I get it. Finding a therapist who's truly the right fit can feel like searching for a needle in a haystack. You hop on Psychology Today or Google, and suddenly there are hundreds of profiles in your area. Maybe a friend raves about their therapist, but you're still left wondering: Do I even need therapy? How often will I have to go to feel better? Does my insurance actually cover this?

These are all incredibly common questions, and honestly, I've been there myself, sitting in the client's chair. Insurance lingo can be tricky to untangle, which is exactly why I put together this guide for you. My goal is to support you in your search for your dream therapist.

What’s the difference between seeing a therapist in-network vs. out-of-network?

Let's cut through the jargon. These terms simply define how your therapist's services are paid for (or reimbursed!) by your insurance company.

In-Network: Your Insurance's "Preferred Partner"

The Upside: This is usually the most straightforward and often the lowest upfront cost option for you. You typically pay a small, fixed copay per session (like when you see your primary doctor), and your insurance covers the rest.
The Downside: While there are many amazing in-network therapists, your choices are limited to those who have this specific agreement with your plan. This can mean fewer options for specialization or longer wait times. Out-of-network means you aren’t limited to who you choose as a therapist, and you’ll pay out-of-pocket. Once your deductible is met, your insurance will reimburse you for a portion of the sessions.

Out-of-Network (OON): More Choice, Potential for Reimbursement

"Out-of-network" means the therapist doesn't have a direct contract with your insurance company. They set their own fees.

The Upfront: You'll typically pay the full session fee directly to your therapist at the time of service.
The Reimbursement Factor: Here's the good news! If your health insurance plan includes "out-of-network benefits" (often found with PPO plans), you can get a significant portion of that money back. Once your deductible is met, your insurance will reimburse you for a percentage of the sessions.

Real Talk: As an EMDR therapist seeing clients across Florida, South Carolina, and Tennessee, I've personally seen many clients get reimbursed up to 80% per session! Your specific reimbursement will vary based on your plan, but it can make seeing a therapist you truly "vibe with" much more accessible than you might think.

A Quick Tip: If you've already chatted with a few in-network therapists and the connection just isn't there, they don't have the specific specialization you're looking for, or their availability doesn't match your life, exploring out-of-network options could be your game-changer. Don't assume it's out of reach just because they're not on your insurance's list!

What Exactly Are Out-of-Network Benefits?

Out-of-network benefits are a feature within your health insurance plan that allows you to get money back for services from mental health providers who aren't directly contracted with your insurance company. Think of it as your insurance saying, "Okay, we'll still help you out, even if they're not on our 'official' list."

*Your out-of-network benefits kick in once you've met your deductible.*

Making It Easy For You: My Partnership with Thrizer

Forget the headache of calling your insurance, verifying benefits, submitting complex superbills on your own, and waiting for a check in the mail. That sounds like a whole other stressor, right?

That's why I partner with Thrizer to take care of all this for you! Thrizer's whole goal is to help you focus on YOU, on your healing, not the confusing cost of therapy.

How can I use my out-of-network benefits with Thrizer?

Using your out-of-network benefits with our practice is super easy and seamless. Here's how it works:

Let's Connect: We'll start with a free, no-pressure 15-minute intro call to see if we're a good fit. During this call, we'll also quickly check your OON benefits using Thrizer's tool. This helps us understand your specific deductible and potential reimbursement before you even commit to sessions.
Hassle-Free Billing: After each session, our practice will automatically bill your card.
We Handle the Paperwork: We'll then submit your claim directly to your insurance company through Thrizer.
Your Choice of Reimbursement: Thrizer gives you two great options:
- Instant Reimbursement: You can choose to have Thrizer apply your out-of-network benefits for instant savings each session, meaning you pay less upfront (once your deductible is met).
- Direct Deposit: Or, if you prefer, you can wait a couple of weeks for a direct deposit of your reimbursement straight into your bank account.

Ready to find out your persoanlized plan details? Click here to book your free intro call.

Can you share an example of using Out-of-network benefits with Thrizer?

Absolutely! First let’s define a couple of key terms to know when using your OON benefits.

Then, we’ll break down how this might look, using a common scenario. Keep in mind, this is just an example; your actual costs will depend on your specific plan. Thrizer's benefit checker will give you a personalized estimate during your free intro call!

Why should I see an out-of-network therapist?

There are many phenomenal and skilled in-network therapists out there, truly. But relying solely on in-network options is going to significantly limit your choices. Sometimes, investing a little more upfront in an out-of-network therapist can lead to a more tailored, deeply supportive, and ultimately more effective therapy experience.

