Online therapy has long been an option, but many people didn’t know much about it. That all changed during the pandemic. Suddenly, it became the default choice for most counseling centers and therapists. Many states enacted policy changes at the beginning of 2020 to ensure that the services you receive via virtual counseling are the same as the ones you’d get in-person (service parity) and to ensure that the amount you pay for in-person and online therapy is the same (payment parity).
Pre-pandemic, only 16 states had a payment parity system in place. Once COVID-19 hit, most states enacted policies regarding reimbursement parity — at least for people insured with Medicaid. Two dozen states look poised to keep their policy parity enforcement intact.
What does this mean for you? You’ll likely be able to find online therapy that doesn’t cost more than in-person sessions. That can be a huge help if you have an inflexible schedule, don’t live near a therapist’s office or feel anxious about an in-person visit.
If you think virtual counseling could be right for you, the trick is to find online therapy that takes insurance or find a budget-friendly online therapist.
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How much does online therapy cost?
Online therapy isn’t too different from traditional in-person therapy in terms of services and effectiveness. That’s also true when it comes to insurance coverage. Some virtual therapy providers don’t take insurance at all, while others only take certain forms of insurance. In other words, your hunt for a provider who accepts your coverage will probably be fairly similar whether you want in-person or online sessions.
This also applies to the cost of online therapy. A lot of therapists charge the same amount for online therapy and in-person therapy because they’re providing the same services. Without insurance, the median fee can run anywhere from $130 to $200, according to TherapyDen, a mental health directory.
To bring the cost down, a lot of people explore large therapy platforms like BetterHelp (which says an average session costs between $60 and $90), or Talkspace (which charges $99 per weekly session).
Fortunately, insurance may help you bring these fees down — if your provider takes insurance. Under the Affordable Care Act, most health plans include coverage for mental health services. If you’re concerned about your online therapy cost, you can seek out online therapy from a therapist, counseling center or online platform that takes insurance. Once you find a therapy provider that accepts your coverage, you’ll need to cover your copay (usually $10 to $50), meet your deductible or both.
Do online therapy services take insurance?
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About half of therapists and counseling centers don’t accept insurance. However, you have options outside of tapping your insurance coverage. Many therapy providers offer sliding scale fees that are set based on your income level. That can help to bring down your online therapy cost. Plus, some providers and platforms offer financial aid — the requirement to qualify generally hinges on your income level.
Beyond that, even if your therapist isn’t able to bill your insurance provider directly, you can explore applying for a reimbursement through your policy. If your therapist is out or network, you can call your insurer to ask about reimbursement. If they give you the green light, you can request a reimbursement by navigating to your provider’s claims portal and submitting your therapist’s bill. While this will require you to be able to afford the therapist’s fees upfront, it gives you a way to get some of that money back.
Does my insurance cover online therapy?
This is the question of the day. While it can make the process straightforward to find online therapy that takes insurance, the much more pressing question if your current health insurance policy includes coverage for mental health care.
Mental health coverage varies by insurance provider and plan. The best way to get all of the details you need is to call your insurance provider (if you’re covered through an employer-sponsored plan, get in touch with your HR team). Either way, here are two helpful questions to ask:
1. Does my plan include coverage for mental health services?
2. Can you provide me with a list of in-network therapy providers?
If they give you a list but it only includes therapists who only offer traditional in-office sessions, you can reach out to the therapist. Many therapists offered telehealth visits throughout the pandemic and plan to do so moving forward to help their clients.
We outlined coverage options from several of the largest insurers.
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What coverage includes |
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Medicare Part B covers telehealth services, including virtual therapy and online counseling. Once you meet your Part B deductible, you pay 20% of the cost and Medicare covers the rest. |
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Aetna offers plans that include virtual counseling (what they call televideo). For coverage, you’ll generally need to work with your primary care doctor and an Aetna care advocate. |
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Some United Healthcare plans include mental health coverage and extend to virtual visits when offered by a covered provider. Many plans also cover services from Talkspace and Sanvello, an on-demand emotional support app. |
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Most Blue Cross Blue Shield plans include coverage for mental health care, although some employer-sponsored plans don’t. If your policy includes coverage, you can use the Teladoc behavioral health service to talk to a therapist with a $0 copay. |
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Many Humana plans offer coverage for telehealth visits with a behavioral health specialist. |
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Anthem Blue Cross members have access to LiveHealth Online Psychology with the same copay as in-person visits. |
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Most Cigna policies include virtual care, including online mental health care. They also cover Talkspace services. |
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Many Kaiser plans include mental health coverage. Kaiser can also help you find a therapist. You don’t need a referral to access mental health care through your Kaiser plan. |
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While Centene doesn’t offer plans of its own, most of the plans in its marketplace are through Ambetter, which partners with Teladoc to offer virtual visits. These telehealth offerings don’t explicitly mention mental health care. If you have coverage with either, it’s best to contact your plan provider to get all of the details. |
If your insurance provider covers mental health care and your therapist accepts it, you’ll pay your copay or deductible just like you would with any doctor’s visit. If you get charged a different amount, you should contact your insurer. The 2008 Mental Health Parity and Addiction Equity Act requires insurers to establish the same financial requirements for mental health care as they do for physical health care.
What to do if your insurance doesn’t cover online therapy
If your insurance policy doesn’t cover mental health coverage — a relatively common issue for workplace plans or ones developed before the ACA — you may explore other options.
Here are some of the best ways to find virtual counseling that works for your budget:
- Look for sliding scale options or discounted rates. A sliding scale fee structure can help you find more affordable therapy. With a sliding scale, the rate your therapist charges gets based on some factor specific to you. In almost all cases, that’s your income. That means the less you’re bringing home, the less your therapy will cost.
- Seek out community mental health centers. If there’s a mental health center in your area, get in touch with their team and ask what they offer. Some local centers have financial assistance to help community members. Even if they can’t offer you monetary aid, they may offer alternative, more affordable forms of therapy that you can explore, like group sessions or one-off workshops.
- Explore employee assistance programs. Some employers offer employee assistance programs (EAPs). Reach out to your HR team to see if anything like this exists at your company. In a lot of cases, the EAP will cover the cost of a set amount of mental health services (e.g., six free sessions a year).
- Students, ask around your college or look for discounts. Most higher education institutions offer some level of free therapy to their students. This may be with your campus counselor. Many online therapy platforms, like BetterHelp, also offer student discounts.
- If you live in an area with a university that has a graduate training clinic, contact them. Most training clinics offer low-cost therapy. You’ll be paired with a future therapist who’s still learning the ropes, but you can dramatically slash the cost of your sessions by choosing this route.
- Hunt for free therapy services. Some therapists offer their services pro bono, and that’s especially true with virtual visits because they can be more convenient for both of you. You can try contacting therapists in your area to see if any are willing to extend some free online therapy sessions to you.
If you’re in a dire situation and you need free help now, you can call the National Suicide Prevention Lifeline at 1-800-273-8255 or, if you’re reading this after July 16, 2022, by dialing 988.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.