Choosing A Therapist Outside Of Your Insurance Network

Medically reviewed by Andrea Brant, LMHC
Updated April 30, 2024by BetterHelp Editorial Team

Are you looking for an out-of-network therapist? Many individuals seek in-network providers to ensure services are covered without having to pay out-of-network fees. However, there can be reasons why you may want to consider seeking care outside your health plan network of providers. 

Below are a few options that may be available to you, providing you supportive information about navigating health insurance plans with an out-of-network therapist.

Have Questions About Choosing An Out-Of-Network Therapist?

Out-of-network therapist information

At times, health insurance providers may change their list of accepted plans, switch company ownership or reduce coverage options. If you were seeing an in-network therapist that is no longer covered, you may have the option to keep working with them as an out-of-network therapist, pay higher co-pays in alignment with your current benefits plan, or pay for your session with your own money. In some cases, individuals might find in-network providers to switch to, although they may risk losing progress with their prior provider. 

Some individuals may dread this scenario, because it can involve paying out of pocket for session fee amounts or submitting complicated insurance claims. However, you may find support from out of network providers if you can't find in-network options. You might also find a more significant amount of out-of-network therapists if you previously were not offered many options using your plan’s find a therapist tool. 

What is an out-of-network therapist?

When a therapist is out of network, it can mean they do not have a contract rate with your health insurance company, so they might not accept insurance payments from your insurance plans. An in- network therapist has generally negotiated what they will earn through your insurance provider; a price that is covered by your network provider. 

On average, it may cost patients more to use services out-of-network. Conversely, it generally costs insurance companies and patients like yourself less when you use an in-network provider covered by the insurance plan—which is why many choose to work with network therapist options that take their network benefits. 

While the options to minimize therapy costs may seem clear-cut, there are times that require an exception to the normal flow. A doctor or specialist, for example, may choose to be an out-of-network provider because they did not approve a contract arrangement with the insurance company. Additionally, they might experience a lack of reimbursement for services through the health insurance(s) in question; as the insurance companies may pay less than the total cost when they submit claims.

You may be required to submit a claim to your insurance for out-of-network benefits for out-of-network therapists if your insurance falls under this category. In some cases, you can get an out of network reimbursement. You may also qualify for discounted session fees via cash payments, enjoying discount rates. Paying the total amount in cash may not be required, but this could be an option if you receive services without filing an insurance claim. Some out-of-network therapy options and providers may also provide a special rate or bundle offers to make it easier to pay when therapy session fees are out-of-network.

Check your policy for out-of-network benefits

It can be beneficial to check with your insurance network to learn more about their out-of-network policy, as all companies can have different standards and network benefits. The information about these out of network benefits may be added to your health insurance policy's "summary details" section. 

Your insurance company website may also have details about how they handle payments to out-of-network providers and whether they offer any out-of-network insurance or out-of-network claim options. If in doubt, you can contact the insurance company directly and ask about the network offered to you, how many sessions they cover and their policy for out-of-network therapy reimbursement. Checking policy details carefully can help you avoid paying out of pocket unexpectedly for mental health services.

Understanding how your insurance plan pays for out-of-network services can be valuable when planning for other medical expenses and co-pays. You may benefit from knowing if there are any essential details about coverage for mental health services and ensuring you have a more comprehensive understanding of these options. 

If you’re not sure where to start, you can ask your insurance company the following questions: 

  • Is the out-of-network deductible the same amount as the in-network deductible for mental health specialists?
  • Has the deductible been met yet, and is there an out-of-pocket limit?
  • What is the co-insurance for outpatient mental health services?
  • Do you qualify for reimbursement for out-of-network fees? How are requests for reimbursement made?
  • Is a referral required to see an out-of-network specialist?

Some companies may mail you a check reimbursing you for services. However, you may have to pay the total price yourself upon utilizing the service, which can be costly for some individuals. 

Why people might choose to pay out-of-pocket

Some insurance pays for specific therapeutic services and sessions, or covers a certain number within a calendar year. Some people may decide not to work with an insurance company because they are working with a mental health specialist not covered under their insurance. In some cases, a diagnosis may be necessary to give a referral, and the insurance company may require that diagnosis and referral authorization before insurance pays for a reimbursement.

You may be required to pay out-of-pocket if you meet a deductible before the insurance coverage kicks in.

