Everything You Need To Know About Online Therapy and Insurance

Medically reviewed by Kimberly L Brownridge , LPC, NCC, BCPC
Updated October 22, 2024by Regain Editorial Team
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The average cost of in-person mental health counseling in the US is $100 to $200 for individuals and $175 to $275 for couples. For many, these costs present a barrier to receiving support. However, as mental health advocacy grows and more people understand counseling benefits, more options are opening up for people to manage counseling costs and get behavioral coverage.

For many, online therapy can be cheaper and more convenient than in-person options. However, for those with insurance, barriers can arise with coverage and knowing whether their plan pays for telehealth services. Learning more about the various ins and outs of online therapy pricing and insurance can help you decide if these services would be within your budget.

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Finding the help you need should be affordable

Does insurance cover online therapy?

If you have health insurance, you might assume that your insurance plan covers therapy. However, while a major healthcare insurance company, like Blue Cross Blue Shield, may offer clients coverage for behavioral health services online with licensed and certified providers, health insurance coverage for online therapy can vary by state. Research your health insurance plan to learn what benefits you may qualify for under your plans' behavioral health benefits or call the number on the back of your insurance card to speak with a representative who can answer your questions. It can be important to know what your insurance covers before attending therapy sessions to avoid unexpected out-of-pocket expenses. Additionally, it may be helpful to be aware that insurance providers often only cover care deemed “medically necessary,” meaning that they may only cover mental health clients with a diagnosed mental illness.
Have you ever found yourself wondering, “Does health insurance cover therapy?” If you have, you might come across the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA). This health parity act was passed to ensure that mental health treatments for mental illnesses and addiction are given equal coverage, as compared with physical conditions. The National Alliance on Mental Illness (NAMI) provides a more in-depth overview of mental health parity and how it might apply to your health insurance plan.

Online behavioral health benefits operate like their offline counterparts, providing clients to participate in online therapy sessions with licensed therapists authorized by their plan. The coverage offered by insurance companies for therapy can be complicated. Not all plans cover therapy, and even if coverage is offered, it may exclude online therapy. For example, one-on-one practice therapists working online must still apply to accept insurance from various insurance companies. Not all practice therapists are on the same panels or take insurance. In addition, online platforms may not accept insurance due to billing policies. 

How much does out-of-pocket online therapy cost?

The average cost of therapy depends on where it occurs. Factors that affect the prices may include geographical location, education, experience, concurrent conditions, whether it's a one-on-one or public practice, and any specialties the therapist has. 

Mental health clients living in major cities or states with a high cost-of-living index may expect to pay more for online mental health care services in their state than behavioral health clients in those with a lower cost of living.

Online therapy sessions through an online platform often range from $35 to $90 per session and provide unlimited messaging. Sessions can be via chat, video, or phone call. With an affordable cost, many people can get therapy for a fraction of the price of a traditional session. In addition, couples can use an online platform like Regain to pay $65 to $90 a session, split between two people. 

Taking part in therapy sessions online can eliminate frustrating commutes, lower gas costs, and offer a safer-seeming option for those with social anxiety or immobility-related concerns. It can be challenging to find a therapist that meets all of your needs within one city, and online therapy can expand your reach to your entire state and providers outside of your state licensed to practice where you are. 

How do you pay for counseling? 

There are generally three categories of counseling costs, including the following. 

Free or low-cost counseling 

Free or low-cost therapy is an income-based payment option that provides low, reduced-cost, or free therapy to income-qualified mental health clients. Free or low-cost therapy can often be offered through organizations like non-profits. In some cases, free therapy may be available to individuals through a student health care plan at a university or an individual's employment mental health plan. Free or low-cost therapy can encompass various types of services. If you're struggling to find resources in your area, consider dialing 211 for support. The 211 line is a national hotline to help low-income individuals and those in crisis find financial support, food resources, housing, and mental health help. 

Sliding fee scales 

Sliding-fee scale therapy provides services based on client income. Sliding scale therapists don't charge clients the same standard rate and may offer therapy at a reduced rate compared to the average cost of treatment. If you’re interested in working with a therapist, but do not have insurance or are not in-network with the provider, it may be worthwhile to inquire about sliding scale pricing options.

Standard counseling rates 

Standard counseling rates include standard out-of-pocket fees for offline and online therapy providers. Often, these rates depend on the coding the therapist uses for the session, which depends on the time of the session. Online therapists often offer lower fees due to not having to pay for extra costs like office rent, parking, or transportation. 

