Current Events > Is an $80 co-pay too much for therapy?

(+) Yeah! (+)

Finally found a place accepting new clients where I live, and they keep saying "Oh... Your copay is really high... Are you okay paying $80 per session?" and it keeps weirding me out. Should I like, not go? I'm not in a crisis situation or anything.

For comparison, my fiance was paying like $100 for a 50 minute session.

Whether or not you should go is only something you can answer, though.

She eventually stopped going when she felt like she wasnt getting anything else from it

Sounds reasonable compared to what I've seen. If you have a deductible on your insurance, that could be why it's that high. Or maybe it's out of network. Ask them why.

I pay $150 an hour and my benefits cover $500 per year. Lotta out of pocket for me

MegaTech posted...

Sounds reasonable compared to what I've seen. If you have a deductible on your insurance, that could be why it's that high. Or maybe it's out of network. Ask them why.

Yeah I have a $1100 deductible.

It's just weird because I was expecting to pay around that number when I started looking for therapists again. But the people I keep speaking with are all acting weird and being surprised I have a deductible, and it's throwing me off :|

FTR I do live in NY where everything is expensive lol. But based on what you guys are anecdotally saying, $80 per sesh doesn't seem astronomical to me.

Ah yeah that'll do it. They probably want to make sure you understand. I'm sure they've had people get charged and then complain only to understand after what they were paying.

I dont understand why people pay for insurance and then have a high co pay. It must be the area youre in. Therapy sessions here are around the $60 hour range for uninsured.

good lord. I was paying 20-30 for therapy.

80 is reasonable

$80 isn't a high-copay for therapy. It's a little below the average cost, actually.

--Zero- posted...

I dont understand why people pay for insurance and then have a high co pay. It must be the area youre in. Therapy sessions here are around the $60 hour range for uninsured.

Yeah it really sucks. Like I said, I live in NY. Long Island specifically, which has some of the highest cost of living in the U.S.

LostForest posted...

Yeah I have a $1100 deductible.

It's just weird because I was expecting to pay around that number when I started looking for therapists again. But the people I keep speaking with are all acting weird and being surprised I have a deductible, and it's throwing me off :|

FTR I do live in NY where everything is expensive lol. But based on what you guys are anecdotally saying, $80 per sesh doesn't seem astronomical to me.

If you haven't met your deductible more than likely it's not a copay. Assuming the provider is in-network $80 is probably the negotiated cost for members between the provider and insurer. Then once you hit you deductible there is generally an 80/20 split until you reach your Maximum out of pocket. That depends a lot on the rules of your plan though.

Source:
Currently I work for one of the big insurance companies, and I used to be an insurance agent. I still have my license for health insurance.

Thanks for all the help everyone! I appreciate it.

That sounds high and unaffordable to be weekly visits. Maybe if it's monthly

Wow, never mind then. I wanted to go and talk to someone to help with the horrible thoughts I have, but I'm not paying that much. I thought it would have been covered. My medication is only like $5

Bad_Mojo posted...

Wow, never mind then. I wanted to go and talk to someone to help with the horrible thoughts I have, but I'm not paying that much. I thought it would have been covered. My medication is only like $5

Check your policy. Insurance is not anything close to one size fits all.

Wal-Mart and Target can both offer Aetna, and the benefits can be completely different. With group coverage it's typically the company that designs the plans and cost, and they just use the insurer's network and claims processing.

I pay... uh... $5 lol. I didn't realize a lot of plans actually had them that high. Though to be fair, I don't think my current therapist can actually handle me. She says I'm by far the worst case in terms of severity she's ever dealt with, but she's trying and it's hard for me to just cut it off.

But I'm pretty sure it's $5 for me whoever I pick. I'm about to move to another state so I'm hoping it's not too wild wherever I go.. Or I'm probably just not gonna do therapy.

Look at it like this:

A court-ordered Intensive Outpatient (IOP) substance abuse recovery program is typically 3 four hour group sessions a week for four months, along with weekly or biweekly individual sessions.

After that is aftercare, which is a good 6 months of hour long weekly group sessions.

If you have a court order to attend therapy coupled with your insurance, that would kinda suck.

If you're doing biweekly or monthly sessions, it's better but still not great.

Helping people deal with financial stress is usually a big part of the interventions, so providers usually try to keep an eye on what clients have to pay.