When it comes to paying for therapy, the second most common question we hear is, “Does insurance cover therapy?” While the answer isn’t a simple “yes” or “no,” we’ll help you understand the basics of how insurance works in therapy, the pros and cons of using it, and how to check if your therapy sessions will be covered.
Does Insurance Cover Therapy?
At Olive Branch Counseling, we currently accept Cigna, United Healthcare/Optum, and Sana Benefits. However, we’re moving away from being an insurance-based practice, and here’s why:
- Privacy Concerns: Did you know that insurance companies can request access to your therapy records at any time? This is often necessary for them to “approve” ongoing therapy, but it can feel like a privacy invasion for many clients. At Olive Branch, we believe in protecting your confidentiality as much as possible.
- Therapy Duration: In some cases, insurance companies may limit how many therapy sessions you can have or require you to prove that therapy is “medically necessary.” While this may work in some cases, it doesn’t always align with what’s best for your healing journey.
- Diagnosis from Day One: Another important thing to know is that when a therapist bills insurance, they have to provide a diagnosis from the very first session. This diagnosis is what allows insurance to cover your therapy. But the truth is, diagnosis doesn’t happen in one session, and sometimes clients aren’t comfortable with being labeled right away. This can make the therapy process feel a little more rigid than it needs to be.
How to Check If Your Insurance Covers Therapy
If you’re set on using insurance, the first thing you’ll need to do is check your benefits. Here’s how:
- Check Online or Call: Look at your insurance card or log in to your insurance provider’s app/website. You’ll want to look specifically for mental health coverage. Not all plans cover mental health services, so this is an important step.
- Out-of-Network Benefits: Even if we don’t accept your insurance, we do work with a service called Thrizer that allows us to help you file claims for out-of-network benefits. Many people don’t realize they have out-of-network benefits, but you can check this the same way you check regular benefits—just look for a section on out-of-network coverage. Thrizer can even front the money for you after your deductible is met, so you only have to pay your copay (check Thrizer for details: https://www.thrizer.com).
- Know Your Deductible: Sometimes your deductible (the amount you have to pay before insurance starts covering things) is so high that you end up paying for therapy out-of-pocket anyway. In that case, you’re better off finding the therapist that’s right for you, even if they don’t take insurance.
Why Olive Branch Counseling is Moving Away from Insurance
While insurance can be helpful for some clients, there are several reasons why Olive Branch Counseling is shifting towards private pay:
- Lower Payouts: Insurance often pays therapists half or less of what our actual self-pay rates are. This isn’t sustainable long-term if we want to offer the best care possible, pay our therapists well, and continue investing in their ongoing education.
- Therapist Well-being: We believe that therapists deserve a fulfilling career that compensates them fairly for their expertise, and companies often make this difficult by dictating fees. By offering private pay options, we can better support our team while continuing to provide high-quality care to our clients.
- Flexibility in Care: Insurance tends to follow a medical model, where mental health is treated as a short-term fix. But we know that true healing, especially for those dealing with trauma or long-term anxiety, can take time. Private pay allows us to work together at your pace, with no limitations on the number of sessions or treatment style.
What is Thrizer and How Does It Help With Out-of-Network Insurance?
If your plan includes out-of-network benefits, you’re in luck! You can still use those benefits at Olive Branch Counseling, and we’ve partnered with Thrizer to make the process seamless.
Here’s how it works:
- Thrizer files your claims for you: Instead of you submitting paperwork to your insurance company after every session, Thrizer handles the claims for you.
- Upfront payments: Once you’ve met your deductible, Thrizer fronts the money for your sessions. You only have to pay your copay, so you’re not waiting for a reimbursement from insurance.
- Out-of-network benefits: Check your plan for out-of-network mental health benefits. These are often overlooked, but they can help offset the cost of therapy with providers who don’t take your insurance directly.
To find out if you have out-of-network benefits, check the back of your insurance card or log in to your insurance portal to see what’s available under mental health coverage.
Common Insurance Issues in Therapy
While insurance can make therapy more affordable, it also comes with its own set of challenges. Here are a few things to watch out for:
- High Deductibles: As we mentioned earlier, some plans have high deductibles, meaning you have to pay a significant amount out-of-pocket before insurance even kicks in. If you don’t anticipate hitting that deductible within the year, paying for therapy out-of-pocket might be just as cost-effective, giving you more freedom in choosing your therapist.
- Insurance-Limited Session Length: Insurance companies often dictate how long your therapy sessions can be, sometimes pushing for 30-minute appointments or restricting coverage for longer, in-depth sessions. This may not work for everyone, especially for those dealing with complex issues like trauma or anxiety that benefit from longer, more flexible sessions.
- Diagnosis Requirements: As mentioned earlier, insurance companies require therapists to provide a diagnosis from the very first session in order to approve claims. This isn’t always ideal, as building rapport and understanding a client’s situation fully can take a few sessions. Immediate diagnoses can feel impersonal or even premature for some clients.
Key Takeaways
- Some plans do cover therapy, but coverage varies. Always check your mental health benefits through your provider’s website or by calling the number on the back of your card.
- Olive Branch Counseling accepts some insurances but is transitioning away from them due to privacy concerns, limited session flexibility, and low reimbursement rates.
- If your plan offers out-of-network benefits, services like Thrizer can help make therapy more affordable by handling claims and covering upfront costs once your deductible is met.
