How Much Does Therapy Cost?

Access to affordable health care is a genuine worry in the United States, where phrases like premium and out-of-pocket maximum may complicate what should be a straightforward process—and that's assuming you have healthcare coverage at all.

According to an online study done in 2020 by SingleCare, 33% of Americans feel the expense of treatment is the most significant barrier to receiving the mental health care they require.

Regular therapy appointments can cause an extreme financial burden for those who do not have medical insurance, making therapy appear unreachable. Fortunately, anybody in need of therapy has access to free or low-cost solutions.

How to Pay for Therapy

Whether you want to utilize insurance or pay cash, you must choose a provider that suits your budget and therapy needs. There are numerous methods to pay based on who you visit and your insurance situation:

• In-network care insurance: If you see an in-network practitioner, your insurance will cover at least a portion of your therapy. Based on your insurance, your plan may cover the entire cost of therapy or ask you to contribute. Check the summary of benefits for your plan, which should outline your cost-sharing obligations. When in doubt, call the number on your insurance card and ask them to explain your behavioral health options.

• Employee assistance programs: Your employer offers to pay for a set number of therapy sessions, generally for a short-term condition like work-related anxiety rather than a long-term ailment like severe anxiety or clinical depression.

• Out-of-network care insurance: Your insurer will pay a predetermined amount (typically a fraction of the therapist's cost) when you visit an out-of-network therapist. Typically, you pay the fee in advance and then have your insurance refund you after your appointment.

• Out-of-pocket: If you see an out-of-network therapist and your insurance plan does not cover out-of-network therapy, you will have to pay for treatment out of pocket. (If a therapist does not accept insurance, you will have to pay out of pocket.) A therapist may bill you their entire cost or grant you a reduced, sliding scale fee. Often, you will experience the most selection out of pocket, as many providers cannot afford the cost or administrative burden of being in-network with insurance. The average cost of a therapy session out of pocket will vary by state; for example, it hovers around $250/session in NYC.

What Is Sliding Scale Therapy

Sliding scale therapy price is one answer to the cost of therapy. Some therapists provide sliding scale therapy to people who are interested in working with them and need their particular style and expertise but cannot afford their full fee for any number of reasons. The therapist may then offer a sliding scale fee, for either a specific or indefinite amount of time, to increase access to their care. uninsured people whose policy is not approved by the therapist of choice.

A sliding scale structure can assist patients in receiving treatment without breaking the budget. A sliding scale therapist will charge varying rates depending on a person's financial level. People with lower incomes will pay less for a therapy session. Those at the highest end of the salary scale will pay more.

Is Therapy Covered By Insurance?

Yes, most insurance policies cover some form of therapy. This is partly due to the 2008 Mental Health Parity and Addiction Act, which mandates insurance companies to cover both mental and physical health alike. In principle, mental parity regulations prohibit insurers from providing more excellent coverage for things like, for example, surgery, than for psychotherapy sessions or a drug use disorder treatment. Subsequent federal legislation has enhanced and improved the original Act of 2008, and several states have supplementary mental health coverage statutes.

Mental health parity regulations apply to most private policies, including individual plans acquired via the insurance market. Non-qualified short-term coverage is the major exception. Some consumers choose these bare-bones policies instead of individual plans since they are less expensive, but they are not obliged to include mental health treatments. This is important to keep in mind when choosing your coverage during open enrollment, as even if a plan is a lower cost monthly, it may not offer the coverage that you need for your mental health, which would lead to higher cost over time.

You may expect to receive therapy coverage if you do not have a non-qualified policy. The amount that you and your insurance provider pay is based on the plan design. HMO plans, on average, have cheaper premiums and out-of-pocket payments for medical and mental healthcare. PPOs, however, have higher monthly premiums but enable consumers to see both in-network and out-of-network therapists.

If your plan includes a deductible, you will have to pay for therapy out of pocket until your deductible is met. At that time, your policy kicks in, and you're only liable for your coinsurance, based on how your plan handles cost-sharing. You can learn what your specific deductible and coinsurance are by either reviewing your plan details or calling your insurance provider.

