Insurance 101 for Counseling Visits: Copays, Deductibles, Superbills
For many people, the hardest part of starting therapy is not finding a counselor they like. It is understanding how to pay for counseling visits without unpleasant surprises.
You might have questions like:
Will my insurance cover counseling
What is the difference between a copay and a deductible
What on earth is a superbill
If insurance terms feel confusing, you are not alone. The language around mental health coverage often sounds technical and distant, especially when you are already dealing with anxiety, depression, stress, or burnout.
This guide is meant to make counseling and insurance feel more understandable and less overwhelming. You do not need to become a billing expert. You just need a clear, simple sense of what these terms mean and how they affect what you pay for therapy. it shows up now, and map out a kind and realistic path toward healing.
A counseling session focused on mental health awareness, emotional support, and healing.
Why therapy and insurance feel so confusing
Mental health counseling sits in a unique place. It is health care, but it feels very personal. You are talking about your inner world, not just getting a lab test or an X ray. When money and insurance get added to something so personal, it is normal to feel some tension.
Common worries include:
“What if I start therapy and then find out I cannot afford it.”
“What if I ask my therapist about costs and sound rude.”
“What if my insurance refuses to pay for mental health counseling.”
These fears are understandable. The goal is not to pretend money does not matter. The goal is to bring the financial side of counseling into the light in a calm, practical way so you can plan ahead and focus on healing.
Key insurance terms you will see with counseling visits
Here are some of the most common terms you will see and how they connect to therapy:
Premium
This is what you or your employer pay each month to have health insurance at all. It is the subscription cost for your health plan.
Copay
A copay is a fixed dollar amount you pay at each visit. For example, you might pay 20 or 40 per counseling session when you see an in network therapist. Your insurance pays the rest according to the plan.
Deductible
Your deductible is the amount you must pay out of pocket each year for covered services before your insurance starts sharing the cost. Some plans have a separate deductible for mental health or for out of network care.
Coinsurance
After you meet your deductible, you may pay a percentage of the session cost instead of a flat copay. For example, you might pay 20 percent and insurance pays 80 percent of the allowed amount for counseling visits.
Out of pocket maximum
This is the most you will have to pay in a year for covered services, including medical and mental health. Once you hit this amount, insurance usually pays 100 percent of covered costs for the rest of the year.
You do not have to memorize all of this. Just knowing these basic ideas can help you ask better questions and understand the answers you get from your insurance company or provider.
If you want to have a clearer idea, you can start a conversation with us. There is no commitment to continue after the first chat.
A person discussing costs for counseling visits in a calm and supportive setting
How copays work for counseling visits
If your therapist is in network with your insurance, you may have a copay for each counseling session. This is often the simplest arrangement for clients.
In this situation:
The therapist agrees to a contracted rate with the insurance company.
You pay your copay at each visit.
The therapist bills the insurance for the rest.
For example, if your plan says “mental health office visit copay 25 in network,” you can generally expect to pay 25 each time you see an in network counselor for an individual session, as long as you have met any mental health deductible required by your plan.
Some plans have a copay that starts right away. Others apply the copay only after you meet a deductible. This is why it is important to ask specifically, “Do I have a separate mental health deductible, or do my therapy copays start immediately”
How deductibles and coinsurance affect therapy costs
If your plan has a deductible for counseling visits, things work a little differently.
Here is the basic idea:
Until you meet your deductible, you pay the full contracted rate for therapy sessions.
After the deductible is met, you may switch to a lower copay or a coinsurance percentage.
For example:
Your therapist’s contracted rate with your insurance is 130 per session.
Your plan has a 1000 deductible for in network services.
You go to therapy once a week.
You might pay the full allowed amount for those early sessions until you reach the 1000 deductible. After that, your cost may drop to a copay like 25, or coinsurance like 20 percent of the allowed rate.
This can feel frustrating, especially at the beginning of the year. The benefit is that once you meet your deductible and move into the coinsurance or copay phase, care often becomes more affordable. If you also have medical visits, those can count toward the same deductible and out of pocket maximum, depending on how your plan is structured.
