Santa Barbara counseling services
Answers to your therapy insurance questions!
Have peace of mind by knowing how much therapy will cost,
before you walk through the door.
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What therapy insurance do you accept, and how does it work? I'm "in network" for Blue Cross. For all other insurance I'm "out of network." How much do I pay at each session? 1. Blue Cross:
2. All other insurance (out of network):
*Amounts vary according to specific insurance plan. |
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How do I start using therapy insurance? Before your first session, give a quick call to customer service (phone number is on the back of your insurance card) and tell them you need to know your mental health insurance benefits to find out how much therapy will cost. |
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Ask your customer service representative these questions, and write down the answers to bring to session, along with your insurance card:
Why do I need to call my insurance to find out about my benefits?
Increasingly, mental health therapy insurance benefit details vary, even within the same insurance company.
Do I need a diagnosis to use insurance?
Yes. Insurance companies typically cover treatment that is "medically necessary." This means that the patient has symptoms beyond what might be considered expected for the stressor. Also, insurance companies require a diagnosis on the claim, or the the claim won't be accepted.
For example, "Major Depressive Disorder" is a diagnosis, but "divorce" is not. True, a divorce is usually emotionally painful, but it's not assumed the person has a psychological disorder.
If I don't have a diagnosis, do I still have to pay for the first session?
If in our first session it appears that you don't have a disorder, you have two options:
- Continue the regular session anyway and pay my private rate, or
- Change our session to a "30-Minute Consultation" for a charge of $40. We can discuss together what your best options are.
If I don't have a diagnosis, should I still get counseling?
Yes, if you want it. Many clients do not have a diagnosable condition. They simply desire the perspective and support of a psychology professional. I think of it as similar to getting any type of professional care, such as the dentist, mechanic, spiritual advisor, financial planner, or exercise trainer.
Counseling can reduce suffering, give you ideas, techniques, education, and help you solve problems or cope effectively earlier. You can also get counseling for personal growth issues, coaching for success with specific goals (weight loss, job change, etc.), career or family planning, or for other issues that aren't causing you diagnose-able symptoms.
If I pay for sessions myself, is there any way to keep the costs down?
Yes. Financial concerns are common. We can adjust how often we have a session according to your needs and pocketbook. Some clients come in regularly weekly to once or twice a month, but it varies. It's possible to come in every couple months, or just once or twice during a rough spot. There are also other resources that I can recommend to extend our work, that you can do out of sessions, such as readings or specific techniques.
What types of therapy treatments are there?
In general, common treatment modalities are: individual sessions, family sessions, group sessions, and couple therapy.
Particular therapy methods or techniques (such as cognitive behavioral therapy, etc.) vary by therapist training and client need. Many therapists, myself included, use a mix of methods, theories, and techniques according to what may help the client.
Is couple therapy covered by insurance?
Mental health (therapy) insurance benefits cover couple therapy as long as the person with the insurance has a mental health diagnosis (see above).
What if I'm worried about having a mental health diagnosis on my insurance record?
If this worries you, it may be best to pay out of pocket so that your insurance company is not informed.Read more on this issue here, when not to use therapy insurance.
What's the difference between a "deductible," "a co-pay," and "co-insurance?"
Deductible
The deductible is the amount the patient pays every year for health care services before insurance will begin to pay anything. After the deductible is met, you then pay a smaller co-pay each time you see a health care professional, for the rest of the year, for both your mental health and regular doctor visits.
Remember, insurance deductibles start over every year, typically in January or in June.
Find out if you have a deductible and how much of it is left to pay for the year by calling the member number on the back of your insurance card. They're there to help you!
Co-pay
The co-pay is the the amount the patient pays per visit to a health care professional (after the deductible is met). Almost all plans have a co-pay. Co-pays for a mental health session are often different than for a regular doctor visit, typically somewhere between $10-$40.00.
Co-insurance
Like a co-pay, it's the amount the patient pays per visit to a health care professional (after deductible is met). The co-insurance is a percentage instead of a flat rate co-pay. For example, if the rate is $100 and your co-insurance rate is 20%, you'd pay $20 per session.
What type of authorization do I need to use therapy insurance?
There are two types:
A doctor referral. (This is becoming less common.) Or a simple authorization number given to you over the phone by your insurance company customer service representative.
Sometimes no authorization is needed to start therapy, but you still need to find out if you have a deductible, if it's been met, and what your co-pay will be.
Please call you insurance company member services number to find out.