There are many good resources for finding a therapist out there, but often the people who contact me have questions about using their insurance to help pay for therapy. Navigating insurance is frustratingly complicated and sometimes discourages people from reaching out for help at all! Let’s take a closer look at how your insurance works and how to use it (or not!) in looking for a therapist.

For a variety of reasons that I’ll address, you may conclude that the best option for you is choosing a therapist who is not covered by your insurance. The subjective sense of ‘fit’ between a therapist and patient is the strongest predictor of therapy success, and limiting yourself to therapists covered by your insurance may minimize your chances of finding that fit. We all know how expensive healthcare can be, but because you will be investing a lot of time and energy into your therapy I encourage you not to choose based exclusively on cost. I’ll explore some options for managing cost while maximizing choice later.

I’ll start by guiding you through the basics of health insurance as it pertains to mental health professionals. Particularly, we’ll review how insurance networks work and what they’ll mean in your therapist search.

Then, I’ll tell you how to search for a therapist in your network who meets your needs.

Next, I’ll talk about out-of-network coverage; why you might choose an out-of-network therapist and how to use your benefits to see the therapist of your choice.

Finally, I’ll consider options for maximizing your choice while managing costs. I’ll suggest some alternatives if you don’t have out of network benefits and/or can’t find a therapist meets your needs and is in your network.

Get to know your insurance. What therapists can I see?

Your insurance will likely fall into one of two categories: it will either offer out-of-network coverage or it will not. Every insurance company has a pool of therapists (a “panel”) who have agreed to see that insurer’s subscribers for a reduced fee and under their terms. These clinicians who have contracted with your insurance company are in-network for you. All others are out-of-network. If your plan allows you to see out-of-network providers, you can choose your therapist freely (with some caveats that I’ll discuss in the out-of-network section). If not, then you must choose from within the insurers network or they will not cover your sessions.

Take a look at your insurance card – does it contain acronyms like HMO or PPO? Most HMO plans (including most plans through Commonwealth Care or the state Marketplace) restrict their coverage to in-network providers. Most PPO plans do offer out-of-network coverage, though the details can change from plan to plan. In either case, you can call the number on your insurance card to ask about your coverage for mental health visits (sometimes called ‘behavioral health’), or look up information on your insurance company’s website under your specific plan.

If you know you only have in-network coverage, proceed to the next section, where I’ll cover how to find an in-network therapist match. If you have out-of-network coverage, keep reading – you can still choose an in-network person, but you’ll also want to ask some more questions of your customer service or HR person to learn about the particulars of your out of network coverage.

This series was created and written in collaboration with Scott Bortle, Ph.D.