3 Ways to Pay - Finances and Therapy
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Though many clinicians don’t like to talk about it, good therapy costs money. Understanding the 3 basic payment options will improve your chances of finding the right therapist for you.
Despite agreement among researchers that Psychotherapy improves outcomes, fewer than than half of individuals with mental health conditions receive treatment during any given year (NIMH, 2016). Geography, scheduling, and social pressure to “tough it out” are among the common barriers to seeking and receiving care. In addition, of course, are financial concerns. Even though many clinicians don’t like to talk about it, good therapy costs money.
Managed care, private pay, out of network, out of pocket, HMOs, PPOs, and CPTs plus diagnoses from the DSM-5 and the ICD-10… As with medical care, the jargon can get confusing! Understanding the 3 basic payment options will improve your chances of finding the right therapist for you:
1) Insurance – In Network. Seeing someone “in network” means that you are seeing a therapist who has signed a service contract with your health insurance company. Your cost for services, in the form of co-pays or full fee payments toward a deductible, is determined by your plan’s “behavioral health benefits."
2) Insurance– Out of Network. Some insurance plans offer their subscribers Out of Network (OON) benefits for behavioral health. Often labelled “Preferred Provider Organizations” (PPO), these plans reimburse some portion of treatment cost – still subject to your deductible – without any restrictions on who you can see for therapy.
3) Private Pay. Also known as “Out of Pocket”, these financial arrangements don’t involve insurance at all. Instead of a co-pay or partial reimbursement, you agree to a fee which you pay directly to your therapist at the time of service or according to an agreed upon billing schedule. Many therapists employ a “sliding scale” whereby they offer discounted fees to a limited number of private pay clients in need.
In my private psychotherapy practice, I do not accept insurance (though I do provide receipts to those seeking OON reimbursements). This is primarily because I believe that it is best to make decisions together with my clients without any interference from their insurance companies. For example, insurers reserve the right to decide how often and for how long their subscribers can see a therapist. Insurers can also demand diagnoses, clinical notes, and treatment plans – very personal information that could become a permanent part of your medical record.
You can read a more detailed discussion of finances and therapy here. With or without insurance, therapy can be affordable – take that first step and find what works best for you. If you or a loved one is struggling with mental health please reach out for help.