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How to afford therapy when you can't find an in-network provider

If you are one of the many, many Americans who can’t seem to find that holy grail–an amazing therapist who is in-network with your insurance–you may want to consider some of these strategies to help make therapy a bit more affordable.

Look for therapists who offer a sliding scale option.

Many therapists have a certain number of “slots” on their caseload allocated for sliding scale. How many sliding scale slots they have available, and the extent to which they can lower their fee, depends on a variety of factors, such as the therapist’s own cost of living, student loan burden, overhead, and financial goals. If you find a therapist who seems like they may be a good fit, there's no shame in asking about a sliding scale rate!

Find out if you have out-of-network coverage through your insurance.

Some insurance plans will reimburse you for a certain percentage of the fee you pay your therapist. The way this usually works is:

  1. You pay your therapist the full fee at the beginning or end of each session

  2. Once per month, your therapist gives you a “superbill” which lists all the sessions for that month.

  3. You submit the superbill to your insurance

  4. They reimburse you for a portion of the fee (this can take several weeks)

Be aware that sometimes, your insurance provider may decide that your therapist’s fee is too high, and they will only reimburse you for a percentage of what they think is a reasonable fee. For instance, your therapist’s fee might be $225, but your insurance might think that a more reasonable fee for this service is $175. They might reimburse you for a percentage of the $175, but you would be left to cover the balance of your therapist’s actual fee.

Use your HSA or HCFSA.

Often employers will offer a Health Savings Account (HSA) or a Health Care Flexible Spending Account (HCFSA) as part of their benefits package. These types of accounts allow you to set aside money for healthcare expenses on a pre-tax basis. Sometimes your employer might even contribute money to your account. By using your HSA or HCFSA to pay for therapy, you can save some money on taxes.

Look for a less experienced therapist.

There are plenty of extremely qualified, talented therapists who are earlier in their careers and are not yet fully licensed. These therapists are working under the direct supervision of a more experienced therapist, and they are often in the process of receiving advanced training in their speciality. Trying looking for an LMSW (as opposed to LCSW), MHC (as opposed to LMHC), post-doctoral fellow (as opposed to a PhD or PsyD), or even an intern, and you may find that their rates are much more doable. The most important thing is to find somebody who you connect with.

You might even be able to use these ideas in combination. For instance, you could use your HCFSA to pay your therapists’ full fee, then use your out-of-network benefits to get reimbursed for some of the cost. If you do your research and get creative, you may be surprised to find that you actually can access quality therapy without too much of a financial hit.

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