Understanding Your Out-of-Network Benefits

Navigating insurance shouldn't feel like a second job. Here's a straightforward breakdown of how to find out what your plan covers and how to get reimbursed for our work together.

Call your insurance provider

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Grab your insurance card and call the member services number on the back. If you see a number labeled "BH" or "Behavioral Health," start there. Then ask these three questions:

  • "Do I have out-of-network benefits for mental health or behavioral health services?"

  • "What is my out-of-network deductible, and how much have I already met?"

  • "What percentage of the allowable amount do you reimburse for outpatient psychotherapy?"

A few things worth knowing: if your card says HMO, you likely do not have out-of-network benefits. If it says PPO or POS, there's a good chance you do. Reimbursement rates vary by plan but often fall between 50 and 80% of the allowable amount once your deductible is met.

Request a superbill

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Let me know at the start of our work together that you'd like to use your out-of-network benefits. I'll provide you with a monthly superbill, which is a detailed receipt that includes the service provided, the date, my provider information, and a diagnosis code your insurance requires to process the claim. We can talk privately about what diagnosis fits your experience.

Submit your claim

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You can submit your superbill directly to your insurance company by mail or through their member portal. Many clients also use the Reimbursify app, which streamlines the process and takes just a few minutes (they do charge $3.99 a claim). Once submitted, reimbursement checks are typically mailed directly to you from your insurance company.

A few things to keep in mind:

Any out-of-network healthcare you receive, including therapy, counts toward your annual deductible. Once you meet that deductible, your insurance will begin reimbursing a portion of each session. While I can't guarantee any specific reimbursement amount, many clients find that their out-of-network benefits make a meaningful difference in the overall cost of care. You are responsible for the full session fee at the time of service.

Still have questions? Reach out. I'm happy to help you figure it out.

Why I Don't Accept Insurance

This is a question worth answering honestly, because you deserve to understand where your money is going and why.

The short version is that insurance companies are not designed to support good therapy. They are designed to minimize cost. In practice, that means they determine how many sessions you're allowed before I've even met you, require me to assign you a diagnosis that becomes part of your permanent medical record, and reimburse at rates that make it functionally impossible to run a sustainable practice without seeing so many clients that the quality of care suffers. Many therapists who accept insurance see thirty or more clients a week just to keep the lights on. That is not the kind of therapist I want to be, and it is not the kind of care you deserve.

Therapy is also not a neutral administrative task. It is some of the most demanding relational and cognitive work I do, and doing it well requires that I have enough time and capacity to be fully present with each person I see. That means keeping my caseload intentionally small, investing in ongoing training and consultation, and protecting the kind of focused attention that actually moves the needle. Insurance reimbursement rates do not support that model.

Going out of network puts more of the financial burden on you, and I don't take that lightly. It's part of why I reserve a number of reduced fee spots and provide superbills that you can submit for partial reimbursement. My goal is to make this as accessible as I responsibly can while being honest about what it takes to do this work well.