How Insurance Can Help Cover the Cost of Therapy for Teens
If you’ve been wondering how much therapy for teens costs, and whether insurance can help cover it, you’re not alone.
Trying to understand insurance, especially for mental health care, can feel confusing at first. Coverage varies, plans are different, and the language alone can make it hard to know where to start.
Many parents I talk with are surprised by how complicated insurance feels when it comes to mental health care… especially when they’re just trying to support their teen the best they can. 💛
This page walks you through how insurance coverage for therapy works, what your main options are, and what questions actually help when you’re trying to figure out next steps.
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Why Insurance Is Often Confusing for Mental Health Care
In the United States, insurance providers are required to offer mental health coverage that is comparable to coverage for other health conditions. This is sometimes referred to as mental health parity.
That said, equal coverage doesn’t always mean easy coverage.
Insurance plans can look very different from one person to the next, even when families use the same company. What’s covered, how much is reimbursed, and which providers qualify all depend on your specific plan.
Because of this, the most accurate source of information will always be your insurance provider directly. The sections below give you a clear framework so you know what to ask… and how to understand the answers you get.
Three Ways Insurance May Cover the Cost of Therapy
There are three main ways insurance may be able to cover the financial cost of therapy:
In-network coverage
Out-of-network coverage
Single case agreements (sometimes called out-of-network exceptions)
Each option works a little differently….
What In-Network Therapy Means
When a therapist is in-network, they have a contract with your insurance company. This means they agree to accept the rate your insurance pays for services.
With in-network therapy:
Insurance pays the therapist directly
You follow your plan’s rules for copays, deductibles, or coinsurance
You can check whether a provider is in-network by:
Visiting your insurance company’s website
Checking the provider’s website
Calling the number on the back of your insurance card
While in-network therapy can feel like the most familiar option, it doesn’t always mean care is easier to access or costs are simpler to understand. Many plans have specific carve-outs for mental or behavioral health, limited provider availability, or restrictions around who is considered “in-network” for certain services.
Because of this, some families find that even when they technically have in-network coverage, it can still be difficult to find a provider who has openings, works with their teen’s needs, or is a good fit.
What Out-of-Network Therapy Means
Many therapists choose to work out-of-network. This means they are licensed and qualified to provide therapy, but they do not have a contract with your insurance company.
With out-of-network therapy:
You pay the therapist directly
You submit claims to your insurance for reimbursement
Coverage depends on your plan’s out-of-network benefits
Many families are surprised to learn that out-of-network therapy can sometimes offer more availability or flexibility, especially when in-network providers have long waitlists, limited openings, or don’t work with their teen’s specific needs.
If your insurance card includes PPO or POS, you may have out-of-network coverage, though it’s always best to confirm with your insurance company directly.
Four Questions to Ask Your Insurance Company
You don’t need to decide anything before asking these questions. This step is just about understanding what options are available to you. When you call your insurance provider, these questions are especially helpful:
Do I have out-of-network benefits for mental or behavioral health services?
(Some plans use “behavioral health” instead of “mental health.”)What is my reimbursement policy and deductible?
This helps you understand how much you may need to pay out of pocket before insurance contributes.Which diagnoses and billing codes are covered?
If you already have a provider in mind, you can also ask which billing codes they use.Is telehealth covered the same way as in-office therapy?
Some plans cover virtual sessions differently than in-person visits, so it’s helpful to ask how this applies to mental health care.
Insurance coverage can be very specific about codes, session type, and provider credentials, and reimbursement may vary based on how services are delivered.
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What a Single Case Agreement Is
A single case agreement is a more involved option, but it can be helpful in certain situations.
This may apply when:
You can’t find an in-network provider
In-network providers don’t work with your specific needs
A therapist offers specialized services that aren’t otherwise available
In these cases, insurance may agree to temporarily treat an out-of-network provider as in-network.
This process often requires:
A clinical assessment
A diagnosis
A letter of medical necessity
Single case agreements are not guaranteed, and approval is ultimately up to the insurance company. Still, for some families, this option can make therapy more accessible when other paths aren’t working.
What This Means for You (and Your Family)
Insurance coverage for therapy isn’t one-size-fits-all — but understanding your options can make the process feel more manageable.
You don’t need to have everything figured out right away. Having the right questions and knowing the main pathways available can help you move forward with more confidence and less guesswork.
If you’re also wondering how this works specifically with my practice, you can review my Session Rates & Insurance Information here.
🎥 Watch the Video This Post Is Based On
This blog post is based on the video below, where I walk through these options step by step and explain how they tend to work in real life.
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A Helpful Next Step If You Want More Clarity
If you’re reading this and thinking, “Okay… but I still don’t know exactly what to say when I call my insurance company,” you’re not doing anything wrong.
Insurance conversations can feel overwhelming, especially when you’re trying to make therapy financially doable.
That’s why I created a free guide that walks you through:
The exact questions to ask your insurance company
How to find out if you have out-of-network benefits
What your answers actually mean for therapy costs and reimbursement
It’s designed to help you feel prepared before you make the call — not rushed, not confused, and not guessing.
Some families use this guide right away, and others save it for later — both are completely okay.
👉 Tap Here to Download a FREE “Your Guide to Out-of-Network Insurance Benefits”
Recommended Next Reads
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