Step 1: Determine your coverage
Call the number on the back of your insurance card or access your account online. Determine whether your plan covers psychotherapy, whether there are any session limits, and whether you need a referral or can self-refer to a behavioral health provider.
Step 2: Obtain information about your deductible and copay or coinsurance
Determine the amounts of your deductible and copay or coinsurance, and how much of your deductible you have already met. These amounts are defined below:
Deductible: The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. For example, if you have a $1,000 deductible, you must pay $1,000 for your own care out-of-pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.
Copay: Your copay is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your health provider and a $10 copay for each monthly medication.
Coinsurance: Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
Step 3: Determine if your provider is “in network” or “out of network”
A network is a list of health care providers who have agreed to accept your health insurance. Health insurers contract with these providers to pay rates that are often lower than their cash-pay prices. When you are seen by an in network provider, your bills may be cheaper than if you go out-of-network and what you pay will count toward your deductible. If you get care from an out-of-network provider, you may have to pay the entire bill yourself or the portion you pay may be larger (e.g., 40% versus 20% for an in network provider). What you pay may not count toward your deductible, or it may be applied toward a “out of network” deductible that is larger than your “in network” deductible.
Step 4: Obtain information about your provider’s rates
As your provider what their rates for services are. For an in network provider, these amounts will what your provider has contracted with your insurance company.
Step 5: Estimate how many psychotherapy sessions will be needed
It is impossible to precisely determine in advance how many sessions will be needed. However it is possible to arrive at a general estimate in consultation with your therapist. The number of sessions will depend on several factors, including the nature of the challenges you are facing, your goals for therapy, the therapeutic approach, the amount of work you put into therapy, and your rate of progress.
Step 6: Do the math
Start with a general estimate of how many sessions may be needed, or a certain range of sessions (e.g., 10 to 16 sessions). Determine the cost of sessions depending on whether you have met your deductible and the amount of your copay or coinsurance.
You can also compare the costs of seeing in network providers versus out of network providers. Often, your total costs will be lower seeing an in network provider, however there may be some situations in which it may cost less to see an out of network provider.
If you are concerned about being able to afford therapy
There are two major strategies to controlling the cost of psychotherapy. One way is to seek providers who offer lower cost services. The county mental health departments offer lower cost psychotherapeutic services to people who qualify. Some psychotherapists sometimes offer what is called a "sliding scale" (a fee based on a patient's ability to pay). Unlicensed psychotherapists who are being supervised by a licensed therapist typically cost less. Group psychotherapy is another lower cost option. For more information about lower-cost services in our area, visit the following webpage:
https://sites.google.com/site/ccbhreferrals/services/lower-cost-services
Another major strategy is to work with your therapist to increase the efficiency of your therapy. Ways to do this include: (A) Set clearly defined treatment goals; (B) collaboratively work with your therapist to establish a clearly defined treatment plan; (C) (D) utilize well-selected self-help materials that supplement the work you are doing in session; and (D) engage in a significant amount of psychotherapeutic activities (i.e., homework) outside your sessions.