If you would like to walk through the first steps with you, you can meet our team and set up a first session.
An example of how professional counseling supports individuals in every aspect of their struggle.
In network vs out of network for mental health counseling
When it comes to therapy and insurance, the terms “in network” and “out of network” are important.
In network therapists
Have a contract with your insurance company.
Agree to specific rates for services.
Are usually cheaper at the time of each visit, especially if your plan has copays for mental health counseling.
If you look up counseling providers on your insurance website, those listed are often in network.
Out of network therapists
Do not have a contract with your insurance.
Set their own fees.
May still be partially covered through out of network benefits, if your plan includes them.
If your insurance has out of network mental health coverage, they might reimburse you for a portion of each counseling session after you meet an out of network deductible. This is where superbills often come in.
Sometimes people choose an out of network therapist because of their specialty, style, or availability, even if it means more financial responsibility. It is a personal decision that depends on your budget, your mental health needs, and your values.
What is a superbill and how does it work
If your therapist is out of network, they may offer a document called a superbill. A superbill is like a detailed receipt for your counseling visits that you can submit to your insurance company to request reimbursement.
A superbill usually includes:
Your name and basic information
The therapist’s name, credentials, and license number
A diagnosis code, if used, for mental health billing
A service code for the type of counseling session
The date, length, and fee for each therapy visit
Here is how the process often works:
You pay your therapist directly at the time of service.
Your therapist provides you with a superbill each month or after each session.
You send the superbill to your insurance company, usually through a portal, app, or mail.
Your insurance processes the claim according to your out of network benefits.
If your plan covers out of network counseling, they may send you a reimbursement check or deposit.
The amount you get back, if any, depends on your specific plan, deductibles, and allowed amounts. It is a good idea to call your insurance and ask, “What are my out of network benefits for outpatient mental health counseling” before relying on reimbursement.
Emphasizing trust, communication, and mental health care
Questions to ask your insurance company before starting therapy
Insurance language is often clearer when you have specific questions ready. Here are some you can use when you call the member services number on your insurance card:
Do I have mental health or behavioral health coverage for outpatient counseling
What is my copay or coinsurance for in network therapy visits
Do I have a separate deductible for mental health counseling, and if so, how much is it
Does my plan cover telehealth therapy sessions and is the cost different from in person visits
Do I have out of network benefits for counseling, and what percentage is reimbursed after my out of network deductible
What information do you need from a superbill if I see an out of network therapist
What is my out of pocket maximum for the year.
If you want help planning, you can schedule a session to prepare.
You can write down the answers or ask the representative to email a summary. When you later talk with a therapist or counseling practice, you can share what you learned so they can help you plan realistically.
Making choices that fit both your budget and your mental health
Money and mental health can feel like they are in tension. You might think, “I know I need therapy, but I am worried about the cost,” or “I feel guilty spending money on counseling when there are other expenses.”
It can help to think of mental health counseling as both care and investment. Supporting your mental health can improve your ability to work, care for others, make decisions, and enjoy your life in ways that ripple out over time.
At the same time, your limits are real. You are allowed to:
Ask about fees and payment options without shame.
Explore in network and out of network choices.
Start with biweekly visits if weekly sessions are not possible at first.
Reevaluate your plan if your financial situation changes.
Your therapist or their admin team should be open to talking about practical concerns. You are not being a difficult client by asking how copays, deductibles, or superbills will work in your situation. You are being thoughtful and wise.
Finding a path that honors both your mental health and your financial reality might take a few conversations, but it is possible. Even one clear phone call to your insurance company or one honest conversation with a therapist can turn a confusing blur of terms into something you can navigate with more confidence.
You deserve counseling that supports your emotional wellbeing and a plan for paying for it that feels understandable and manageable. Step by step, you can move toward both.
If you are ready to start, we would be honored to walk with you. Book a first session or a consult here. Bring your story and we will begin there.