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If you are seeking mental health care and find the process frustrating, you are not alone. In 2019, only 40% of people that needed therapy received professional health care. The reasons people did not receive them include a lack of access, embarrassment, and lack of insurance.
Many online therapists take insurance, but not all insurance carriers cover online therapy. There is much confusion regarding coverage since coverage can vary from state to state. You should consult your insurance to determine what they cover and whether the online service is in-network.
When you or a loved one need counseling, you should not also have to navigate the frustration of determining whether the therapist will take insurance. Unfortunately, that is often the case. We can help guide you through this process.
What Is Online Therapy?
In some ways, online therapy is like in-person therapy—a person seeks help from a trained therapist for issues affecting their mental health. Therapists provide support with marital counseling, anxiety, anger management, and depression, among others.
In traditional, face-to-face therapy, the patient goes to the therapist’s office—a quiet, soothing, and confidential space. That setting allowed the patient to feel safe enough to speak honestly and the therapist to listen carefully and provide meaningful advice and suggestions.
There are several limitations to that model—time, money, and availability.
- Time. First, since the counseling happened in the therapist’s office, the patient has to include the time in a session and the time-traveling there. For some patients, that means driving across town or even to another city.
- Money. Patients usually have limited control over when sessions can occur. Often, they have to rearrange their schedules to see the therapist. That time also costs money—taking time off from work, and the added expenses of traveling to the office can add up.
- Availability is another hurdle that prevents face-to-face therapy. Some therapists do not take insurance, and others will take some insurance but not others. Finally, even finding a therapist who takes your insurance won’t mean they will be available. Many therapists have a busy schedule, so even if you find a therapist who accepts your insurance, that person might not be taking on any new patients.
Online therapy is an attempt to solve those problems.
Different Kinds of Online Therapy
Unlike face-to-face therapy, there are numerous ways to receive care with online therapy. Treatment can happen through videoconferencing. But it can also occur through text messaging, email, real-time chats, internet phone services, and mobile device apps. This means that even people without laptops or computers can receive therapy from their smartphones.
Who Should Use Online Therapy?
Online therapy is new enough that there haven’t been enough studies to determine how effective it is in treating mental health conditions. The studies that have been done show that online therapy is most useful for anxiety, stress, and minor depression.
A person suffering from more severe conditions or thinking about harming themselves should consider seeking in-person therapy.
Online Therapy and Insurance
There’s good news and bad news. The good news is many insurance companies will cover online therapy. The bad news is that figuring out what your health care provider will cover will not be easy. Having to deal with these hassles when you are already stressed out is unfortunate, but there are some steps you can take to make it less stressful.
First, making a plan can be helpful. To create a plan, you need to know what steps to take. Sometimes planning is straightforward—like a shopping list where you see what you need, go to the store, buy your groceries, and then take them home. Finding an online therapist that takes insurance is not straightforward like that.
These are the steps you will need to take:
- Choose a provider.
- Figure out what kind of therapy you want.
- Find out what type of insurance they accept.
- Determine what your insurance carrier covers.
You can take these steps in practically any order. Maybe it makes the most sense to start with your insurance and see what coverage you have. If your coverage isn’t from a major company like Blue Cross/Blue Shield, then your options might be more limited than you realize.
Another approach is to start by finding a therapist. Since counselors must go through a lengthy process to become approved by an insurance company, you can search to locate a therapist who takes your insurance.
Or you could start with figuring out what kind of therapy you want. This includes both how—do you want to use a text-based service or videoconferencing and what kind of modality (that is therapist-speak for their approach) you want.
Determining What Your Insurance Covers
If you find that figuring out what your insurance covers and who is in-network are complicated, you are not alone. The federal government, insurance companies, and therapists are also confused. State laws vary, governmental requirements change, and insurance companies are continually adjusting their policies to reflect the uncertainty around those changes.
And that was before COVID impacted online therapy.
Figuring out what your insurance covers can be done via phone call or the web. If you call, most likely: a. you will have to wait to speak to someone, and b. that person will tell you to check out the website. So skip the phone call, at least at first.
