If you’re searching for a therapist in White Plains or elsewhere in Westchester County, you’ve probably run into the phrase “out-of-network” or seen that a therapist doesn’t take insurance. It can feel confusing and a little discouraging. Here’s how it works so you can decide what’s right for you.
What does out-of-network mean?
I don’t accept insurance directly, so I’m an out-of-network therapist. You pay at the time of your session, and depending on your plan, you may be reimbursed for part of the cost. Many plans include out-of-network mental health benefits, but they vary a lot. Some reimburse a percentage after you meet a deductible, and some don’t cover out-of-network care at all.
What is a superbill?
A superbill is a detailed receipt you can submit to your insurance company to request reimbursement. After each session, I can provide one with the date and length of service, the service code, a diagnosis code, my credentials and provider information, and the fee you paid. You submit it through your insurer’s online portal or by mail, and they reimburse you according to your plan.
Questions to ask your insurance company
A quick call to the number on your card can save you surprises. Ask:
Does my plan include out-of-network outpatient mental health benefits?
Do I have a separate out-of-network deductible, and how much have I met?
What percentage is reimbursed after the deductible?
Is there a per-session limit or a cap on the number of sessions?
How do I submit claims, and what is the filing deadline?
Pros and cons of private pay therapy
Benefits: You choose a therapist based on fit and specialty, not just network lists. Session length and frequency follow your goals, not an insurer’s rules. If you pay privately and don’t file a claim, nothing about your therapy goes to your insurance company. If you do submit a superbill, it includes a diagnosis code, which becomes part of your insurance record.
Things to consider: You pay upfront and wait for any reimbursement, reimbursement isn’t guaranteed, and claims take a little paperwork.
Is private pay therapy right for you?
There’s no single right answer. For some people, the flexibility, privacy, and choice of therapist are worth the investment. For others, in-network care makes more financial sense, and that’s completely valid.
I offer in-person therapy at my White Plains office and virtual therapy for clients across Westchester County. If you have questions about how out-of-network therapy would work for you, visit my FAQ page or click the button below to request a free 15-minute consultation.
Sonia Gonzalez, LMHC, LPC | Serene Within Mental Health Counseling PLLC | White Plains, NY
