You may be considering therapy but feel overwhelmed or limited by the financial aspect of it all. In some cases, it can be a little more complex than going to see your primary care doctor. You may decide that you would like to begin therapy but don’t know where to start. You could get referrals from friends, google, or your insurance company. But, what do you do with that information? 

The Basics

Like other medical settings, licensed therapists, or group practices can decide which insurance panels they are on. This means they can decide which insurance companies they are “in-network” with. Some panels are already closed. So, they will not take new providers so sometimes it is impossible for us to get on their panel. Other times, the insurance provider contracts out the mental health coverage. This can be a real pain for everyone. The provider that is on your card is not actually who you have mental health benefits through. For example, you might have Blue Cross Blue Shield insurance for everything except mental health. That might be through another company with which the therapist is not in-network. Confusing right? It is for us therapists too! Usually, clients or therapists can bill an out-of-network claim. But, we never know how much will get covered.

In-network, out-of-network, what?

In some insurance plans, you have to meet their deductible before they will pay anything. Some high deductible plans could have you paying the full rate the entire time you are in therapy. At that point, you might want to consider doing the therapist’s private pay rate instead. There can be major benefits to that! Sometimes you will owe your co-pay. Sometimes that is the primary care co-pay. Other times, mental health falls under the “specialist” co-pay. We can check that for you! 

Deductibles, Co-Pays, and Private Pay Rates

In some insurance plans, you have to meet their deductible before they will pay anything. Some high deductible plans could have you paying the full rate the entire time you are in therapy. At that point, you might want to consider doing the therapist’s private pay rate instead. There can be major benefits to that! Sometimes you will just owe your co-pay. Sometimes that is the primary care co-pay and sometimes mental health falls under the “specialist” co-pay. We can check that for you! 

Private Pay Benefits

At the end of the day, the most important thing is getting the care and expertise you need. Many times, private pay can be the way to do this. Private pay cuts out all the insurance hassle and has benefits for you. With billing the insurance, the therapist needs to give a diagnosis at the end of the first session. This diagnosis is a part of your health record. Also note that now, couples counseling is not covered by insurance. If you want to start couples counseling and use insurance, we will have to bill it under one person’s name. Then, we will give only one person a diagnosis for the couple. The private pay rate can often also be less expensive than paying the full rate toward your deductible. 

Begin Therapy in Wake Forest, NC, Raleigh, NC, or Fuquay Varina, NC

We know that this can be complex and finances can be limiting. But, our team is here to help every step of the way and wants to connect you with the best expert for your situation. Please reach out if you are considering beginning therapy and let us answer your questions. We are here for you in Fuquay-Varina, Raleigh, and Wake Forest. If you are ready to start your therapy journey, follow these simple steps: 

1. Request an appointment
2. Get to know our team
3. Start overcoming the issues affecting you most

Counseling Services Offered at Foundations Family Therapy

We offer a variety of services from our Wake Forest, Raleigh, and Fuquay offices. This includes online therapy in North Carolina, and services for teens, young adults, families, and couples. In addition, we offer Christian counseling, infertility therapy, therapy for anxiety, grief, depression, and recovery from trauma. For more helpful information, visit our blog or FAQ today!