State Medicaid plans cover some mental health treatments, including outpatient therapy, if you do not have private insurance. However, coverage regulations differ by state and policy. The requirements can become complicated since not all Medicaid programs are bound to the mental health parity laws.

Medicare pays for a variety of mental health therapies. Part B mainly focuses on outpatient therapy.

CHIP (Children's Health Insurance Program), VA Health Care, and Tricare cover outpatient therapy.

Factors That Influence Cost

Cost has been a significant barrier to people receiving mental health care. Despite regulatory improvements, most individuals continue to face difficulties in gaining access to such services. 

Here are some of the factors that influence the cost of therapy:

1. Insurance coverage: Most people are unaware that insurance coverage may significantly impact therapy costs. If you have joined up with an insurance provider, they will pay the fee. They merely need to call a therapist in their system to handle the task. It implies you won't have to pay anything out of pocket. However, there are some drawbacks to this. For example, you will be limited in choosing your preferred therapist because the insurance provider will handle this. There is also the issue of such a firm mandating session lengths and ideal therapy approaches. Often, there may also be long wait times or the available providers in-network may be entirely at capacity.
2. Reputation: Some therapists have a history of providing excellent care to patients. They have assisted many individuals in overcoming issues like anxiety, fear, despair, rage, and others. A professional therapist's reputation will rise as he helps people address their difficulties. This may result in many favorable reviews, which may cause their service costs to rise.
3. Therapist training: Therapists differ in their levels of expertise and knowledge.  They are well familiar with patients' concerns and know-how to recommend appropriate remedies. To be effective in this sector, they must have undergone extensive training. They are well qualified to assist people with their mental health issues. Therapists with less training or fewer years of experience often have lower session fees, so if the fee is your primary concern, it may be worth looking into providers who are earlier in their careers.
4. Specialization: The discipline of therapy is divided into several parts. Some include anger management, depression, group therapy, marriage counseling, and fear. Therapists that specialize in a specific niche are typically more costly because demand for their specific expertise may be higher than the volume of providers uniquely trained, studied, and equipped to help. It also likely takes many years for them to develop this expertise, which accrued a volume of training and professional expenses. If budget is your primary concern, perhaps seek a provider who is more generalist in their approach, as this may keep cost at bay. 
5. Appointment time: Often, the most sought-after appointment time is in the evening after work, and the therapist only has so many of these session times available. If the fee is a top concern for you, consider seeing a therapist in the morning or afternoon. This time slot will be in less demand, so the therapist will be more likely to be able to discuss a sliding scale (or lower fee) with you. Also, the length of your session will impact the fee. If your session is 90 minutes long, that will cost more than a 30-minute session. If the fee is a barrier for you, consider going to therapy for shorter session durations, as that may be less than half the cost.  
6. Sliding scale therapy: This is a cost structure used by therapists to assist their clients/patients in paying lower rates. It is typically used to help those on tight budgets who wish to experience the benefits that an experienced therapist can provide. If you are interested in going to therapy and have found a therapist who you are interested in seeing, but you are not sure whether you can afford their fee, ask them if they offer a sliding scale. It is possible they will be willing to work with you at a special rate while you get back on your feet.  
7. Type of therapy: There are several kinds of therapy. These may include marriage counseling, group therapy,  couples therapy, and anger management, among others. The fee you will pay will vary depending on which techniques you select. For example, if you choose to hire a group therapist, your cost may range from $30 and $80 per hour. Individual therapists can, however, charge between $100 and $200. If you are ready to begin therapy but cannot afford individual therapy 1:1, consider starting group therapy for a lower fee per session.
8. Chosen center: Different therapy locations and centers will have different policies, rates, and fees for care.. Students, for instance, can often receive free treatment at their institutions, at least for a particular volume of sessions. There are also employee benefit programs targeted at lowering the cost of therapy. Whatever your circumstances, think about what resources may be available to you, and be sure to inquire as to what the behavioral health care benefits and offerings are.
9. Location: This is another essential element that most people overlook when discussing what factors impact the cost of engaging professional therapists. Remember that various specialists incur variable fees throughout a specific period. For example, therapists whose offices are in places with high living costs would charge more than those who work in distant locations.

