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The short answer: usually, yes
In-network vs. out-of-network (and why it matters)
The five terms that actually decide what you pay
How to check your mental health benefits in 10 minutes
What to know by plan: Cigna, Aetna, CareFirst, UnitedHealthcare, Medicaid
Does insurance cover couples and family therapy?
If your therapist is out-of-network: superbills and reimbursement
Insurance at Sanare Counseling
Final thoughts

The Short Answer: Usually, Yes

If you’ve been putting off therapy because you’re not sure whether your insurance will pay for it, here’s the reassuring part: in most cases, yes — it does. Under federal law, most health plans are required to cover mental health and substance use care at the same level they cover physical health care. That rule is called mental health parity, and it’s the reason “I have a copay for a doctor’s visit” usually means “I have a similar copay for a therapy visit.” The harder part isn’t whether you’re covered — it’s understanding the specifics. How much is your copay? Do you have to hit a deductible first? Is the therapist you want in your network? Those answers vary by plan, and the language insurers use to describe them is genuinely confusing on purpose. This guide walks through exactly how to find out what you’ll pay, in plain English, so you can stop guessing and book the appointment.

In-Network vs. Out-of-Network (and Why It Matters)

The single biggest factor in what you pay is whether your therapist is in-network with your insurance.

In-network means the provider has a contract with your insurer and accepts a pre-negotiated rate. You usually pay just a copay (often $0–$40 per session) or a percentage after your deductible. This is the least expensive route.
Out-of-network means there’s no contract. You may pay the full session fee up front, then submit for partial reimbursement — if your plan includes out-of-network benefits at all. Some do; many narrower plans don’t.

When you search “therapist that accepts my insurance,” what you’re really doing is filtering for in-network providers — because that’s where the cost is predictable. The good news is that a practice can be in-network with several major plans at once, which is why it’s worth asking a specific practice what they accept rather than assuming.

The Five Terms That Actually Decide What You Pay

You don’t need to understand all of insurance. You need to understand five words. Once these click, your benefits summary stops being a wall of jargon.

Copay. A flat fee you pay per session — say, $25. Simple and predictable.
Deductible. The amount you pay out of pocket each year before insurance starts contributing. If your deductible is $1,500 and you haven’t met it, you may pay the full negotiated session rate until you do.
Coinsurance. A percentage you pay after the deductible is met — for example, 20% of the session cost, with the plan covering the other 80%.
Out-of-pocket maximum. The most you’ll pay in a year. Once you hit it, covered care is essentially free for the rest of the plan year.
Prior authorization. Some plans require approval before certain services. For standard outpatient therapy this is increasingly rare, but it’s worth a quick check.

Here’s the pattern most people land on: a modest copay per session, or full-rate sessions until a deductible is met and then a small coinsurance after that. Knowing which of those two scenarios applies to you is the whole game.

How to Check Your Mental Health Benefits in 10 Minutes

You can get a clear answer today without waiting on hold for an hour. There are two reliable routes. Option 1 — Call the number on your card. Flip your insurance card over and call the member services line (often labeled “Behavioral Health” or “Mental Health”). Tell them you want to verify outpatient mental health benefits and ask these exact questions:

“Do I have outpatient mental health coverage, and is telehealth therapy covered the same as in-person?”
“What is my copay or coinsurance for an outpatient therapy session — CPT code 90837?”
“Do I have a deductible, and how much of it have I met this year?”
“Do I need a referral or prior authorization for outpatient therapy?”
“Do I have out-of-network benefits if my provider isn’t in-network?”

Option 2 — Let the practice check for you. Most practices, including ours, will run a benefits verification on your behalf before your first session so you walk in knowing your expected cost. This is usually the faster, less stressful option — you give them your insurance details and they come back with the numbers. When you reach out to schedule, just ask them to verify your benefits.

What to Know by Plan: Cigna, Aetna, CareFirst, UnitedHealthcare, Medicaid

Coverage details depend on your specific plan, not just the insurer’s name — two people with “Cigna” can have very different benefits. That said, here’s the general landscape for the major Maryland payers.

CareFirst BlueCross BlueShield. The largest insurer in Maryland, with strong outpatient mental health coverage on most plans. If you’re a CareFirst member, see our dedicated page on therapy with CareFirst BCBS in Maryland.
Cigna. Cigna administers behavioral health through Evernorth and generally covers outpatient therapy with a copay or coinsurance. This is a frequent question we get, including for couples work — more on that below.
Aetna. Broad behavioral health coverage on most commercial and federal (FEHB) plans, typically with a per-session copay once any deductible is met.
UnitedHealthcare / Optum. UHC routes behavioral health through Optum; outpatient therapy is widely covered, with telehealth treated the same as in-person on most plans.
Maryland Medicaid. Medicaid covers outpatient mental health care for eligible Marylanders, often with little or no out-of-pocket cost. See our overview of therapy with Maryland Medicaid.

The takeaway: the major plans Marylanders carry almost all cover individual outpatient therapy. The variable is your specific copay, deductible, and network — which is exactly what the 10-minute check above tells you.

Does Insurance Cover Couples and Family Therapy?

