Paying for Therapy
If you are seeking the highest degree of privacy and choice, paying out-of-pocket is the preferred option.
Not only will you enjoy the most confidentiality of any payment option, you will not be labeled with a mental health diagnosis (see below), which all insurance companies require.
Additionally, our work together will not be affected by any changes in your health plan coverage or network. And depending on your particular tax situation, you may be able to write off therapy expenses.
The next best thing to out-of-pocket, using funds from a flexible spending account (FSA), a health saving account (HSA), or a health reimbursement account (HRA), allows you to use pre-tax dollars to pay for therapy.
Because my practice is coded as a health expenditure, your FSA or HSA card will be automatically accepted.
Regarding privacy, only the organization or bank that administers the FSA/HSA account will know about your therapy charges.
Note: Your HSA/FSA administrator may require an itemized receipt, possibly including a mental health diagnosis (see below), if you opt to turn in your own receipts or if they decide to audit charges made to your account. These will be supplied upon request.
This is a good option for people who value choice, but would also like to utilize their health insurance benefits.
Using out-of-network benefits is very similar to using in-network benefits in that insurance will pay for a portion of each session, although sometimes the percentage they pay is a less than they pay for in-network (70% vs 80%, for example).
I will electronically submit out-of-network charges to your insurance company automatically. Or I can supply you with an itemized receipt, called a super bill, if you'd like to do it yourself.
There are a few downsides to this option to be aware of. The first is that you will be assigned a mental health diagnosis (see below). Insurance companies require this in order to reimburse for any service.
The second downside is that you may have a deductible which must be satisfied before any reimbursement can occur. For some people, this deductible can be sizable. However, many in-network plans also have a deductible, so there may not be a significant difference in out-of-pocket expenses depending on your particular plan.
The best way to find out about your out-of-network deductible and the percentage of reimbursement you can expect is to ask your insurance company directly.
When you call your insurance carrier directly ask these questions:
HERE'S WHAT TO ASK:
1) Do I have out-of-network benefits for individual therapy/family therapy/hypnotherapy?
2) If yes, what is my out-of-network deductible?
3) Is this deductible combined with my in-network deductible or is it separate?
4) How much of this deductible has been satisfied so far?
5) What is my co-insurance once my deductible has been satisfied? (This is usually a percentage)
6) What is my out-of-pocket maximum? How much as been met this year?
7) Do I have any kind of special mental health network or require any special authorizations?
8) What is the process for reimbursement and how long do I have to submit claims?
I do offer reduced fee sessions. However, I am also able to provide referrals to low-cost or in-network options in the area.
IN-NETWORK INSURANCE (NOT ACCEPTED*)
For people who know they want to use their health insurance benefits, this option can be the most affordable (although not always), but it comes with the greatest restrictions and the least amount of choice.
In-network means that the therapist has agreed to be a network provider for your particular insurance company. Specifically, this means that in order for the the provider to be paid for each session, they are contractually obligated to regularly communicate information about your treatment goals and progress to your insurance company.
The insurance company often uses this information to determine how many sessions they will allow. This also means that you will be required to have a mental health diagnosis.
* Because of the high value I place on your confidentiality and choice when it comes to therapy, I have not signed contracts with any insurance companies. Therefore, you will be unable to use in-network benefits while seeing me.