Tuesday Therapy Notes: In-Network vs. Out of Network

We’ve talked in the past on this series about some of the considerations that go into choosing a new therapist. One of those considerations, of course, is the cost. And while the cost can be greatly reduced with the help of private insurance, the fact of the matter is that getting insurance to cover treatment might be difficult.

A 2017 report from the National Alliance on Mental Illness, or NAMI, detailed that 34 percent of individuals with private insurance had a difficult time finding a mental health provider. Ultimately, 28 percent went out-of-network, a decision that ultimate carries with it considerable cost.

The report goes on to discuss that part of the reason why it is harder to get in for mental health care than for other types of care is because the insurance companies want to limit access to limit their overall cost. However, as the report discusses, there are many other reasons, such as fewer therapists and psychiatrists in rural areas as well as the unwillingness of some therapists to join insurance networks.

There are solutions. The most notable are mental health parity laws, which can exist at the federal and state level. For example, California’s mental health parity law requires insurance companies to cover mental health services the same as they do for physical services. By contrast, the federal mental health parity law only requires mental health services that are equal to an insurer’s physical services if the insurer already provides mental health services, although President Biden has stated publicly that he would like to improve the federal parity law.

Ultimately, these insurance complications can frustrating. They can even differ people from getting the help they need. However, it is still worth investigating therapists that are out of network because they sometimes offer cost sliding provisions that allow you to pay less if the services aren’t covered by insurance. And as someone who has had to go out of network in the past, I can assure you that it is still worth, even if it is frustrating. My hope is that more people find ways to successfully access therapy if they need it, and that mental health parity laws continue to improve.

And as always, thanks for reading.

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