Many potential clients are confused about what it would mean financially to seek services from an out-of-network provider of their choice, or to use their traditional insurance vs. their EAP (Employee Assistance Program) when both options are available.

Typically, seeking mental health services first requires payment of a deductible and thereafter paying a percentage of the fee.  This is usually true whether seeing an in-network or out-of-network provider, though you need to confirm this with your insurance company.  If you or family members have had past medical services this year, you may have already met some or all of this deductible.  Many deductibles renew on January 1st, but some renew on a different calendar date (based on the employer’s fiscal year).  Psychologists’ fees are based on the amount of professional time and attention you receive.  Dr. Hill generally will meet with you for 50 minutes, whereas a family doctor visit may only involve 5-10 minutes of face-to-face time.

EAP services provide a true zero copay for a limited number of sessions, but only pay providers about half the rate of even the worst insurance coverage.  You can imagine the quality you often get for this price.  EAP is designed for very short-term counseling on very straight-forward problems.  For this reason, I never believe EAP is a wise choice for marital therapy, family therapy, bipolar, or other long-standing conditions.  Likewise, if your situation has the potential to gravely injure relationships or your job if not improved quickly, EAP may not be the right option.

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