In-Network vs. Out-of-Network Therapists
What does in-network therapist mean?
A therapist is considered in-network if they have a contract with your health insurance company to accept a set fee for every session. Working with an in-network therapist is typically more affordable than out-of-network therapists because your health insurance pays the bulk of the therapy session fee and you only pay the copay amount.
How much does it cost to see an in-network therapist?
The cost of an in-network therapy session depends on your deductible and copay amounts. Copays typically ranges from $20 - $40 per session.
However, if you have a high deductible plan, you may have to pay more upfront before your health insurance benefits apply. For example, if you have a deductible of $3,000 and have no other medical costs, you may be paying the same amount overall, whether you see an in-network therapist or an out-of-therapist.
What does out-of-network therapist mean?
A therapist is out-of-network if they don't have an agreement with your health insurance company and set their own professional fees. Therapists may choose to be in-network with many, some, or no health insurances at all.
How do out-of-network therapy sessions work?
When you see an out-of-network therapist, you pay the full session fee at each appointment. Therapy session fees vary by geography, therapist education level, and years of experience.
How much are out-of-network therapy sessions?
Psychologists, who have doctorate degrees, may charge higher rates than social workers and counselors who have masters degrees. Therapists with particular specialties such as an eating disorder or substance use expertise will charge higher rates. Psychiatrists (who are medical doctors and can prescribe medications) charge the highest rates, often above $300 per session.
To offset costs, consider using your health insurance plan’s out-of-network benefits. If you work at a company that boasts great benefits, such as large tech companies like Google, it’s very likely you have generous out-of-network benefits.
How do I use out-of-network health insurance benefits for therapy?
Here is how to use your out-of-network health insurance benefits for therapy:
- Pay the full session fee at your therapy session.
- Mail, fax, or submit a claim online to the insurance company. The claim may be submitted after every session, or in aggregate every month.
- The insurance company will send you a reimbursement in the form of a check.
As a result of the reimbursement from your insurance company, you ultimately pay only a set percentage of the therapist's fee, for example, 30% of the session fee.
What are the benefits of seeing out-of-network therapists?
You may consider seeing an out-of-network therapist if you are looking for a therapist with a unique specialty, seeking highly personalized services, and/or have a high deductible health insurance plan such that you would have a high out-of-pocket cost either way.
Here are additional reasons people seek out-of-network therapy services:
- You’re looking for a therapist with a unique skill set
- You want highly personalized services
- You have a high deductible plan or good out-of-network benefits
- You don’t wish to use insurance benefits
- You don’t want to wait to start therapy
- You found a great match!
Find in-network and out-of-network therapists on Zencare
Use Zencare.co to find your ideal in-network or out-of-network therapist. Try searching by in-network providers, and expand your search by session fees to find the right fit for you.