Clients can reach out and contact their therapist directly to find out more information about their therapy rates. This page will share some information about how many Mental Health Care systems work in Maryland.
Mental health and wellness can be incredibly important to living a full and happy life. Too often, managed care companies predetermine the necessity of therapy, while many therapists believe these needs should be determined through a collaborative process between you and your therapist, driven by your personal progress and needs.
Professional therapy services in the behavioral health industry will at times qualify for reimbursement under a clients insurance plan, as many therapists in the area are considered Out Of Network providers for most insurance companies. Although the choice to use your insurance for reimbursement of therapy is yours, many clients consider the following before making an informed decision:
- Insurance companies are designed to reimburse for the treatment of illness. Therefore, a psychiatric diagnosis is usually required before any reimbursement is allowed. This diagnosis becomes a pre-existing condition if you ever have to reapply for insurance and can affect your rates.
- Managed care companies control many facets of your therapy, including the medical necessity of care, the type of therapy they will cover, and the duration and pace of therapy (without regard to your personal progress).
- All insurance companies require some personal information in order to facilitate processing your claim. Once this information is transmitted to an insurance company, there is no way to ensure that it will remain private and confidential.
If you do chose to submit to your insurance company, you can request a bill from any therapist you see that contains all of the required information needed that can be submitted to your insurance company for out-of-network reimbursement. You are welcome to check with your insurance coverage carefully by asking the following questions:
- What are my Out Of Network, Mental Health insurance benefits?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session? (It is usually expressed as a percentage, like 80% or a flat rate, like $80.)
- Is preauthorization (e.g. preapproval, precertification) required from my insurance company or primary care physician?
Additional Options
Some employers offer health savings accounts to their employees, which can be used to pay for deductibles, copays, and general health expenses that will not be covered by insurance. Ask your employer if they offer a Health Savings Account (HSA), Medical Savings Account (MSA), Health Reimbursement Arrangement (HRA), or a Flexible Spending Account (FSA).
These accounts work by taking pre-tax dollars from an employee’s income and setting them aside to use for medical expenses. Typically, in the counseling setting, the client will pay their therapist using an HSA or FSA account card, issued to them by their employer so the client will have access to a separate financial account with their HSA/FSA savings money in it to pay for the therapy session.
Good Faith Estimate – Notice
Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask any health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during treatment. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, see your Estimate, or visit www.cms.gov/nosurprises.