Why You Might Choose an Out of Network Therapist

Everyone has their share of stories to tell about health insurance.

You do, too. It’s no secret that the health care system is not always the most efficient or friendly. But, have you ever considered bypassing the entire system itself? This is not as drastic or rare as it sounds and can provide some clarity regarding your needs and care.

For example, let’s say you have decided it’s time to start therapy. There are issues you want to address as soon as possible but… the hold-up is the whole “network” concept. Do you feel restrained or limited in your choices? Have you ever considered going out of network? This can be a rational and self-loving choice.

If you’re like most people, you grew up being conditioned that some topics aren’t to be spoken about.

• Don’t show weakness.
• Maintain privacy.
• Toughen up and deal with it.
• Emotions are not a topic for polite conversation.

The list and the many variations go on. Meanwhile, each and every one of us is craving more. And meanwhile, mental health conditions like anxiety and depression keep becoming more common.

Right now, it seems like it’s all catching up with you. 

You see, we are all heavily conditioned to color inside the lines when it comes to health care. This may often be good advice. But there are countless situations in which you need to improvise for the sake of your well-being.

So, in this post, we will be discussing why it’s time to reach out to a therapist, how you can do it without hassle, and the details of what that will cost you. 

 

Why Should You Choose An Out Of Network Therapist?

It’s a scary idea, but once it gets some momentum and perspective, it’s not hard to understand why you and everyone you know could benefit from having access to a therapist. 

Let’s talk about why this might be a good idea and why you might choose to go out of network. 

 

1. You Want Help But Don’t Want to Wait

This is, perhaps, the most fundamental reason to ponder an out-of-network option. People, for the most part, don’t consider starting therapy until there is a cause to do so. Then, a problem arises and you might find yourself scrambling. If you opt to not search based on who accepts your insurance, you may connect with a compatible therapist far more quickly.

Side note: you may want to take a closer look at your health insurance plan. There’s a reasonably strong likelihood that you have far better out-of-network benefits than you imagine.

 

2. Privacy Concerns

There are countless scenarios in which you might prefer to keep things private. This could mean keeping family members or even your health insurance company out of the loop.

Other concerns might be other entities who might want access to your medical records. These might include divorce lawyers, life insurance companies, or other outside entities wanting to screen for risk factors.

However, there is a downside here. When you eschew all insurance, you also lose access to out-of-network benefits. 

 

3. Cost

Depending on the cost of your insurance deductible, there can be virtually no difference between in-network therapy and out-of-network therapy. We will specifically discuss cost later on. 

 

4. You Have Very Specific Therapy Needs

Each and every therapist brings a unique blend of skills and experience to the table. Then, of course, there are your personal preferences.

For example, you may be seeking a woman or a person of color — or both!

Or, you may be seeking therapy for an issue that requires a therapist with specific training such as for an eating disorder or OCD.

You might also be looking for a specific type of therapy to help with your symptoms such as Brainspotting, Somatic Therapy, or EMDR therapy for trauma. 

Once you’ve given this process some thought, you’ll probably have an ideal type of therapist in mind. Going out of network dramatically increases your chances of fulfilling these needs.

Also, when your therapist is in-network and using insurance, they have to follow strict guidelines as to services provided. An out-of-network therapist can offer more treatment approaches.

 

5. You Have Already Found Your Therapist

Maybe it was word of mouth or just plain luck. Whatever the process, if you have found someone you feel compatible with, do not let them go based solely on a health insurance decision.

This also goes for those of you who are already in therapy. Scenarios arise in which your insurance coverage changes. You should not have to automatically move on from a mental health professional with whom you connect and feel good.

No matter how you come about it, finding your therapist is a special thing. 

 

Strictly Financial Criteria

If your primary goal is to save money, you will probably choose an in-network therapist. After all, health insurance is not cheap. You make regular payments and as a result, you can see a therapist and “only” be responsible for a co-pay. On a micro, financial level, this makes sense.

But …you’re not just operating on a financial level. There’s more to consider in finding a good fit therapist. Finding a good match in terms of a therapist can be easier said than done.

This may be because: 

• You have some very specific therapy needs
• The therapists in your town are not accepting new clients
• The client-therapist relationship is nuanced and requires some trial and error

So, if you’ve gone the traditional route and had no luck, it may be time to think outside the box.

 

Considering Out of Network Options

Carefully Check Your Plan 

There is a reasonable chance that your insurance plan offers “out-of-network benefits.” The financial and logistical details may vary widely so get some guidance if necessary.

Depending on the specifics of your plan, you may find that your out-of-pocket costs are not nearly as high as you have imagined.

Using an app like Reimbursify can help you navigate the reimbursement process in a few clicks.

You Have a High Deductible Plan

If you have a high deductible plan and don’t have other high medical expenses, the cost of therapy would be the same whether you are in or out of network.

Reducing Session Frequency as Symptoms Improve

When you begin therapy, you will make the most progress if you meet with your counselor once a week. Over time, however, as your symptoms improve, you may decide to reduce your session frequency. 

For the best therapeutic outcome, be mindful of not reducing your session frequency too soon. The most effective outcomes typically come after approximately 12 sessions. And the consistency of coming to therapy and practicing new skills in between sessions builds upon each other.

Consider a Therapy or Support Group

Group therapy can actually be a powerful way to heal. Not only do you learn new skills, but you connect with people with similar situations or symptoms as your own. Learning from others who “get you” helps you feel more connected and takes the stigma out of your experience. You’re not alone!

Use Your HSA or FSA Plan

If you have a high deductible insurance plan (or even if you don’t), you can reduce your tax liability by using an employer-sponsored HSA or FSA plan. The way it works is that you set aside a specific amount at the beginning of the year pre-tax to pay for medical expenses. In many cases, you can access these funds via a debit card provided by your FSA plan.

By setting aside medical expenses on an FSA or HSA plan, you reduce your medical costs by approximately 20% or your current tax bracket as the expense is set aside in pre-tax dollars from your paycheck.

The Positives of Seeking Out Therapy On Your Own

This may seem like an odd topic but we’re talking about a very important part of your health.

If you need therapy and you find the right practitioner for you, it very well may be worth some sacrifices. For example, there are likely to be other parts of your budget that can be tweaked in order to make more money available for counseling. 

Do you really need every single streaming service? Can you cook more and order in less? Take a closer look at your finances. You might find the trade-off to be quite agreeable.

Another factor to consider is motivation. Therapy is hard work.

It can be jolting at times and rarely is changed with a simple flip of a switch. When you opt to pay out of pocket for your sessions, it could inspire a deeper commitment to the process. You take it more seriously and do the work all week — in-between sessions.

To get started with our of our Houston, Montrose, or Sugar Land therapists, call (832) 559-2622 or text (832) 699-5001 us today.