in the previous section.

  1. an in-network therapist…

As countless people have found, finding an in-network therapist has become increasingly complex. One Reddit user summarizes a common dilemma succinctly: “All the Pennsylvania therapists that accept my insurance refuse to work with me because I live in New Jersey and all the New Jersey therapists I talked to don’t accept [the insurance I receive from working for a company in Pennsylvania.]” As a result, searching for a therapist who is in your insurance network  may not necessarily yield usable results.

  1. who you feel good about…

Mainstream therapy is susceptible to many of the biases and types of exclusion that exist elsewhere in the world. For example, people who are trans, disabled, fat, and polyamourous report particular difficulty finding a therapist who doesn’t retraumatize them—or pathologize elements of their identity that aren’t actually problematic. People of all demographic groups report difficulty finding an ideal “match” when their “pool” is limited. Many therapists do not take insurance, so you may over-limit your options if you search only for therapists who are part of your insurance plan. 

  1. offers the mental health services you need…

Insurance companies generally only cover services that they categorize as “medically necessary”. The National Alliance on Mental Illness (NAMI) identifies commonly denied areas of care, which include residential treatment for mental illness, intensive outpatient treatment, psychological rehabilitation, partial hospitalization, assertive community treatment, and office-based diagnostic and treatment interventions. If your insurance denies coverage, you may be able to submit an appeal—or you may simply need to pay out of pocket in order to receive services that you need… or would simply be happier with.

  1. and your insurance plan covers enough of the cost of your appointments…

Insurance rarely covers the entire cost of mental health care—it usually covers a significant percent of the costs after the deductible is met, and excluding the co-pay. Make sure you’ve calculated all of the relevant factors so you know what the bottom line is, even after you’ve found a therapist that takes insurance near you. Many therapists offer sliding scales, so it can sometimes be more affordable to see a therapist and pay out-of-pocket. 

  1. at the frequency you desire… 

 “Medically necessary” is a subjective term, which your insurance provider may interpret in a way that would limit the frequency or total number of therapy appointments. Be sure that your expectations are aligned with what your insurance actually provides – which you can check by calling the number on the back of your insurance card.

  1. and you feel comfortable receiving a mental health diagnosis…

In order to determine the “medical necessity” of mental health services, insurance companies require a mental health diagnosis. Setting aside the fact that mental health professionals offer significant criticism about the premise of diagnoses, you may resist being diagnosed because of the associated stigmas. Others worry about their privacy—and having their mental health “problem” exposed to their professional network.

Read more about ther pros and cons of using insurance to pay for therapy.

What is the process for using insurance to pay for therapy?

Once you’ve decided to use insurance to pay for therapy, contact your therapist (or their office staff) and inquire about their process for billing insurance. Some therapists will bill your insurance for you—others may have special instructions. 

In some cases, you will need to pay out of pocket for your first appointment and request reimbursement. In other cases, as with Kaiser Permanente and others, you will need to complete an assessment with an on-staff therapist who will make a mental health diagnosis. Usually, your therapist (or their office staff) will manage further communication about billing with your insurance.

Once your therapist and insurance are synced up, you can generally “set it and forget it”—which may dispel some anxiety around small factors like keeping track of your insurance card.

How do I check my insurance coverage for therapy?

Normally, your health insurance and therapist’s office will send you regular billing notices, which usually include a summary of costs including the amount paid by your insurance and the balance you owe to the therapist. Make sure to check that these amounts align with your expectations. If you don’t receive this automatically, follow up and ask for them—they could be going to the wrong address. There’s always potential for innocent human error!

What is a superbill?

Superbills are itemized invoices that summarize services. It is often very useful to archive these in a secure location for your records, especially if you need to submit claims to your insurance provider for reimbursement. Often, therapists are required to use this form when users are paying out-of-pocket.

How do I find a therapist who accepts my insurance?

If you’ve determined that using your health insurance to pay for therapy is right for you, the next step is to find the right therapist for you. There are so many therapists to choose from, and it’s not always easy to know who is actually in-network, accepting new clients, and fits your communication style. Unfortunately, finding a great therapist is not as easy as a Google search—and the available options come with complications.

Problems with insurance websites

Many insurance companies’ websites include a feature that aggregates contact information and other relevant data about in-network mental health providers. In theory, these search mechanisms eliminate the guesswork around insurance coverage, but they are demonstrably unreliable. Stat is among the news sources that have reported an inconvenient pattern of insurance providers whose search mechanisms provide useless results, including incorrect or defunct information about therapists. 

Easy ways to find a therapist who accepts your insurance

Mental Health Match is the easiest tool for finding a therapist, whether or not you wish to use your insurance. Our model, which was inspired by the infrastructure of dating apps, is explicitly designed for usability as it integrates search criteria that actually matters to users. We’re not vulnerable to any financial pressures that would bias us towards any particular outcome—except to continue deserving the trust of therapists and their clients. When you use Mental Health Match, you bypass all the guesswork and consternation and focus on choosing from among the therapists who meet your needs.

What should I look for in a therapist?

Once you’re looking at a curated list of therapists who meet your basic criteria, you have the luxury of choosing one who meets your wants in addition to your needs. This process can be fun—treat it like you’re chairing a job search.

Consider the types of people you feel most comfortable expressing yourself with. Read candidates’ introduction statements on their (or their agency’s) website and get a sense of their values and interests. From there, choose a small number (2-4) of therapists and see if they allow for consultation calls; many therapists offer initial conversations for free, so that you and they can determine if you’re a “match.” 

The right therapist for you is someone who you trust and feel spacious with, but who also can gently push you out of your comfort zone. Identifying the right therapist is not an exact science; no therapist, no matter how skilled or experienced, is going to be “right” for everyone!

Matching with a therapist is a sensitive process, but you don’t need to fend for yourself. Set yourself up for success by letting Mental Health Match bring you a list of professionals who meet your needs. With the guesswork out of the way, you can focus on choosing the therapist you have the best chemistry with.

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Written by Mental Health Match

Mental Health Match is building the best place to find therapeutic care. Use our matching tool to instantly discover the therapists who meet your needs.