You’re overwhelmed, stressed, unhappy in your relationship and starting to think maybe a therapist could help. But finding the right therapist is intimidating. And, once you find them, how do you afford them? Don’t worry, I got you covered. But first you might be wondering…
Why is Therapy so Expensive?
Therapy is a highly skilled profession. It requires a master’s degree and extensive training. Plus we have more work than just be in session with clients. In addition to seeing clients, we prepare for sessions, write notes, and run a business. Because we can’t do 40 sessions a week (or even 30) without burning out, we have a higher hourly fee. And, because most of us are self-employed, that rate allows us to take a vacation and come back rested and refreshed. So, all things considered, that $150 isn’t such a ludicrous fee.
How do People Pay for Therapy?
When it comes to paying for therapy you have three options. You can use your insurance, pay a sliding scale or reduced fee, or pay the therapist’s full price. I’ll go through each of these options so you have an idea of the advantages and disadvantages of each. And hopefully you’ll feel confident in knowing what option is right for you and your loved ones.
Every therapist has a different way of handling fees. Some quote prices based on income. Others are open to negotiation of fee. And some, like myself, have a couple of reduced fee slots and then see everyone else at full price.
Using your insurance
There are two ways to use insurance. The first is by finding an “in-network” therapist. The therapist will submit the claim to the insurance company on your behalf and you will only be responsible for your copay, coinsurance, and/or deductible. While this is often the most desirable for a lot of people, this is also the hardest way to use your insurance. Why? Because you are limited to the therapists who are in-network with your plan. And if you have an HMO, Medicaid, or even most PPO plans, finding a good therapist on your plan is a struggle.
The second option for using insurance is by using your “out-of-network” benefits. This means that you pay the therapist out of pocket and submit a “superbill” to the insurance company for (partial) reimbursement. Many clients find that this makes seeing a therapist more affordable. But not all plans have out-of-network benefits. So you want to check before assuming that your insurance will reimburse some of your out-of-pocket expenses.
Why is it so hard to find a therapist that takes my insurance?
The struggle is real. I’ve been on HMOs and PPOs and needed to use my insurance to pay for therapy in the past. I have since stopped relying on insurance to pay for therapy, but at the time it was a struggle to find someone that took my insurance. Actually finding someone wasn’t terrible. The problem was finding someone good, someone who was the right fit. Therapeutic fit is the biggest predictor of success in therapy. So, if you want things to get better, you want to find the right therapist. And it can be hard if you’re limited to those who are in-network with your insurance.
There are a few reasons why many therapists don’t take (many) insurance plans. The first is that most insurance plans reimburse poorly. And, in order to provide quality therapy, we have to limit the amount of clients we see per week. If I took insurance, I’d have to see double the clients I currently see. This means that I’d be burnt out and wouldn’t be able to provide high quality therapy.
Secondly, using your insurance requires that your therapist give you a mental health diagnosis. When couples seek me out for therapy it is rare that it’s because of a mental health diagnosis and, while I use research-backed approaches, my techniques are not in compliance with insurance company’s requirements. So I can’t comply with my personal and professional ethics and an insurance contract.
Seeing a Specialist
Now there are plenty of generalists who take insurance if you’re looking for run-of-the-mill therapy. But if you’re looking for a specialist (such as a couples therapist, sex therapist, or someone who does EMDR), it can be even harder to find someone in network. There are a couple of reasons for this. First, specialists spend a lot more time and money on training. In addition to my master’s degree, I’ve spend thousands of dollars on training for my two specialties: couples therapy and discernment counseling. My fee reflects my training. Secondly, insurance limits how therapists can practice (time of sessions, frequency, length, who’s included in therapy, and what you focus on in session). This makes certain specialties (like couples therapy and discernment counseling) very hard to do within the confines of insurance.
If you’re struggling to find a therapist who takes your insurance but you don’t have the means to pay full-fee, there is another option…
Sliding Scale/Reduced Fee Therapy
This is a popular option when in-network options and funds are both limited. It gives you a little more flexibility with who you are able to see, doesn’t require an insurance diagnosis, and allows you more control over therapy. Because I believe in accessibility of therapy, I offer a couple of reduced fee slots for people who need them. Those, as you can imagine, are almost always filled.
The downside to this option is that not all therapists are able to take on clients at a reduced fee. To be able to maintain our own standard of living, we do have to be cognizant of our personal and business needs. Which is why I cap the number of sliding scale spots. So you might not be able to see the therapist that you wish to work with on a sliding scale fee.
However, with some creative budgeting, I’ve seen many clients be able to afford my full fee.
For many people, affording a therapists fee is doable. Even if it feels like a stretch…
How to Afford a Therapist’s Full Fee
This option is not just for the rich. In fact, none of my clients would say they were wealthy and many wouldn’t even consider themselves well-off. But they see me for therapy because they have decided that their well-being and their marriage is worth the $150 a session price tag. Therapy is an investment. And, I’ve always said, a co-pay is too much to pay for bad therapy. I would know, I’ve done it. And afterwards, I was more than happy to shell out money for a good therapist.
For some people, paying out of pocket requires sacrifices. It means focusing on what you want most (feeling connected to your partner, being satisfied in your relationship, feeling confident and happy) over what you want right now (your daily Starbucks latte, a new pair of shoes, a trip abroad). My clients know that an investment in therapy means an investment in their future and that they’ll enjoy that latte, trip abroad, and new kicks more when they’re happy in their relationship and life.
While some clients are able to move around things in their budget to accommodate something as important as therapy/their marriage, other clients have been resourceful in other ways. In order to afford therapy, some clients use a Health Savings Account (HSA), Flexible Spending Account (FSA), or Health Reimbursement Arrangement (HRA) to cover the costs. Others have supportive family members who’ve helped foot the bill for a period of time.
No matter what option you choose, your mental health and your relationship are important. So you want to make sure you’re investing wisely and pick the right therapist to help you. If you’re thinking about couples therapy, check out the link to my comprehensive guide to choosing a good couples therapist below.
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