Why Some Therapists Don’t Accept Insurance

Finding a therapist can be a challenging task. You need to find someone who is licensed, has experience with your specific concerns, and who you feel comfortable being open with. Many people experience the frustration of identifying a therapist who meets all these criteria, only to discover they don’t accept insurance. In fact, approximately one-third of therapists in the U.S. do not take insurance, a figure that tends to be even higher in larger urban areas like Washington, D.C.

Why Many Therapists Don't Accept Insurance

There are actually quite a few reasons why some therapists choose not accept insurance from patients:

Low Reimbursement Rates

The average cost of a therapy session typically ranges from $150 to $200. Patients often expect to pay a copay of $20 to $50, with the assumption that the therapist will be reimbursed for the remainder. However, insurance companies frequently reimburse only a fraction of the session cost, making it difficult for therapists to earn a sustainable living. 

Difficulty Working with Insurances

Another reason therapists may shy away from insurance is the cumbersome process involved in working with insurance companies. Therapists are often required to submit extensive documentation to justify the treatment, and proving the necessity of mental health care can be more challenging than for physical health treatments. Even then, insurances can deny claims, or only approve a number of sessions allotted for particular diagnoses, regardless of the clinician's recommendations.

Supply and Demand

The demand for mental health therapy has surged, particularly since the COVID-19 pandemic. With many individuals willing to pay out of pocket, therapists may find less need to navigate the complexities of insurance.

Finding Affordable Mental Health Care

If you’re on a budget, there are still options for accessing quality therapy without breaking the bank.

Out of Network Benefits

Check your health insurance plan for any out-of-network benefits. You might be eligible for partial reimbursement by submitting your receipts for therapy sessions, which could help offset costs after meeting your deductible.

Sliding Scale

Look for therapists who offer sliding scale fees. This means the cost of therapy varies based on a client’s income, making it more affordable for those with limited financial resources. Many clinicians in training also offer lower rates.

Employee Assistance Plans

Some employers provide a set number of therapy sessions as part of their benefits package. For instance, I collaborate with Lyra, which partners with various large organizations to offer employees up to 26 sessions per year.

Don't let the sticker price shock you out of acquiring mental health therapy. 

SOURCES:

https://www.psychology.org/resources/therapists-who-dont-accept-insurance/

https://www.heartmatterstherapy.com/post/5-reasons-why-some-therapists-do-not-accept-insurance

https://mendmoderntherapy.com/3-reasons-why-many-therapists-dont-take-insurance/