Learn about potential costs and payment terms

When considering out-of-network coverage, you may consider checking your health insurance policy to learn what is covered and what is not. If your doctor refers you to a specialist for therapy sessions, you can check to see if they are in-network or out-of-network. It can be helpful to try to avoid assuming that they are automatically in your network, as it may result in a session fee or high co pay you weren't expecting. 

Research how much you'll pay for services, depending on the network status. At times, the cost is estimated before services, and you may learn from checking your policy what you'll be responsible for paying. An added deductible may be included, regardless of the network.

Check the payment terms of the therapist you'll be working with beforehand to learn if they accept insurance or if you need to pay in full, finance, or make flexible payments. At times, a therapist might also file an out-of-network claim to your insurance company for you, so ask them if that is part of their billing process. If not, you may need to fill out a form and file the insurance company claim yourself, based on their network status and your insurance benefits. Details of who to contact can often be found on your insurance card.


How to compare therapists

Choosing a suitable therapist for you can depend on a few factors, including your personal needs. There are therapists skilled and trained to provide support for different areas of mental health. Some provide short-term therapy, and others conduct frequent sessions over a more extended period. Some diagnose conditions, while others offer various treatment options and combine medication management. 

It can be helpful to keep the following in mind when comparing therapists: 

  • Educational background, credentials, licensing and training
  • Specialization 
  • Approach to treatment
  • Type of therapist desired 
  • Personal concerns and symptoms 
  • Diagnosis
  • Whether counseling, medication or other treatment forms may be necessary 
  • Health insurance policies, co-pays and mental health coverage 

You may consider connecting with more than one therapist before making a decision. Get leads to potential therapists to compare by getting a referral from your doctor, receiving a recommendation from family or friends, asking local mental health organization associations or browsing online therapist directories.

Questions to ask potential providers

As you go through the process, you may gain confidence in your therapist and find out if they are suitable by asking questions about aspects of the care they provide. Many therapists may be available online or in-person to provide services and advice. If you feel uncomfortable with working with a therapist, you might consider making a list of questions to break the ice and start a conversation. 

Below are a few questions you might ask: 

  • What experience do you have treating clients with depression, anxiety and related disorders?
  • Do you provide treatment for children, adults or both?
  • Do you provide a free first session to new clients?
  • What are my options if I don't feel better within a specified timeframe?
  • Can you describe your approach and treatment options?
  • How can you help me cope with my problem?
  • If your insurance covers dependents, what services does the parent's insurance plan provide?
  • Is there a co-pay at the time of service?
  • Do you file out-of-network claims, or should I? 
  • Do you prefer to lead or let the client lead? 
  • Can we discuss (symptom or concern)? 

Internet-based options for counseling

Online therapy might be an affordable option if you are struggling to pay for therapy. Some platforms, like BetterHelp, offer sessions at an approximate rate of $65 to $100 rate per session (based on factors such as your location, referral source, preferences, therapist availability and any applicable discounts or promotions that might apply) to have sessions with a qualified therapist. As traditional in-person therapy in the US averages around $100 to $200 a session without insurance, online therapy may be cheaper for many. As therapists may not have to pay for office rent or commute costs, they may offer a lower session price. Clients may also save money by not having to commute and being able to stay home. 

Additionally, the National Center for Health Research conducted an in-depth review of dozens of online therapy studies in the face of rising mental health concerns during the pandemic. They found details that suggest that online therapy can be as effective as in-person therapy for various conditions and concerns, including depression, anxiety and PTSD.

Suppose you are living with mental health challenges, and your insurance provider does not cover therapists in your area or for your specific needs. In that case, an online therapist could benefit you and save you money spent on co-pays or out-of-network fees. 

Have Questions About Choosing An Out-Of-Network Therapist?


Choosing to talk with a therapist about your situation with a professional can be a step toward finding support and reducing distressing symptoms. Researching the policies for therapists in and out of your insurance network can ensure you find a compatible provider to build a working relationship with. While cost may be a factor in choosing, some specialists could provide financial aid or a sliding scale fee. You can also consider online counseling for a lower hourly rate. 

Situations such as moving, traveling or seeking specialized care are common reasons that prompt many to find an out-of-network provider. It can be helpful to review the listing directory provided by your insurance company to see if the provider is in-network. They may be out of network if they don't appear on the list. In this case, you can talk with your insurance provider to further understand their billing process. While some policies cover out-of-network services, you might be asked to pay the balance—so checking beforehand can be valuable.

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