North Shore Psychotherapy is in network with:
Please reach us at Admin@northshorepsychotherapy.com if you cannot find an answer to your question.
Look for plans with fixed copays and no deductible for behavioral/ mental health.
Some insurance plans charge a fixed copay for outpatient mental health visits such as $20 or $30 per session. Others require you to pay the full negotiated cost of therapy until you've met your deductible. One of the most important things to look for is a plan where the deductible does not apply to outpatient mental health visits.
For example:
Plan A: $30 copay per therapy session, deductible does not apply.
Plan B: $4500 deductible, followed by 20% coinsurance.
With Plan A, you may pay just $30 per session from the beginning of the year. With Plan B, you could be responsible for the full negotiated rate until you've met your deductible. For someone attending therapy weekly, that difference can be substantial.
Don't choose a plan based on premiums alone.
A plan with a lower monthly premium isn't necessarily the least expensive option. Plans with higher premiums sometimes offer lower deductibles, smaller copays, or more generous mental health benefits which can help you save a lot over the course of the year. Consider your total annual costs, not just your monthly premium.
For example, imagine you attend therapy 40 times per year:
Plan A Plan B
Monthly premium $100 $175
Annual premium total $1200 $2100
Deductible $4500 waived
Therapy cost per session $150 $30
($30 after
deductible)
Annual therapy costs $4800 $1200
Total annual cost $6000 $3300
For illustration, Plan A has a $4500 deductible with the $150 in network rate paid until the deductible is met, followed by 20% coinsurance. Despite the higher premium, Plan B saves $2700 annually.
*This example does not include other health services that go towards your deductible. If you utilize health services outside of therapy you would meet your deductible faster and may pay less for therapy over the course of the year.
Pay attention to your deductible and out of pocket maximum
Your deductible is the amount you generally must pay for covered services before your insurance begins sharing certain costs. When comparing plans, consider:
If you expect regular mental health or medical visits during the year, a lower deductible plan or one that waives the deductible for mental health can be easier on your budget.
Your out of pocket maximum is the most you'll generally pay for covered, in-network services during the year, excluding premiums. If you anticipate significant healthcare expenses, this number can be just as important as your deductible.
Before making a final decision, confirm your benefits directly with your insurance company so that you know exactly what is covered before the plan year starts.
Check whether your therapist is in-network
Before selecting a plan or changing to a new plan, confirm that your current therapist (or the therapist you are considering) is in-network. Even plans offered by the same insurance company can have different behavioral health provider networks.
Consider using HSA or FSA funds for therapy if available
Health savings accounts and flexible spending accounts can be used to pay for eligible therapy expenses with pre-tax dollars. This can help reduce your overall healthcare costs. If your employer offers these benefits, consider how much you plan to spend on therapy when making your elections for 2027.
Be aware of potential changes to Illinois Therapy Reimbursement Rates
Illinois House Bill 1085 introduces changes to how certain insurance plans reimburse mental health providers. These changes may increase the in-network negotiated reimbursement rates for therapy services beginning in 2027. If you have a self-funded insurance plan these changes generally will not apply to your coverage. If your plan covers therapy visits at a fixed copay without a deductible, an increase in reimbursement rates generally won't affect your out of pocket cost per session.
If your plan requires you to pay the full in-network rate before meeting your deductible or a percentage of that rate through co-insurance, an increase in reimbursement rates could mean higher out of pocket therapy costs. However, higher in-network rates may also help you meet your deductible faster because more of each session's cost may count towards it.
Don't hesitate to reach out to us for help as you are making sense of different insurance plan options!
Often, insurance companies require that you pay a certain amount (“deductible”) of medical/mental health costs in a given year before the insurance begins contributing. Once you have paid this amount (“met your deductible”), insurance begins to make payments to your medical / mental health providers and you are only responsible for the copay or coinsurance amount.
Some insurance plans waive the deductible for mental health services.
Often, insurance companies require that you pay a certain amount (“deductible”) of medical/mental health costs in a given year before the insurance begins contributing. Once you have paid this amount (“met your deductible”), insurance begins to make payments to your medical / mental health providers and you are only responsible for the copay or coinsurance amount.
While we can not adjust the out of pocket costs required by your insurance company if we are in-network, North Shore Psychotherapy can arrange a payment plan over a period of months to make the weekly financial burden caused by deductibles more manageable.
Therapy is an investment in your health, yourself, your community, and your future. We find it helpful to think about therapy in this way when considering your copay or out of pocket costs.
We understand that financial constraints can be a significant barrier to seeking services and are committed to helping you find a therapist. We have information for lower-cost psychotherapy services on our resources page. If you can not afford our services and can not find a therapist elsewhere give us a call and we will do our best to provide ideas to help you in your search for a therapist in the Chicago, Evanston, and Skokie areas.