Your Explanation of Benefits — or EOB — is one of the most confusing documents in American healthcare. It arrives after every insurance claim, looks like a bill but says “This is not a bill” and contains numbers that rarely seem to add up clearly. This plain English guide walks you through every section of…
A superbill is an itemised receipt from your therapist that contains the specific billing codes and information required for you to submit an out-of-network insurance claim. If your therapist does not accept your insurance directly but you have out-of-network benefits, a superbill is how you get reimbursed. What a Superbill Contains A valid therapy superbill…
Using your Health Savings Account (HSA) or Flexible Spending Account (FSA) for therapy is one of the most effective ways to reduce your out-of-pocket mental health care costs. Because these accounts use pre-tax dollars, paying for therapy through them effectively gives you a discount equal to your tax rate. Are Therapy and Mental Health Services…
Prior authorisation — also called pre-authorisation or pre-certification — is when your insurance company requires you to get approval before receiving certain mental health services. Understanding when it applies and how to navigate it prevents treatment delays and unexpected bills. When Does Mental Health Require Prior Authorisation? Prior authorisation requirements vary by plan. Common situations…
Yes — Medicare covers mental health services under Part B (outpatient medical insurance). Understanding exactly what is covered, what you pay and how to find providers helps you access the care you need. What Medicare Part B Covers for Mental Health Medicare Part B covers: What You Pay for Mental Health Under Medicare Part B…
Yes — Medicaid covers mental health services. In fact, mental health and substance use disorder services are among the essential health benefits that all Medicaid programmes must cover under the Affordable Care Act. What Mental Health Services Medicaid Covers Federal law requires all state Medicaid programmes to cover: Individual states determine specific coverage details —…
The cost of therapy with insurance in 2026 depends on your plan type, whether you have met your deductible and whether your therapist is in your network. This complete breakdown covers every scenario. Average Therapy Costs by Plan Type HMO Plans:Typical copay: $15 to $40 per sessionReferral required: Yes, from primary care physicianNetwork: Restricted to…
A deductible is the amount you pay for covered health services before your insurance begins paying. If your deductible is $1,500, you pay the first $1,500 of covered services yourself each plan year — then your insurance starts contributing. Does My Deductible Apply to Therapy? It depends on your specific plan. Plans handle therapy deductibles…
Not having health insurance should not mean not getting mental health care. In 2026, more affordable therapy options exist than most people realise — from free community services to significantly discounted private therapy. This guide covers 8 specific options for getting quality therapy without health insurance. Option 1 — Apply for Medicaid If your income…
Yes — health insurance covers psychiatrists. But the cost-sharing, coverage rules and network availability differ from therapy in important ways that are worth understanding before your first appointment. What Does a Psychiatrist Do vs a Therapist? A psychiatrist is a medical doctor (MD or DO) who specialises in mental health. Unlike therapists and psychologists, psychiatrists…