What to Know About Your Health Insurance as a New Year Begins
Introduction
As the new year begins, it’s common for health insurance plans to reset, bringing changes to deductibles, benefits, and coverage. Whether you’re starting therapy for the first time or continuing care, understanding your insurance can help you feel informed, empowered, and confident in navigating your mental health journey.
Here are key things to keep in mind about your health insurance as you step into the new year.
1. Your Deductible (If You Have One) Likely Resets
At the start of a new year, most insurance plans reset your deductible—the amount you pay out-of-pocket before your coverage kicks in.
Why It Matters: If you haven’t met your deductible yet, you may need to pay more upfront for therapy sessions.
Tip: Check with your insurance provider to confirm your deductible amount and track what you’ve paid so far.
2. Know Your Mental Health Benefits
Mental health services, including therapy, are typically covered under most plans, but the details can vary.
Questions to Ask:
How many therapy sessions are covered annually?
What’s the co-pay or co-insurance for therapy?
Do you need a referral to see a psychologist?
Pro Tip: If you’re unsure, ask your insurance provider for a breakdown of your mental health benefits.
3. In-Network vs. Out-of-Network Coverage
Therapists can be in-network or out-of-network with your insurance plan.
In-Network Providers: You’ll pay less out-of-pocket for sessions because they’ve contracted rates with your insurance.
Out-of-Network Providers: You may pay more upfront but could still get partial reimbursement, depending on your plan.
Next Step: Check out my FAQs page for more information on payment, insurance, and reimbursement.
4. Understand Co-Pays and Co-Insurance
A co-pay is a fixed amount (e.g., $20 per session) that you pay for therapy.
Co-insurance is a percentage of the session cost you’re responsible for after meeting your deductible.
Why It Matters: Knowing these details will help you budget for therapy and avoid unexpected costs.
5. Verify Telehealth Coverage
Telehealth therapy continues to be a valuable and accessible option for many clients.
What to Ask:
Is telehealth covered under my plan?
Are there any restrictions or additional fees for virtual therapy sessions?
Good News: Many insurers now cover telehealth services at the same rate as in-person visits.
6. Use Your FSA or HSA Funds
If you have a Flexible Spending Account (FSA) or Health Savings Account (HSA), therapy sessions are often eligible expenses.
Benefit: Using pre-tax dollars to pay for therapy reduces your overall costs.
Reminder: Some FSAs have a “use it or lose it” policy, so plan accordingly.
7. Don’t Be Afraid to Ask Questions
Insurance jargon can feel overwhelming, but you have the right to clear information.
Conclusion
Navigating insurance can feel confusing, but a little preparation can make a big difference as the new year begins. Understanding your coverage, deductibles, and benefits helps you make informed decisions and start therapy with confidence.
Ready to prioritize your mental health this year? I’m happy to help you get started!
