Why Out-of-Network Therapy Might Be More Affordable Than You Think
If you’re wondering whether out-of-network therapy is worth the cost, you’re not alone. When people see “out-of-network,” they often assume therapy will be too expensive. But in reality, using an out-of-network (OON) therapist can sometimes be surprisingly affordable. Here’s why:
Insurance Reimbursement: Many plans reimburse a large portion of OON therapy costs after you meet your deductible.
Fewer Limitations: OON therapists aren’t bound by the same restrictions insurance companies place on in-network care, which often means longer sessions and more personalized support.
Health Savings Accounts (HSA/FSA): You can often use pre-tax dollars to pay for therapy, lowering your overall cost.
How does out-of-network reimbursement work?
The best way to verify if you have out-of-network benefits is to call the number on the back of your insurance card and speak to your insurance carrier. If your insurance provides out-of-network coverage for services, you could be reimbursed for a portion or the full amount of each session cost. Services are paid for out of pocket and then reimbursements are made directly to you by your insurance company if you have out-of-network coverage.
Important questions to ask your insurance provider to ensure reimbursement are:
Do I have out-of-network benefits for outpatient mental health services?”
What is my deductible and has it been met?
How many mental health sessions per calendar year does my insurance plan cover?
How much does my plan cover for an out-of-network mental health provider?
Your insurance company may ask you for the “service code.” If they do, you can give them the following codes that apply to the therapy you are seeking:
90791: Intake session
90834/90837: Individual session
Before ruling it out, check your benefits—you may find that OON therapy costs about the same (or even less) than you expected.