Out-of-Network Benefits
Your step-by-step guide to using health insurance benefits for therapy
Stressed because your therapist doesn't take your health insurance? Working with an out-of-network (OON) therapist doesn't have to break the bank. Many health insurance plans include OON mental health benefits, which is when your insurance helps to cover the cost of therapy.
How It Works
How It Works
Step 1
You pay the full session fee upfront
Step 2
Your therapist provides you with a Superbill (a receipt of the therapy services you have already paid for), which you then submit to your insurance. At Repose, we can submit the Superbill to your insurance on your behalf for a small processing fee.
Step 3
Upon processing your Superbill, your insurance will then reiumburse you for a portion of your therapy session, typically in the form of a mailed check or direct deposit.
Depending on your specific plan, your insurance provider may reimburse you anywhere from 50-70%. Some providers will even reimburse you 80-90%! That means that the actual cost of a $200 therapy session for you could be just $20-$100.
Questions to Ask Your Insurance
Contact the Member Services phone number on the back of your health insurance card. Ask your insurance representative the below questions to understand your out-of-network mental health coverage and out of pocket costs.
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Do I have out-of-network outpatient mental health coverage?
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What is my out-of-network deductible?
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What percentage of outpatient psychotherapy sessions are covered per session?
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How many outpatient therapy sessions are allowed per calendar year?
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What is the process for submitting claims?
Some insurance plans require you to meet a deductible first before your OON benefits kick in. A deductible is a specific amount of money you must pay out-of-pocket, and once you pay that amount, your insurance plan will begin to cover the cost of therapy.
For example, let's say your deductible is $500. That means you will have to pay $500 out-of-pocket first. Once you have paid that amount, your insurance will start to cover 50-90% of the OON services you receive.
Benefits of Working With an Out-of-Network Therapist
Research consistently shows that the therapeutic relationship–how much you like, connect with, and trust your therapist–is the most important ingredient for successful psychotherapy. Being open to working with an OON therapist will allow you the flexibility to find someone with whom you feel a genuine connection with, and who can best help you meet your therapeutic goals.