Why Using Insurance for Therapy isn’t Always Easy and What You Should Know

At Meadows Counseling Group, we believe everyone deserves access to quality mental health care. But if you’ve ever tried to use your health insurance for therapy, you may have found yourself confused, frustrated, or even discouraged. You're not alone.

We often hear from clients who want to use their insurance but don’t fully understand how it works or why it sometimes feels like insurance makes therapy harder to access, not easier. Let’s break it down:

Common Insurance Challenges for Mental Health Care

1. High Deductibles

You might assume that if you have insurance, your sessions will be covered right away. But most insurance plans require you to meet a deductible first. That means you’re responsible for paying out of pocket until you’ve spent a certain amount, often thousands of dollars, before your insurance even kicks in. For many people, that can make therapy feel financially out of reach.

2. Mental Health Coverage isn’t Equal

While the Mental Health Parity Law was created to ensure mental health and physical health are treated the same by insurers, in practice, we still see a huge gap. Some plans offer only limited sessions or restrict coverage to certain diagnoses. You might be fully covered for a broken arm, but you need to jump through hoops to see a therapist. It’s frustrating and unfair.

3. High Copays or Coinsurance

Even after your deductible is met, many plans still require you to pay a copay (a fixed fee, like $25 or $40 per session) or coinsurance (a percentage of the session cost, like 20 - 30%). For weekly therapy, those costs can add up fast.

4. Limited Networks

Sometimes, the therapists you want to work with aren’t even in your insurance network. Out-of-network benefits (if your plan offers them at all) often reimburse you at a lower rate, meaning you’re still paying the majority out of pocket.

Understanding Insurance Lingo

Let’s take a moment to break down a few common terms:

• Deductible: The amount you pay out of pocket before your insurance starts paying. For example, if your deductible is $1,500, you must pay that amount first even for therapy.
• Copay: A set fee you pay for each session. If your copay is $40, that’s your responsibility every time you meet with your therapist.
• Coinsurance: A percentage of the session cost you pay, even after the deductible is met. If your coinsurance is 20% and your therapist charges $150, you pay $30 and insurance pays the rest.
• Out-of-Network (OON): A provider not contracted with your insurance company. You may still be able to see them, but you'll likely pay more and may have to file your own claims for reimbursement.

Why This Matters to You

We know it’s a lot to navigate and it shouldn’t be this hard. Insurance was meant to help people access care, not create barriers to healing.

At Meadows Counseling Group, we’re committed to transparency. We’ll help you understand your benefits, estimate costs, and explore options. And for those who want to avoid the stress of insurance entirely, we also offer private pay and subscription-based therapy where you can get consistent support at a flat monthly rate, without surprise bills or insurance roadblocks.

A Final Thought

Mental health is just as important as physical health. You shouldn’t have to fight for it. If you're struggling to understand your insurance coverage or want to talk about your options, reach out. We're here to help guide you, every step of the way.

Visit our website or call us today to learn more about your options for care insurance or not.