Therapy Insurance Made Simple: 7 Questions to Ask Before You Start

Many people reach a point where they’re finally ready to begin therapy. Whether it’s after months of consideration or prompted by a tough season of life, taking that first step can bring a sense of hope and relief.

But for many, a new question quickly follows: “How does my insurance work with therapy?”

Terms like deductible, in-network, superbill, and copay can make the process feel overwhelming—especially when you’re already carrying stress. If you're feeling confused or hesitant because of insurance questions, you're not alone.

At Hearten Therapy, we’re here to help you feel supported—not just emotionally, but logistically too. This guide is designed to walk you through the key questions to ask about your mental health benefits, so you can start therapy with clarity and confidence.

Why Understanding Your Insurance Benefits Matters

Taking time to understand your therapy benefits upfront can:

• Prevent unexpected costs

• Make scheduling smoother

• Help you choose the right provider

• Empower you to make informed, stress-free decisions

We’re In-Network With These PPO Plans

Hearten Therapy is in-network with the following PPO insurance plans:

• Blue Cross Blue Shield

• Aetna

• United Healthcare

Being in-network means we’ve already negotiated rates with these providers, which typically translates to lower out-of-pocket costs for you. If you’re not covered under one of these plans, don’t worry—we also provide superbills for out-of-network reimbursement, allowing many clients to receive partial insurance coverage still.

7 Key Questions to Ask Your Insurance Before Starting Therapy

Use this list when calling your insurance provider, checking your benefits online, or talking with your HR rep:

1. Is outpatient mental health therapy covered under my plan?

Confirm that individual therapy or mental health counseling is included in your benefits. Some plans may only cover specific types of providers or diagnoses.

2. Is Hearten Therapy in-network with my insurance?

If a PPO plan insures you through Blue Cross Blue Shield, Aetna, or United Healthcare, the answer is yes. In-network coverage typically means easier billing and reduced session fees.

3. What is my copay or coinsurance per session?

• Copay: A flat fee (e.g., $20–$40 per visit)

• Coinsurance: A percentage of the session cost (e.g., you pay 20%, your insurer pays 80%).

  Knowing this helps you prepare financially for ongoing care.

4. What is my deductible, and has it been met?

Many plans require you to meet a deductible before covering therapy sessions. Ask what your deductible is and how much you've paid toward it this year.

5. Do I need a referral or prior authorization?

Some insurance plans require pre-approval or a referral from your primary care provider before you begin therapy. Missing this step can lead to denied claims.

6. Are there any session limits per year?

Ask if there’s a cap on how many therapy sessions your plan will cover annually. This can help with long-term planning.

7. Can I submit superbills for out-of-network therapy reimbursement?

Yes! If your plan offers out-of-network coverage, we’ll provide you with superbills—itemized receipts that you can submit for partial reimbursement. Be sure to ask how to submit them and what documentation is required. The process for each insurance company can vary.

Using Insurance for Therapy: What You Should Know

When using insurance for therapy services, there are a few things to keep in mind:

• A clinical assessment is required during the first session.

• A mental health diagnosis must be submitted to your insurance provider in order for services to be covered.

This is standard across most insurance plans. If you're not comfortable having a diagnosis on file, private pay might be a better option—something we’re happy to talk through with you.

Quick Glossary of Therapy Insurance Terms

• Deductible: The amount you pay out-of-pocket before insurance begins to pay.

• Copay: A fixed fee you pay for each therapy visit.

• Coinsurance: A percentage of the visit cost you pay after meeting your deductible.

• Superbill: A detailed receipt we provide for you to seek reimbursement from your insurer.

• Out-of-pocket maximum: The most you’ll pay in a plan year before insurance covers 100%.

Still Feeling Unsure? We’ve Got You.

We know the insurance side of therapy can feel like a maze. That’s why we offer to verify your benefits for you and give you an estimated session cost—so you can focus on feeling better, not deciphering policies.

Whether you're using Blue Cross Blue Shield, Aetna, or United Healthcare PPO, or exploring out-of-network reimbursement, we’re here to make the process easier; however, we always recommend verifying your benefits directly with your insurance company!

You Deserve Support Without the Stress

Therapy should be about healing, not headaches. Understanding your insurance options—whether you’re in-network with us or planning to use superbills—helps you step into therapy with peace of mind.

Not sure where to start with your insurance? Reach out to Hearten Therapy—we’ll help you verify your PPO benefits, walk you through superbill options, and answer your questions so you can feel fully supported from day one.