Health insurance plans are not created equal. Some are far superior than others regarding their coverage for psychotherapy, their costs, the scope of their in-network therapists and their out-of-network benefits.
One thing is certain: all insurance plans must cover therapy in the U.S. But they vary widely. Read on and choose wisely!
1. Pay Attention to the Copay Amount Specifically for Therapy Sessions
If you are looking to best utilize your health insurance benefits, the number one thing to pay attention to is the co-pay/ office visit cost for psychotherapy specifically.
Therapy is a recurring expense. Don’t expect to resolve all your issues within the first couple sessions. The commitment to show up consistently is essential to entangling and enhancing your mental health. Paying attention to your copay (your actual cost per session) is an important consideration to make sure you can afford to sustainably work toward greater mental health.
Your insurance plan might refer to it as “mental health, behavioral health, or substance abuse services” or “mental health outpatient.” So look carefully for those categories.
Don’t assume that your co-pay is the same for psychotherapy as it is for say a medical checkup. Mental health is a category of its own under most insurance plans. For therapy, the cost per session or copay is usually the same no matter how many sessions you do. You are covered for therapy sessions as long there is a medical necessity for them.
2. There is a Wide Range of Copay Amount for Psychotherapy
The cost per session vary widely from one plan to another, from $0-80. In New York, many plans have a $30-50 co-pay which makes it very affordable for many New Yorkers to work on their mental health on a sustainable basis.
out-of-pocket, Psychotherapy can get very expensive. Many New York therapists charge upwards of $250 and do not accept insurance. Individual therapy In Manhattan, NY, averages $350 per session.
If you can find a good therapist that accept your insurance and pay $40 or so per session, this is a tremendous way to improve your life and outlook at an affordable cost.
3. Is the Deductible Waived for Mental Health Sessions?
Another important consideration is whether the deductible is waived for mental health visit. For many New York plans fortunately deductible are waived for therapy. So if you have a $5,000 deductible you would not need to pay the full therapy cost until the deductible has been met. This is a huge relief for many people and contributes to making therapy affordable from the get-go.
That said, there are some insurance plans that do not waive the deductible for mental health therapy. Stay away from those.
4. Set Fee Copay are usually Preferable to Percentage Copay
Be mindful that for some plans, the copay is not a set fee but a percentage of the session cost. This can turn out to be a large sum depending on the session cost and the co-insurance percentage.
Set fee copay are usually preferable. At minimum, they provide you clarity as to what your cost will be for therapy. This clarity is helpful so you can budget for therapy as a regular foreseeable expense.
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5. Stay Away From Insurances that Have A Small Network of Therapists
Some insurance plans have large network of therapists, and some don’t. It tends to be harder to find a good therapist if your insurance carrier is from a smaller and newer insurance plan or one that is notable for underpaying therapists.
Aetna, Cigna and United Healthcare are large insurance companies with fairly large network of in-network therapists.
6. Out-of-Network Benefits Matter Too
If you can find a therapist that accept your insurance and you have a reasonable copay per session, count your blessings! We know how hard it can be to do that and our therapy practice is actually build around making this process as pain-free and easy as possible.
But if you were not able to find an in-network therapist that suit your needs, look into your out-of-network benefits. These too vary widely from one plan to the next.
If you have good out-of-network benefits, the cost of therapy with your preferred therapist might be similar to the copay with your in-network therapists. In most cases, however, out-of-network benefits for psychotherapy are cheaper than paying out-of-pocket but significantly more than the $0-80 range you’d get with your in-network therapists.
Summary: What is the Best Insurance Plan for Psychotherapy?
1. Pay Attention to the Copay Amount Specifically for Therapy Sessions
2. There is a Wide Range of Copay Amount for Psychotherapy (from 0-$80 in NY at the time of writing)
3. The Deductible is usually but not always waived for therapy
4. Set Fee Copay are usually Preferable to Percentage Copay
5. Stay away from insurance that have small network of therapists
6. Out-of-Network Benefits Matter Too
Using your behavioral health benefits for weekly therapy is a smart way to make the most out of your health benefits and progress toward greater health and happiness.
The therapists at Manhattan Mental Health Counseling are caring, compassionate and well-trained in a variety of therapeutic skills and modalities.
In-Network Therapy: We are in-network with the following insurance plans: Aetna, Cigna, United Healthcare and Healthfirst. Our therapists specialize in anxiety, depression, anger management, grief, trauma, life transitions, family issues, couple’s counseling, OCD, career counseling, women psychological issues including post-natal depression, addictions among others. We provide online therapy from the comfort of your own home.
Take a look at our Meet the Team page to see which therapist you feel drawn to.