Does Insurance Cover Therapy?
NOTES ABOUT FEES & INSURANCE

Therapy Session Fees

Each session is 45-50 minutes and the fee is $115-$200. This depends on the therapist’s licensure, experience, and advanced training.

We accept cash, check, and all major credit cards. FSA/HSA cards can be used to pay for therapy, as well! (People get so excited when they realize that.) And yes, we can provide a receipt (invoice) for your records, should you ever need it.

A Note About Paying for Therapy

Money can be hard to consider for therapy. You want to make sure it’s really worth it. You want to really feel confident about moving forward. We want you to feel that way, too. Reach out today for a free 15-minute consultation and we can talk about what’s going on for you, how we work, and hopefully, you can get a sense of whether we’re a good fit, which may help you feel more confident in moving forward.

Or, you can poke around our team pages or blog, to get a better sense of us. A good fit goes a long way in the counseling relationship and we totally get that. 

I do want to make sure to tell you this, also: YOU are worth the investment for therapy. Your mental health, and all the joys of living that come when your mental health becomes healthy, is SO deserving.

So, while it can sometimes be hard to consider the money side of therapy, I can say I know you are worthy of it. I don’t need to meet you to know that. And I can tell you one more thing: almost every client (mine, and the clients of other therapists, too!) says after their first or second session, “oh wow, I should have started this a long time ago!”

As for the prices for our team, we all have a specialty! Or more than one. Everyone on our team, beyond our Master’s Degrees, has taken advanced training in the service areas where they provide therapy. 

Does Insurance Cover Therapy?

This depends not only on your insurance provider, but also your insurance plan through that provider. In some instances, yes, mental health therapy is covered under your benefits. Sometimes, it is covered but you have a copay. Sometimes that copay is $20/visit and sometimes it is $60/visit.

In some cases, mental health therapy is covered after you meet your deductible for the year. Until that point, it is all out-of-pocket. That out-of-pocket may be able to go toward your deductible.

I tell you this because it can really inform who you pick for therapy! For example, if your copay is $60 but you really want to work with us, maybe that different between $60 and our fee is worth it to you after being out $60 anyway. (Maybe not, and that’s okay, too!)

Or, you realize you’re not even close to meeting your deductible so you think, “well, I might as well go with who I want then, and not just who takes my insurance!”

Our practice does not take insurance and is considered an “out-of-network” provider. Read on for what that means!

Ok, what does it mean to be an “out-of-network” provider? Can that be helpful at all?

An out-of-network provider is a professional who the insurance company recognizes can provide those services, but just is not contracted with their company. Many people have out-of-network benefits which means the insurance company might cover it, but not at a rate of 100%. They may cover it at 60% or 80% but it all depends on your provider and your plan.

If you want to check this out, we definitely encourage that you give your insurance company a call. We’ve listed out the questions that are important to ask them to get an answer!

If you do go this route, you’ll need a superbill from us, which we can absolutely provide!

1. What does my plan cover for out-of-network, out-patient mental health counseling with a Licensed Professional Counselor?

2. Are there any diagnoses not covered?

3. Is individual counseling covered?

4. How many visits are covered per year?

5. What’s my out-of-network deductible?

6. What is the Lifetime Maximum for mental health benefits?

7. What is the Allowed Amount of the fee?

Many insurance companies will reimburse a percentage of the total fee paid. For example, your company may reimburse you 80% of the total fee paid. Other companies will substitute the fee for what they deem appropriate, regardless of what you paid. For example, your company may say that they will reimburse you 80% of the “allowed amount” of the fee. You paid $100 for an individual session, but your insurance company only allows $60. Therefore, you will be reimbursed 80% of $60, or $48. They may try to withhold this information from you and can legally do so. Ask to speak to a supervisor and say that you cannot plan your medical expense budget without this number.)

8.  What percent of the Allowed Amount will be reimbursed?

9.   How do I file a claim?

Why doesn’t your practice take insurance?

Fair question, and there are several components to that.

The main one is that insurance companies require that we diagnose you in order to be able to treat you and in order for you to be able to use their benefits for mental health. And we just don’t believe that everyone who walks into our office needs a diagnosis. Life is just hard sometimes; that doesn’t mean you have a mental health disorder.

We also don’t want that diagnosis following you around. To a job in the future; an application for life insurance; etc. Sometimes therapy is just help for hard times. We don’t want the challenges you’re facing now to create a different challenge in the future because a diagnosis is on your permanent record.

Also, there’s a risk your confidentiality not being as protected as it should be when you use your insurance. There have been instances of major breaches from some insurance companies, and especially with a diagnosis attached to your file with them…..we’re not comfortable in participating in that system.

Finally, sometimes the insurance company dictates your treatment. As in, how often you can go or how long you can go. That model just doesn’t align with a) how we see our relationship with you; b) our understanding of life and all of the elements to it; and c) our desire to have the opportunity to be creative in how we collaborate with you. More freedom for you (WHO you work with; how OFTEN you work with them; and how FREQUENTLY you see them) + freedom for us (how we use our interventions; how we pace the sessions with you; and the possibility to use new treatment approaches or environments) we believe lead to better outcomes for you.

Begin Counseling in St. Louis, MO & Chicago, IL or Online Therapy in Missouri or Illinois

We are ready to get started with you and look forward to seeing you in our Ballwin, MO therapy clinic. We can also chat via telehealth for online therapy in Missouri and online therapy in Illinois. Taking this first step is a big deal, so you are already making great progress! Just follow these simple steps and we will get started.

Other Mental Health Services at Marble Wellness

At Marble Wellness, our goal is simple: Counseling services designed to help set you on a path of living a more fulfilled, calm, and happy life. We specialize in anxiety, depression, grief, chronic illness, therapy for men, couples, and maternal overwhelm. We can also help new moms with various postpartum concerns, moms in the thick of parenting, and moms with teens. We can also chat from wherever you are in the state with online therapy in Missouri and online therapy in Illinois. No matter where you are in your journey, we would love to support you.