Therapists and Insurance – Helpful Therapy Tips

Often it's difficult to find a therapist who takes your insurance if you don't know where to look. Here's some quick ways that you can find the right therapist who takes your insurance. Find a therapist through your insurance Do an online search Call or email the therapist or the practice to find out if the therapist takes your specific insurance policy If no therapist locally takes your insurance, you may be able to do online counseling/therapy with a therapist in your state, who may not be near youYou may be able to help your chosen therapist get on your insurance panel if they are willing to do soYou may choose to change your insurance carrier if you find that most therapists in your area or your state do not take that specific insuranceFactor in specific specialties the therapist has when deciding on a therapist - even if the therapist takes your insurance Talk to your therapist if your insurance changes during your course of therapy How Do I Find a Therapist Through my Insurance? Many insurances have websites that they provide for their beneficiaries to find providers who are “In Network with them”. “In Network '' means that they have credentialed the provider and added them to their panel. With group practices, it is usually the case where it is the group that is “In Network” and new therapists are credentialed individually with the insurance and added to the group practice. On your insurance card, you probably have an 800 number that you can call and find out how to get a listing of providers and ask questions about your policy. Your policy number is also on the card and you will need to give them that info to get your questions answered. If you don’t understand how to use their website to find the provider you require, call the 800 number and ask for assistance. Some insurance websites are user friendly, some not so much. Many insurances will have a name and licensure of a therapist but not list the therapists’ Specialties. For that,you may want to search online or call the therapist for their specialties. These days, a lot of information is contained on websites about individual therapists, so it is easier to make a better decision concerning if they are a good fit for you before you even call to make the appointment. This is true for individual therapists in their own practices or in group practices that list their therapists online and basic information concerning them. When you call to make the appointment, expect that your insurance will be verified to make sure the therapist is able to take your policy. Within many insurances, there are lots of different policies and each policy is different. It is important that you understand your policy before you make the call. More about that below under the “specific Policy” question. How can I find a Therapist Who Takes my Insurance With Online Search? Use your favorite search engine and search for “therapists near me (your insurance name),” if you are wanting to do in person therapy. IIf you don't mind/prefer doing online counseling, you can search for therapists who take your insurance in your state. Simply search” therapist (list your state) (your insurance).You may want to also in the search include your specific symptoms which will help you find more of a right fit. Example: Therapist ND,ABC Insurance Insomnia, or Therapist Near Me, ABC Insurance Insomnia. Please Note: It is important to know if your insurance policy covers online therapy because of your preference or not being able to find a therapist near you, but are able to find someone else in your state. Call the 800 number on your policy and ask them if they pay for online counseling or use their keywords “telemental health” or “telebehavioral health”. Tell them you are not talking about on the telephonic counseling, but live video counseling. It is important to use the right words in describing this, or you may be misunderstood, which may result in you getting inaccurate information. It is best to ask how many sessions you are allowed to attend each calendar year, what the frequency of attendance can be (example: once or twice a week) what your co-pay is, what your deductible is currently and if it's paid exactly the same as if you went in person to therapy. Some policies waive copays for online therapy during the Public Health Emergency and for other things. It is also important to know if your policy has out-of-network benefits. If you find a therapist that is not “in network” with your insurance and you have out-of-network benefits, your therapist could still bill your session claims to the insurance, if they are willing to do so. You would likely have a bit higher co-pay or deductible if it is out of network, but would still be less expensive in most cases than paying the full rate the therapist charges. In addition, it is important to ask if the out-of-network policy covers telemental health telebehavioral health or counseling whatever keywords your insurance uses. How Can I Find out if a Therapist takes my Specific Policy? Once you have completed the above searches and have the information you need about your policy, you can call or email the therapist or the group practice where the therapist works and inquire about the policy. They will have to verify your insurance,so you will need to give them the policy information so that they can do so and let you know any deductibles or co-pays you have or if they are unable to take that insurance. (Remember that your policy may have exclusions that you are not aware of, and the therapist/scheduler may find these out and inform you of them during the verification process. An example might be that your policy only lets you see psychologists, but the therapist you want to see is a LMFT (Masters level Marriage and Family Therapist). There are too many possible policy exclusions to list here. That is why insurance verification BEFORE you start therapy is important. Verification is to Verify what exactly your benefits cover and if there is any coverage for the specific therapist you are requesting. Before you call to schedule your appointment, make sure you know the policy or policies that you have. If you have more than one policy you need to tell all of the information on all policies to the therapist or the scheduler who verifies your insurance. You will also need to tell them any supplemental policies that you have. Please note that if your primary policy refuses to pay the therapist your secondary policy will not pay either. Their stance is that you should have gone to a therapist who takes your primary policy. Your supplemental policy is the same. Some potential clients believe if they just don't tell the primary policy and pretend like they only have the secondary policy that they know that the therapist is in network with, it won’t cause any issues. It is seen often as a way to “get around the system”. Unfortunately, what happens later is the therapist has to pay back all money paid to them by the secondary insurance once the