with insurance

Health insurance can be complex and sometimes confusing to navigate. But don’t worry, we’re providing a cheat sheet to help you make better sense of insurance so you know what to expect when you use your insurance to see one of our providers. 

While there are many types of insurance plans, the most common are Health Management Organizations (HMO) and Preferred Provider Organizations (PPO). Which type of policy you have should be pretty clear to you as it’s usually printed on your insurance card. Here are its main differences:

If you have an HMO policy, this means that your insurance will only cover treatment services by providers that are in-network. In-network providers have gone through a credentialing process with your specific health plan, and are contractually bound to accept a pre-set fee for covered services. This means that an in-network provider will never charge you more than what your plan benefits state, which is usually your regular office copayment and any applicable deductible. 

When you work with an in-network provider, our office will collect your copayment after each session and bill your insurance for you. 

Should you choose to work with a provider who’s not in-network with your insurance company, none of your services will be covered and you will need to pay for treatment out of pocket. (Click here to review average costs for out of pocket services)

out of pocket

The benefit to working with in-network providers is that you can save a lot on costs. However, there are many circumstances where somebody may choose to seek services not fully covered by insurance: 

  • You don’t have health insurance
  • Your insurance benefits don’t cover mental health services
  • You have an HMO policy, and the provider of your choice is not part of your insurance network
  • You have a PPO policy with out-of-network (OON) benefits to see any provider of your choice, with the understanding that you will pay for services out-of-pocket (OOP) and will claim reimbursement from your insurance (Click here to read more about your PPO policy) 
  • You’re seeking elective services not covered by your insurance plan

All of our treatment providers are considered solo practitioners and therefore set their own fees. However, to give you an idea of how much they generally charge for services, here’s an estimated range of average costs for services: 

Traditional Psychological Services:

Individual Psychotherapy – $150-$200 / session

Couple’s Therapy – $150 - $200 / session

Family Therapy – $150 - $200 / session

Group Therapy – $40 + / session

Medication Evaluation – $150 + / session

Medication Management – $50 + / session

Attention Testing – $425 / Testing, Clinical Assessment and Interpretation Results (Read More)

with EAP coverage

If you’re an employee of a large company, you may have an annual benefit called the Employee Assistance Program (EAP), which provides you with a set number of psychotherapy sessions per year (typically ranging from 3-12 sessions depending on your EAP benefits) at $0 cost to you. In order to access these benefits, you must contact your EAP company to request authorization to initiate services, and provide details of the authorization to our office. 

After you’ve exhausted your annual EAP allowance and wish to continue seeking treatment, you will need to pay for services out of pocket or with your insurance benefits. 

EAP’s are sometimes handled by independent companies that may or may not be associated with your primary insurance plan. In the event that the person who provided your EAP treatment is not part of your primary insurance company’s network of providers, you may request for that provider to negotiate an out of pocket fee for you to continue treatment with them.