What happens in an in-office session? 

When you schedule an in-office therapy session with your chosen provider, you may be asked to wait a few days or weeks. Some providers have waiting lists, whereas others may take time to get you on the schedule with other clients. 

During your initial consultation, your therapist may ask you questions about your lifestyle, symptoms, and health history and have you complete questionnaires for their records. They might also describe their approach and start to develop a treatment plan unique to your needs. Some therapists diagnose clients after a few sessions, whereas others may avoid diagnosis to focus on treatment. 

The two of you can work together to develop a treatment plan comprising realistic goals and sessions that fit your current lifestyle. Your therapist may suggest incorporating various types of therapy and strategies into your treatment plan. When you agree on a plan for future sessions, you can decide whether to keep sessions in person or online and set future appointments. Many in-office therapy sessions last between 45 minutes to an hour and are billed as an out-of-pocket expense or covered by behavioral health insurance plans. 

How does online therapy work? 

Online therapy encompasses various virtual therapy methods, including mobile therapy, telepsychology, and telemedicine. Online therapy sessions follow the same protocols as traditional in-office therapy but are done from a distance and come at a different cost. 

When mental health clients choose distance therapy online, they can set up an initial consultation with a therapist from home to develop a treatment plan, discuss concerns, and develop new coping skills. Depending on how online therapy is done, the therapist might use other tools like online worksheets, journaling prompts, or screen during sessions. 

Like traditional therapy, therapists often ask clients to adhere to the goals and standards outlined in their treatment plan to achieve recognizable results. Below are four of the ways you might partake in telehealth therapy. 

Web therapy 

Web therapy involves a client and board-certified or licensed therapist meeting virtually via a therapy platform. Clients and therapists connect via video chat sessions similar to Skype from the comfort and the location of their choosing. Web therapy sessions can often be used for groups, families, couples, and individuals.  

A web therapy session may be similar to an in-person session. Meeting with a therapist online can still include techniques like cognitive-behavioral therapy and approaches like art activities or roleplay. When you’re trying to find a therapist who practices in-person, you will be limited to providers practicing within your geographic area. If you’re in a rural location, that may limit the types of specialties and modalities available to you. However, when you look for a therapist online, you may be able to access a wide range of therapists in your state who specialize in hundreds of different modalities. 

Texting and chat therapy 

Online platforms often offer chat therapy. Through these platforms, the client or clients can send messages back and forth with the therapist during an agreed-upon live therapy session. Chat therapy differs from regular messaging in that it is done over a safe chat room and lasts for the duration of the appointment, often 30 to 45 minutes. 

Phone therapy 

Phone therapy sessions allow therapists to connect with clients over the phone and talk without seeing each other face to face. Through an online therapy platform, the therapist may start the session by prompting the safe service to send a call to the client's phone. They can then talk through a safe phone line. With a one-on-one practice therapist, the therapist may call the client directly or use a video chat platform like Zoom without the video feature. 

Online counseling options 

Knowing how much counseling costs can be challenging, as pricing varies across the country, depending on many factors. Although online therapy may not offer insurance coverage options, it can be more affordable than some co-pays and paying out of pocket for an in-person provider. 

If you're looking for a platform that provides therapists for you, you may benefit from an option like Regain for couples or BetterHelp for individuals. Both platforms offer a match-based system with over 30,000 therapists between them and various specialties of care. 

In addition, if you're unsure about the effectiveness of online therapy and why it might be worth the cost, note that studies have found that 71% of participants who try online therapy find it more effective and preferable to in-person counseling. 

Counselor reviews

"My experience with Priscilla has been immensely helpful in better understanding myself and providing me with the tools to see my life and relationships with more clarity and compassion."

“Shannon is very knowledgeable, and skilled in knowing how to use that knowledge to help others. She is also very compassionate and encouraging. I was skeptical about using a counseling service, but this experience has been incredible. I highly recommend Shannon to anyone who needs guidance or help through a difficult time in life. I gave her some enormous challenges, and nothing has been over her head. She has been a tremendous help to me.”

Finding the help you need should be affordable

Takeaway

Online therapy is often a more affordable option for many clients than in-person therapy. Although many online therapists don't accept health insurance, some do, and there are various options to consider. If you're ready to get started, consider signing up for a platform or contacting a telehealth therapist in your area for further guidance.

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