secondary insurance finds out you had a primary insurance. This is of GREAT loss to the therapist, and may move them towards the decision of taking insurance just isn’t worth it. This retroactive denial of claims could be months to years later, after sessions are long over. That means that you are responsible for paying all of the money back to the therapist. It is important that you find a therapist who takes all insurances that you have. if you have a primary and a supplemental insurance as long as the primary pays the supplemental will always pay and it doesn't matter what that supplemental insurance is. Supplemental Insurances are not Secondary Insurances. https://pocketsense.com/the-difference-between-supplementary-secondary-insurance-12524422.html Do I Have to find a Therapist NEAR Me Who Takes my Insurance or can I see Them Online? Many Insurance companies are now paying for online therapy. Some policies are only covering online therapy through the public health emergency. Others have already had permanent telemental health/ telebehavioral health before the PHE started. There is an uptick of insurances who are looking at making online counseling/telemental Health a permanent benefit for their beneficiaries and are looking at treating these sessions the same as “in person” sessions - something that was rare before the Public Health Emergency. This makes a big difference for providers and their desire to be in network with certain insurances. Before the PHE, many insurances only allowed the beneficiary to see a therapist online through specific large corporate contracts where the therapist got paid very little and to use the platform of that large corporation. A lot of control is taken away from the provider, not to mention being paid a much lower rate for services rendered. Now during the PHE, the choices of online counseling have expanded and it is likely that many insurances will make this permanent - hopefully treating it the same as “in person”, so that there is no need to go through the large corporate online platforms. For online counseling/therapy, it is essential that you know your current insurance policy online counseling benefits and what they plan to do for future online therapy. Don’t be afraid to call and ask them. Feedback from beneficiaries can be much more powerful than feedback from providers. If your policy does not cover online, you may consider changing policies in the future to ensure you have this option. . Whether online or in person, you will only be able to see a therapist who is licensed in your state. You will not be able to find a therapist in another state who will be able to see you unless they are licensed in your state AND your insurance policy allows a therapist who practices and lives in another state to provide services to you. Not all insurances allow this - even during the PHE. What do I do if I Find a therapist I Like Who Does Not Take my Insurance? In certain situations if you live in a rural area or in a place where there aren't many therapists who are available to take your insurance. you may be able to talk with your insurance company to get your chosen therapist in the network. The therapist may choose not to do this however, see my article on the reasons at the bottom of this page. If you have out-of-network benefits, some therapists may choose to file claims for the sessions as they don't have to be an in-network therapist to do this. Many therapists don’t know how to do this correctly, so choose not to. Using out-of-network benefits would mean that you would likely pay more for the deductible and copays. What If My Insurance Changes While I am in Therapy? Make sure that you tell your therapist immediately when you know a change is coming up. The therapist can let you know if they will be able to take your new insurance or not. If not, you may want to schedule enough sessions before the change to wrap up what you can. You may also decide to pay out of pocket for a few sessions or more after the end date of when you are covered by the insurance that the therapist takes. You may also go back to the beginning and search for a new therapist who takes your new insurance and/or ask if your therapist has a referral to someone she knows/trusts that takes your new insurance. How can I Choose the Insurance that Most Therapists Take When it's Time to Make my Insurance Change Decisions? When you do your searches online you will start seeing the insurances that come up that most therapists take. You will start seeing a pattern. Many therapists do not take insurance, however the ones who do -and have been in practice for a while- stick with the more user-friendly insurances, as they don't have to spend a lot of time trying to get session claims paid. (See post at the bottom of this page.) Based on your searches, if you are able to change insurances, decide your best choice by starting with that insurance and then asking specifics about their therapy policies. Do they include Telemental Health? Do they include out of network benefits? Some companies allow insurance changes once a year. If you have your own individual insurance policy, you may want to look into other policies, if you are having difficulty finding someone who would be a good fit for you who takes your insurance. It could save you money in the long run not only for therapy but also for other health practitioners. A user friendly insurance for one kind of practitioner, is probably user friendly for other health practitioners. What Other Factors are Important When Looking for a Therapist Who Takes My Insurance? It is always important to look for the right fit therapist for you. For example, if you are having anxiety, you don't want to look for a therapist who specializes in depression only. If you are looking for therapy for your nine-year-old child, you don't want to find a therapist who specializes in working with seniors., even if they take your insurance. Takeaways: For potential and current clients: Do your due diligence in finding the right therapist by taking the steps above and making sure that you tell them ALL of your policies so that everything is smooth and there is no extra expense for either you or your therapist. For potential therapists: Know that insurances can be complicated and that it is very important that you understand all pieces of insurance, such as deductibles, co-pays, out-of-network, in network, etc., before you get started or you could be very frustrated with insurances and wind up not taking insurances (which may preclude you from helping the very people you got into this business to help). This website will offer many clues and items to be aware of so that you can make good choices. For current therapists: Review your insurance policy contracts and your internal process policies so that you are aware of what needs to be done, and what you can and cannot do. Ensure that verification is done efficiently before the very first session so that surprises do not come later and negatively affect the therapeutic relationship.