Here are some reasons why going out-of-network might be the right path for you:

Access to Specialized or Holistic Approaches: This is a huge reason to consider out-of-network. Many therapists who offer highly specialized treatments (like EMDR for trauma, specific CBT techniques, or niche areas of expertise) or who practice with a more holistic, integrative approach often choose not to contract directly with insurance companies. We offer EMDR, Reiki, Yoga, and Somatic healing. Unfortunately, insurance companies can sometimes be rigid about what they will and won't cover, often preferring short-term, symptom-focused treatments.
Limited Availability & Scheduling: This is a big one. You might be ready to start therapy now, but many in-network therapists often have waiting lists that stretch for weeks or even months. Their schedules can be jam-packed, making it tough to find a slot that actually works for your busy life. Going out-of-network often means you can find someone with openings sooner and more flexible scheduling options.
Burnout is Real (for Therapists Too!): Many in-network therapists, while dedicated, are under immense pressure. Because insurance reimbursement rates can be lower, they often need to see a very high volume of clients (you might be 1 of 20 to 40 clients they see a week!) just to keep their practice afloat. This can lead to therapist burnout, which, while not their fault, can sometimes impact the depth and individualized attention they're able to provide. Out-of-network therapists often manage a smaller caseload, allowing them to dedicate more time and energy to each client.
Finding Your "Right Fit" is Crucial: Ultimately, the most important thing is finding a therapist who "gets" you, someone you feel comfortable with, and whose approach truly resonates. When you're limited to only in-network options, you might end up compromising on personality fit, specific expertise, or even just the feeling that this person is truly the right match for your unique journey.
Going out-of-network vastly expands your choices, significantly increasing the likelihood that you'll find that perfect therapeutic partner. Going out-of-network vastly expands your choices, increasing the likelihood that you'll find that perfect therapeutic partner.

Why are we out-of-network providers at Holistic Healing & Wellness?

Simply put, we value being intentional with your care. What does that look like in practice?

Smaller Caseloads (on purpose): This ensures we are fully present and truly focused on you in every session.
Quick Availability: You can often start with us within a couple of days, so you aren't stuck waiting forever to begin your healing journey.
Flexibility to Reschedule: When life happens (because it always does!), we offer the flexibility you need to reschedule so you can still get consistent support.
Specialized, Integrative Care: We specialize in supporting those navigating people-pleasing, anxious attachment, and CPTSD, and we use a blend of EMDR, Parts Work, Yoga, and Reiki. This allows us to offer care that helps you heal from the inside out.
More Time for You, Less for Paperwork: We spend more time with you in session (and less time on insurance-required paperwork), so you are really heard and tended to, not just a checklist item.

I want to re-iterate here, that you may also find some of these qualities with an amazing in-network therapist too. But, we are committed to providing therapy that is truly invested in you.

What are some challenges with going out-of-network for therapy?

Just like in-network therapy, out-of-network options come with their own considerations:

You May Not Have OON Benefits: Depending on your insurance plan, you might not have out-of-network benefits at all. You're more likely to have them with a PPO plan. EPO plans sometimes do, while HMO plans rarely offer them. This is why checking your benefits upfront is so important!
Higher Upfront Costs (Initially): You will generally pay more at the beginning of therapy as you work towards meeting your deductible. Once your deductible is met, your costs will significantly drop, especially if you use Thrizer's Instant Reimbursement.
Reimbursement Timelines Vary: If you opt for Thrizer's Instant Reimbursement, it immediately knocks down your weekly cost. If you prefer Thrizer's Direct Deposit (or decide to submit a Superbill on your own), you might wait a couple of weeks for funds to hit your account. Unfortunately, your therapist has no control over these specific insurance processing times.
Deductibles Reset: Your deductible will reset when your insurance plan renews (typically every 6-12 months). If you're hoping for longer-term therapy, you might find yourself working towards a new deductible again at that point.
Mental Health Diagnosis: Because insurance is still involved in your care (for reimbursement), they will need a mental health diagnosis on record to "justify" treatment and reimbursement. Here at Holistic Healing & Wellness, we firmly believe a diagnosis doesn't mean something is "wrong" with you. We believe it's a guide to understanding your experiences and helping you heal.

What matters most?

The most important thing is that you are making choices that feel good to you! Whether you choose to go in or out-of-network for therapy, finding the right fit and working with someone who really gets you is crucial.

Curious about your OON benefits? Click here to book your free intro call.

👋 Follow @holistictherapywithsabrina to learn more about EMDR, inner child healing, and embracing your authentic self, from a therapist who truly gets it.

About the author: Sabrina Cruz, LCSW, RYT-200 is a psychotherapist and yoga teacher who truly values holistic care. She supports women to break free from people-pleasing and unapologetically embody their light. HHWS specializes in people pleasing, anxiety, and childhood wounds to help you heal from trauma, reparent your inner child, and embrace your authentic self.

Your Complete Guide on How to Use Out-of-Network Benefits for EMDR