The website will be of some help. You will be able to find out what is covered and costs for in-network versus out of network. However, sites might not have current information regarding the coronavirus changes, meaning that it will not indicate whether teletherapy is covered.
Also, listings of therapists might be outdated or not include those who have joined the network recently.
Choosing a Provider
Usually, counselor profiles will show what types of insurance they take. Do not be surprised if individual therapists or those who work for national online groups don’t take any insurance.
The process of becoming a network provider is challenging for therapists. They must request to apply and then provide information about licensing and training. Rates also must be negotiated, and insurance companies typically don’t want to pay counselors market rates.
There are two main ways to find providers online:
- Google terms like “health care online,” “online therapists,” or “teletherapy.”
- Use a reputable, third-party source, such as Psychology Today.
If you use Google, the top search results will be national health care providers, which you will learn about later. If you want local results, then type in one of those terms followed by your city. The top results will give you local providers and some that have networks throughout your state.
Be Prepared to Investigate Further
Once you click on a therapist or network of providers, be ready to do further investigation. Some counselors will clearly show whether they work with insurance, but others will require you to search through their site.
It can be somewhat confusing. Sometimes sites will claim that they are not in-network but then say they work with Tricare, insurance coverage for those in the military. You can also run across sites that suggest you talk with your insurance company or that they will go over insurance costs and reimbursements at your first appointment.
Often one of the search results will link back to Psychology Today.
Figure Out What Kind of Therapy You Want
Not everyone will take this step first, but there are some reasons to consider doing so:
- Whether a therapist will take insurance is something you will have to research anyway.
- There are only so many ways a counselor can describe themselves, so why not scan through what they say but focus on what they treat and how they go about it.
- Most therapists and counselors mention the kind of treatment they offer.
Psychology Today’s Types of Therapy lists over 50 different approaches, modalities and describes what to expect from such therapy, how it works, and what to look for in the therapists.
If you find an approach you like, add that to your Google search and see what pops up. You are likely to find mental health professionals listed who specialize in that type of treatment.
What About National Therapy Providers?
Up to now, the focus has been on insurance and local online therapists. You are not limited to counselors who live nearby. As long as the therapist is licensed to practice in your state, it doesn’t matter if they are next door or across the country. At least that is the idea behind online therapy companies like Talkspace, Betterhelp, and Amwell.
Therapists do not need to rent office space, pay an agency to handle insurance reimbursements, and save on other expenses. Plus, they have the flexibility for where and when they work.
What about these companies and insurance? The good news is that some accept insurance. The bad news is that most of them don’t let you know whether you will be covered until you go through the sign-up process. We will explore some of them. Ultimately, even if the company takes insurance, you will have to check to see if yours will be accepted.
Unlike other online providers that offer only therapy, Amwell provides additional medical services. Medical doctors can diagnose and offer treatment on urgent care conditions, dieticians, pregnancy and menopause counseling, pediatricians, and therapy (and psychiatry).
Amwell claims that its insurance coverage covers 80 million people in the United States. To see whether you are one of those 80 million, check out Amwell’s Insurance Coverage page, which lists the plans they currently work with.
As you look over that page, you will notice that some plans, like Blue Cross Blue Shield, do not cover every state. For example, Blue Cross offers coverage in South Carolina but not North Carolina.
Before you get too excited, though, read the fine print (or scroll down). Currently, the coverage is for Urgent Care visits. Patients must pay for specialists in advance, and Amwell will not submit the bill for reimbursement. Even if your insurance covers the service, you or your provider will have to submit a claim.
Amwell provides a variety of telemedicine and therapy services. Although it is easier to find out if your insurance will cover their services, you or the provider will need to submit the claim.
Doctors on Demand
Like Amwell, Doctors on Demand provides telemedicine and teletherapy visits. Along with therapy, they have preventative, chronic, and urgent care services. Both licensed therapists and psychiatrists are available through this platform.
