How Do I Pay for Counseling?

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Counseling isn’t free, and there are good reasons for this (read more about that here). But how will you pay for it? You typically have one of two options.

  1. Pay out of pocket (called self-pay).
  2. Use your health insurance benefits.

If you are one of the approximately 300 million Americans who has health insurance coverage, you will likely want to use that. (Read this post for the basics.) However, there may be some instances when you would not use insurance.

  1. Your condition does not meet medical necessity– if you are coming in for a brief problem (such as a job change or a move) with no real mental health symptoms (such as anxiety or depression), you will not meet the minimum criteria for a medical diagnosis, and therefore insurance will not cover your visits. If this is the case, you can opt to pay out of pocket. Another option, if your company has one, is to consult your Employee Assistance Program, or EAP. The EAP can link you with a counselor for a few sessions at no charge.
  2. You are concerned about confidentiality– When you use your health insurance to cover medical costs, you are agreeing to two things. One, that you will be given a medical diagnosis (see #1) and two, that any information the insurance company deems necessary will be released to them. This can include session notes, treatment plans, and diagnoses. The insurance company is prohibited by law to release this information to your employer; however, some people do worry about this. You can easily opt out of using your health insurance by signing a form with your therapist.
  3. You have a very high deductible plan– If you have a high deductible, you may find the cost of weekly therapy sessions to be cost prohibitive. For example, if you have a 15,000 deductible, it is unlikely that you will meet this unless you have a lot of medical problems, or major surgery. Weekly therapy sessions at the regular fee could run $400-500 per month. In this case, you may choose to opt out of using your insurance and work with one of our therapists that offers an income-based sliding fee scale. While you would not be contributing to your deductible, you would have a lower out of pocket by working on a sliding scale.

If you do not have adequate health insurance, or if your insurance does not offer mental health benefits, self-payment will be the best option for you. Our rates currently start at $125 per session, and we have two therapists who use an income-based sliding fee scale for those who need it. Please call us today at 317-743-8202 and we will make every effort to accommodate your needs.

All About Health Insurance

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You finally decided you need a counselor. You’ve done your research and found someone that seems like a good fit. The next step is to make an appointment and dive in, right?

Not exactly.

There’s one more step that is easy to skip, but if you take the time to do it now, I promise it will save some headaches down the road.

You’ve got to figure out how to pay for it.

Counseling isn’t free, and there are good reasons for this (read more about that here). But how will you pay for it? You typically have one of two options.

  1. Pay out of pocket (called self-pay).
  2. Use your health insurance benefits.

(If you’re not sure, read this post first to help you decide.)

If you decide to use your health insurance benefits, you will need to know two things.

  1. Does your policy offer mental health benefits? If so, what are they? (If you are doing teletherapy, you will need to check that your policy covers it as well.)
  2. Is the therapist you choose in network with your health insurance?

There are three ways to find out about your benefits.

  1. Consult the information you received when you enrolled in the plan. Benefits are usually listed in detail in this printed material. Often, you can also access this on your company’s HR site.
  2. Log in to your policy online. Go to your insurance company website and sign up for online access. You will need your member number/ID.
  3. Call the number on the back of your card.

As for benefits, these are the numbers you need to know:

Your deductible – this is the amount that you will need to pay out of pocket before your insurance benefits kick in. This number varies greatly among different types of insurance policies. Some people have 0 deductible, while others have a very high deductible. In January, this will be a very important number to you!

Your copay or co-insurance – this is the amount you will need to pay per visit. This is either a fixed amount, or a percentage of what is called the allowable (the maximum amount the insurance company will pay for a particular service).

To find out if your therapist is in network, the easiest way is to ask them (believe me, they will know.) Otherwise, you can call your insurance company or go to the website to find a list of providers in your area.

Generations Counseling Services is currently in network with Anthem Blue Cross/Blue Shield and CareSource (offered through the Marketplace). We do not accept any Medicaid or Medicare plans at this time. If you have an out of state Blue Cross/Blue Shield policy, it will still typically be covered in network. We ask that all clients leave a credit card on file to cover deductibles and copays, and payment is due at the time of service.

In order to use your insurance, please have your information (Member ID, Group number and date of birth) available when you call for your first appointment. We want to provide you with the most seamless care possible, and taking a few moments to make payment arrangements and verify your insurance benefits will make a big difference!

Why Isn’t Therapy Free?

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A few years into my career, I was chatting with an acquaintance about another acquaintance that had gone through a horrible tragedy. Knowing that I was a therapist, she said, “You need to help her.” Then, “And you shouldn’t make it about the money.” She went on to say how a lot of counselors are just in it for money, and that they should just help people because it’s the right thing to do. I was a little rattled – and offended – and although I responded appropriately, I thought of some way better comebacks a few days later.

That exchange got me to thinking a lot about why we counselors charge for our services, and why we need to feel more confident about doing so. If you struggle with the idea of paying for therapy, consider these reasons.

  1. We have significant training and expertise –At the minimum, a licensed master’s level therapist has 2-3 years of post-bachelor’s education and must complete several thousand hours of supervised practice. We must meet state criteria for licensure and are accountable to our state boards of professional regulation. Each year we must complete a minimum number of clinical training hours to keep our licenses current. We also carry malpractice insurance. Many therapists have also obtained additional certificates and training beyond their minimum coursework. When you work with a licensed therapist, you are working with a highly-trained professional.
  2. The therapeutic relationship is not a normal relationship– While good therapy involves talking and laughter maybe even drinking coffee, it is much different than chatting with a friend. Therapy is a one-way relationship, meaning that it is all about the person who is not sitting in the therapist’s chair. It’s one place you get to talk about you all the time, without feeling guilty or worrying about the other person’s needs. Paying the person in the therapist’s chair helps alleviate some of this guilt and allows for important boundaries to be drawn around the relationship.
  3. The therapist is doing more than “just listening”– At every appointment, whether or not you realize it, your therapist is evaluating, assessing and formulating the appropriate treatment. We assess the safety level of our clients, their symptoms, functioning and their interpersonal needs. We make recommendations about what needs to be done to keep people safe, improve their quality of life and help solve their problems. We listen and watch our clients much, much differently than we do people in our other relationships.

Despite all the training and the vetting, not all therapists are created equally. If you feel that your therapist is not honoring the sanctity of your relationship, or if you feel you are not “getting what you pay for,” then it is critically important to talk through this with your provider.

Need more? If you are feeling stuck and need some outside help in managing your communication, emotions, or relationships, our team at Generations Counseling is available! Give us a call at 317-743-8202 or email at: [email protected] today.