On Paying For Therapy

You've decided you want therapy and have narrowed down your criteria. It's almost time to start your search. Let's pause here for a moment to talk about money, because your budget will make a big difference when you start reaching out.

Also, if you're like many people, one of the biggest questions you may have is How am I going to pay for therapy?

Luckily there are options for every budget and what follows are some common examples.

Using EAP benefits (cost: free!)

First, let's talk about the free option you may not be aware of, and that's the one offered through your employer's EAP, or Employee Assistance Program.

Your employer may or may not offer one, but if this sounds familiar, you may have glanced at an EAP worksheet when signing your new hire paperwork, or perhaps you delete their monthly wellness newsletters.

EAPs typically offer, among other things, three to five counseling sessions per issue.

So, say you are having anxiety about your impending wedding. You can get approval for one set of sessions with an approved EAP therapist.

Now say that after a month of meeting, you receive an eviction notice. You can get approval for another set of sessions following the first.

This is a great option if you want or need to talk with someone, but don't have a big budget and aren't interested in longer-term work. It's also a great choice for those who are action-oriented and want to explore some solution-focused conversations with a professional.

Paying Out of Pocket without Insurance (cost: $0-200)

This category affords you the most therapist options and a huge spectrum of price points. Sessions are limited only by your wants and needs. 

Paying purely out of pocket, weekly sessions can still range from $0 - $250, the lower end being in clinics, in which therapists are still in training, the higher end being PhD level clinicians with many many years of experience.

There are talented clinicians at each point on this spectrum. I like to remind people that every wonderful seasoned clinician was at the start of her career at some point. 

In San Francisco, you're going to see many Masters level clinicians (MFTs and LCSWs) with a full fee in the $150 – 200 range. Of those, many offer a limited amount of sliding scale slots, either based on income or category (e.g., students). 

If thinking about paying on the mid- to higher end on a weekly basis feels overwhelming, you are not alone (if you're feeling so tense that you want to stop reading and you have insurance, especially if you have a PPO plan, I urge you to simply skip to the next session or consider a lower-fee clinic option).

Paying for therapy can be an adjustment and may require some reprioritizing of your funds.

It may help to consider some of the ways you are currently spending money, particularly if you're doing it in a way that makes you feel good in the short term, but isn't helping in the long term (read: copious online shopping, expensive dinners out, drugs/booze, etc.).

On a more meaningful level, if you peek back at the elements of your emotional life that you're looking to nurture, you can also ask the question Can I afford not to make a change?

Picture moving through the next five, ten, twenty years feeling weighed down by the same feelings, habits, and relationships you currently struggle with. Picture retiring and having time to be with the self that is struggling. 

Imagine next what it would feel like to lighten that load. Picture being in a phase of life where you not only feel comfortable in your own skin, but have chosen the right people to be in your circle.

Envision that you've made meaning of your past, can be present in the present, and look forward to the future. These are a few key areas therapy can help address.

The short term investment may uncover a priceless part of you.

Therapy is absolutely not the only way to make a change, but it's one good option. I heard one woman recently described her weekly therapy as “a gift to herself,” which I thought was a lovely perspective.

Using Your Insurance (cost: varies, $5 - 100+)

Let's move on to talk about insurance, so we can put it all together. This option will open the door to lower weekly payments and a moderate range of therapist options.

Sessions may be limited to certain number per year, but some insurance companies are quite generous, so it's worth checking out. 

In the post that follows I will give you key questions to ask your insurance provider in order to get the details of your plan. But here's a general run down of how it works.

If you have an HMO plan you will have the least amount of options, as you'll have to choose from only in-network providers. However, you may pay a co-payment of $10 - $40 per session, with many in the $20 range.

If you have a PPO plan, you'll likely have options for in- or out-of network providers, and this opens you up to a lot of possibilities.

You may have a deductable to meet initially, ranging from a couple hundred to a couple thousand dollars, but then you may have either a co-payment or co-insurance (in network, I've seen as low as 10%, out of network 30 – 80%).

In this set up, you will likely pay the fee and then be reimbursed by your insurance company. With so many clinicians offering the option to pay via credit card, you should be able to use your reimbursement to pay a portion of it off. 

Looking back up to the numbers, let's say your therapist's fee is $120. Depending on your plan, once reimbursed you will instead be paying in the range of $12 - $36 - $96.

That's a range of overpriced sandwich to mani-pedi to dinner with friends having ordered that second bottle of wine to share. I've said it before and I'll say it again: Perspective is everything. 

The majority of my clients fall into this category and I've learned about these terrific insurance benefits through my direct experience with them.

As a bonus, many use FSA/HSA accounts to pay for sessions (better explained here than by me), but essentially these accounts use pre-taxed money to pay for medical expenses, and therapy fees are often covered. 

Okay, I know it's a lot to digest, but now you have some basic information about paying for therapy.

Take a little time and think about what option (or options) suits you best, all things considered (including sandwiches). 

Yours in wellness, self-care and compassion,

Shana

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​Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.