Unlike Amwell, Doctors on Demand does not list which insurance providers they work with, nor whether teletherapy insurance is covered. To get that information, you will need to create an account, sign in, and follow a series of prompts to determine if your insurance plan will cover their services.
Prices for services are listed on the FAQ page. One thing to note is that therapy prices are steep. The nationwide average for therapy is listed as $100 per hour (although that varies greatly). Currently, psychology rates for a 25-minute consultation are $129, or $179 for 50 minutes.
Doctors on Demand accepts insurance, but to find out whether they will take yours, you will need to sign up (which is free).
MD Live is another telemedicine and teletherapy provider. They provide medical care for a range of ailments, including dermatology, therapy, and psychiatry. Their What Does it Cost lists a range of prices—such as $0-$108 for therapy and that the price depends on insurance.
However, information about which insurance they take, how much copays will be, and who submits the claim is not provided. To find out, you must sign up.
Finding out whether they will take your insurance requires signing up. One concerning issue is that the main page includes tabs for businesses and providers. Although communication with both is essential, the primary page should be focused on patients.
Talkspace’s slogan is, “Feeling better starts with a single message.” Therapy on Talkspace uses text and voice messaging, as well as videoconferencing. If you want to communicate with your therapist, it’s as simple as sending a text.
The company has a range of plans based on weekly rates. Basic plans provide unlimited texting, and those who want to add videoconferencing (via laptop or phone) can purchase plans that include those features.
Talkspace partners with several insurance companies and individual companies such as Lending Tree and Whole Foods, universities, fraternities, and sororities. Cigna and Humana are the largest carriers they work with.
Talkspace takes a 21st-century approach to therapy through a focus on messaging. Video chats are also available at a higher price. Insurance coverage is limited, and if you are looking for more traditional therapy, then Talkspace probably isn’t for you.
What to Look for When Choosing an Online Therapist
One of the best resources for choosing a therapist, whether in person or online, is referrals. Ask around for referrals from friends, acquaintances, and friends of friends. If they give you a name, ask what it is they like about their therapists.
If that doesn’t work and you choose to go online, look for the following as you make your choices:
- Their pictures. Pictures tell a story. If the therapist has a professionally taken, glamour shot, ask yourself why? Photos of the person engaged in a hobby or pastime can be a red flag, as they could make the sessions about them as much as you. Good therapists are busy enough that they don’t need to entice you.
- Their modality. When you see words such as psychodynamic, cognitive, behavioral approaches, those are the theoretical frameworks the therapist relies on. Use a resource such as Psychology Today’s Types of Therapy to help you. If a therapist lists a lot of modalities, be cautious.
- Their gender. You may be fine working with a therapist of either gender, or you might have a strong preference for one. Make sure you have thought about this and know that it’s okay to have a choice.
Open Path—A Low-Cost Alternative
Open Path is not free, nor does it take insurance, but the costs per session might only be a little more than copays. You need to qualify for income limitations, and there is a one-time membership fee of $59. Sessions are between $30-$60, and therapists indicate whether online therapy is available.
Finding online therapists that take insurance is not a walk in the park. There are many reasons for that, including that therapists often don’t get paid fair market rates from insurance companies. Getting in-network approval is difficult, and there are constant paperwork requirements.
Companies like Amwell and Talkspace provide online therapy but find out whether they will accept your insurance, what your costs will be, and who is responsible for submitting claims will require that you first sign up for their services.
Local providers that offer teletherapy services are more upfront about which insurance plans they offer. If you need to use insurance to help pay for therapy, start local.
- American Psychological Association: What You Need to Know Before Choosing Online Therapy
- APA: A Growing Wave of Online Therapy
- APA: Guidelines for the Practice of Telepsychology
- Telebehavioral Health Institute
- The Mighty: Does Your Health Insurance Pay for Online Therapy?
- Very Well Mind: What is Online Therapy?
- Journal of Technology in Human Services: A Comprehensive Review of the Effectiveness of Internet-Based Psychotherapeutic Interventions
- PsychCentral: Will Insurance Cover Video and Phone Sessions?
- Psychology Today: Types of Therapy
- Talkspace: Home Page