Virtual vs. In-Person

Different types of therapies can help people work through their mental health concerns. After an increase in mental health obstacles during the COVID-19 epidemic and no access to in-person care, virtual treatment gained traction.

Many people benefit from connecting to treatment from home. Others prefer the neutral area of a therapist's office as a transport away from everyday life and a more concentrated environment.

So, what sets the two methods apart?

Convenience

In-person therapy is less convenient than online counseling. Instead of going to a therapist's office, you can connect to a website from the comfort of your own home. Many virtual therapists provide flexible scheduling, making it easy to schedule a session. Some offer reduced fees for virtual therapy, as the therapist may have lower office fees.

Teletherapy is also beneficial for patients who, for various reasons, are unable to get in-person therapy. They may be disabled, lack transport access, live very far from a treatment facility or are unable to leave their home. Online sessions enable these patients to acquire the therapy they deserve.

Privacy

Online therapy is covered by the Health Insurance Portability and Accountability Act (HIPAA). Your medical records and everything you share in therapy are legally protected. However, use caution while selecting a provider. Some platforms might not have enough privacy measures. 

If you intend to pursue virtual therapy, remember that not all online service providers employ encryption, which might expose your personal information. It is often preferable to have sessions on a secure, HIPAA-compliant network.

If you are ever unsure or in doubt, you can always ask your therapist about the platforms they’ve chosen and verify their HIPAA compliance.

Cost

Pricing models vary by practice, and that remains true between virtual and in-person options, as well. 

Most providers charge by the session, particularly in-person therapists. Some online therapy providers make packages or memberships available to you, which may reduce your cost per session over time if you intend to engage in therapy for a longer time period. 

Confirm with your therapist what the fee per session will be and whether that fee varies for in-person or virtual, and be sure to confirm with your insurance provider to determine if teletherapy is covered.

Types of Therapy

If you are considering therapy, you have a lot of options available to you.  Regardless of the style of treatment you receive, therapy is a profound, healthy way to address your difficulties and make positive changes in your life.

Group Therapists

In group therapy, one or more therapists gather a group of five to fifteen patients. Groups often meet once a week for an hour or two. 

Therapists gather such a group to address a specific issue, such as depression or substance abuse. Often, experiencing the perspectives and coping tools of each group mate and working and processing together can add an even deeper and more connected layer of healing than 1:1 care.

Support Groups

A support group is a meeting of people who are dealing with similar concerns and who share and work through their experiences together. They can give support, encouragement, and consolation to the other group members by discussing their experiences, and they get the same in exchange.

Couples Counselor

Couples therapy is a type of psychotherapy that can improve a couple's relationship. 

Couples counseling may help with various relationship challenges, such as frequent disagreements, feelings of separation, an affair, sex problems, or difficulties caused by external pressures. If you have marital problems, couples counseling might help you restore your connection.

Couples counseling can also be a really fantastic preventive tool to grow stronger and closer in your relationship. If you are considering taking your relationship to the next level or want to get to know each other better, or you’re preparing for marriage and want to work on your communication style, couples counseling could be a great resource for you.

Counselors for Children

Child counseling is a sort of therapy aimed at young children, teenagers, and adolescents going through one or more mental health obstacles. It also helps young people who have undergone trauma or live in a dysfunctional or stressful family setting.

Psychologists

Psychologists assist people in learning to cope with life situations and mental health issues more successfully. Their states authorize them to perform various therapies, including assessments and psychotherapy. To come up with a solution, psychologists use diverse strategies based on the best available data and consider someone's values, traits, objectives, and circumstances.

Conclusion

Regardless of where you are in life or how you feel at this exact moment, therapy may help you. 

Often, the cost is a meaningful barrier to accessing therapy, and navigating insurance and sliding scale can be difficult. We hope that this articular has broken down some of the jargon and has provided you with cost-effective options to access the care that you need.

When you are ready to start therapy, MyWellbeing can connect you with the best therapists without breaking the bank. Most therapists working with MyWellbeing provide sliding scale rates that are less than 50% of their full fee because they are prioritizing FIT.

Share your preferences with a therapist today to receive matches that are likely to be a good fit for you. You can then book free phone consultations to confirm your fit, and book a session with the right fit for you in the same week if you want to. Get started today.