Therapy Cost and Insurance at Aurora Counseling

We verify coverage before your first session. If you want to know sooner, call the member services number on the back of your card and ask these, in this order:

1. Do I have outpatient mental health benefits?
2. Is Aurora Counseling Associates in network for my plan?
3. Do I have a copay or coinsurance for outpatient mental health, and how much?
4. Do I have a deductible, does it apply to outpatient mental health, and how much of it have I met this year?
5. Is prior authorization required, and is there a limit on sessions per year?
6. Is telehealth covered at the same rate as in person?

Write down the date, who you spoke to, and a reference number. Benefits quotes are not binding, and having a record is genuinely useful if a claim is later denied.

If we are out of network

If we are not in network with your plan, or you would rather see a clinician who is out of network with it, you can still use your out-of-network benefits.

We provide a superbill, which is an itemised receipt with the diagnosis and service codes your insurer needs. You submit it and they reimburse you directly. How much comes back depends on your out-of-network mental health benefit, which is worth asking member services about specifically: many plans reimburse a percentage of what they consider a reasonable rate rather than a percentage of what you paid, and those are different numbers.

Paying without insurance

Some people choose self-pay even when they have coverage, and it is a legitimate choice rather than only a fallback.

Using insurance requires a diagnosis to be recorded, and that diagnosis becomes part of your medical record. It also gives the insurer some ability to review treatment. For most people that is a fine trade for the cost saving. For some, particularly where a security clearance, certain licenses, or specific future coverage is in play, paying privately is a reasonable decision. We will not talk you out of it or make it awkward.

If you are uninsured or not using insurance, you have the right to a written Good Faith Estimate of expected costs under the No Surprises Act. See Good Faith Estimate for what it includes and your right to dispute a bill that exceeds it.

We accept credit and debit cards, and payments from HSA and FSA accounts. Therapy is a qualified medical expense for both, so if you have one of these accounts you can use it toward sessions, which effectively pays for therapy with pre-tax money.

Payment is due at the time of service unless we have agreed otherwise, and we keep a card on file for session fees, copays and late cancellations.

The costs people do not expect

Missed sessions. We ask for 24 hours notice. Late cancellations and no-shows are typically billed at the full session rate, and insurance does not cover a missed appointment, so that charge falls to you. Our policies page has the detail.

January. Deductibles reset at the start of the plan year. If you have been paying a 30 dollar copay since March, the first sessions of the new year can be dramatically more expensive. It is worth planning for.

Couples therapy. Coverage is inconsistent. Some plans cover it when one partner has a billable diagnosis; some do not cover relational therapy at all. We check before you start. Couples counseling covers how the work itself is structured.

If cost is the barrier

Say so. It is a practical problem and it has practical answers more often than people expect, whether that is a different clinician, a different frequency, using out-of-network benefits you did not know you had, or a referral to a community health center that works on a sliding scale.

What does not help is quietly deciding therapy is not for you because of a number you have not checked. Mental health resources lists low-cost options across Massachusetts, including Open Path Collective and the state Behavioral Health Help Line.