This is one of the most common coverage questions we hear, and the honest answer is: it depends, and more often than you’d expect, no — at least not directly. Insurance covers care for a diagnosable mental health condition. Individual therapy for anxiety or depression fits that cleanly. Couples therapy, on the other hand, is sometimes billed under a relationship-counseling code that many plans don’t cover, because “the relationship” isn’t an insurable diagnosis. However, when one partner has a covered condition and the sessions are part of treating it, family or conjoint therapy codes are sometimes reimbursable. If keeping costs down matters for couples work — and for most families it does — it’s worth asking specifically how a practice bills it, and whether a pay-over-time or self-pay rate might actually be simpler than insurance. The right move is to ask before the first session, not after.

If Your Therapist Is Out-of-Network: Superbills and Reimbursement

Sometimes the therapist who’s the best fit isn’t in your network. That doesn’t automatically mean full price forever. If your plan includes out-of-network benefits, you can often recover a meaningful portion of what you pay. The mechanism is a superbill — an itemized receipt your therapist provides that includes the diagnosis and billing codes. You submit it to your insurer, and if you have out-of-network coverage, they reimburse you a percentage (often 50–70%) after any out-of-network deductible. Practical tips:

Confirm you have out-of-network benefits first — narrow HMO and some marketplace plans don’t include them.
Ask your therapist to provide a superbill monthly; many do this automatically.
Keep submissions consistent — reimbursement is retroactive to when you started, as long as you submit within the plan’s window.

Insurance at Sanare Counseling

At Sanare Counseling, we try to make the money part of therapy as un-stressful as the rest of it. We work with Maryland clients across most major plans and verify your benefits before your first session so there are no surprises. What working with us looks like on the insurance side:

Most major plans accepted, including CareFirst BCBS, Cigna/Evernorth, Aetna, UnitedHealthcare/Optum, and Maryland Medicaid (HealthChoice)
We verify your specific copay, deductible, and coverage before your intake — you’ll know your expected cost up front
Virtual therapy across Maryland, billed the same as in-person under most plans
Transparent self-pay and pay-over-time options when insurance isn’t the simplest route — including for couples work
Superbills (via our Reimbursify partner) for out-of-network reimbursement, plus HSA/FSA accepted and sliding-scale options for those who qualify
Same-week appointments — you don’t have to wait six weeks for an intake

If you’re not sure what your plan covers, you don’t have to figure it out alone before reaching out. Send us your insurance details when you request a consult and we’ll run the check for you.

Final Thoughts

The cost of therapy is one of the biggest reasons people delay getting help — and a lot of that hesitation comes from not knowing rather than from the actual price. For most Marylanders with insurance, outpatient therapy is covered, and the real out-of-pocket cost is far lower than people assume before they check. The most useful thing you can do today is the 10-minute benefits check. Once you know your copay or deductible, the decision gets a lot simpler — and if the numbers feel like one more thing to manage, that’s exactly the kind of thing we’ll handle for you.

Your Path to Care Schedule An Appointment

By Juliann Siwicki, LCPC

Dealing with anxiety involves understanding its triggers and symptoms, then using evidence-based strategies – such as recognizing unhelpful thinking patterns, managing worry, practicing mindfulness, addressing avoidance behaviors, and building problem-solving skills – to regain control and reduce anxiety’s impact on your life. This step-by-step guide offers practical steps you can start using today to navigate and reduce anxiety.

At Sanare Counseling Group, we see how anxiety can disrupt lives. Whether it’s the constant feeling of being on edge, difficulty focusing, or physical symptoms like restlessness and tension, we know the toll it takes.

What Is Anxiety?

Anxiety is the body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The first day of school, giving a presentation, or making a big decision can cause most people to feel fearful and nervous.

However, when these feelings become excessive, all-consuming, and interfere with daily living, it may indicate an anxiety disorder. Unlike momentary worry, an anxiety disorder involves persistent feelings of fear and unease that don’t go away and can worsen over time. It can impact your work, your relationships, and your overall well-being, making it hard to relax or feel calm.

Common Symptoms of Anxiety

Anxiety disorders manifest through a combination of emotional, cognitive, and physical symptoms. While everyone experiences anxiety differently, some common signs can signal that your worry has become overwhelming.

Emotional and Cognitive Symptoms:

Feeling constantly on edge, restless, or wound-up
A sense of impending danger, panic, or doom
Difficulty concentrating or finding your mind goes blank
Irritability or feeling easily agitated
Struggling to control feelings of worry
Catastrophizing, or imagining the worst-case scenario

Physical Symptoms:

Increased heart rate or heart palpitations
Sweating, trembling, or shaking
Shortness of breath or a feeling of choking
Stomach upset, nausea, or digestive issues
Headaches and muscle tension
Fatigue or trouble sleeping (insomnia)

These symptoms can start to take a toll, making everyday situations feel unmanageable.

What Causes Anxiety?

There is no single cause of anxiety. Instead, it’s often the result of a complex combination of factors.

Brain Chemistry: Imbalances in neurotransmitters (brain chemicals) like serotonin and dopamine can play a role.
Life Experiences: Stressful or traumatic events, such as the loss of a loved one, abuse, or major life changes, can trigger anxiety.
Learned Behaviors: Growing up in an environment where others were fearful or anxious can sometimes lead to developing similar patterns.
Medical Conditions: Certain health issues, like thyroid problems or heart conditions, can produce anxiety-like symptoms.

Understanding the potential roots of your anxiety can be a helpful first step in learning how to manage it.

Why Does Anxiety Persist?

Anxiety often continues because of a self-perpetuating cycle. It starts with a trigger – an event, thought, or sensation. This trigger activates anxious thoughts (“What if I fail?”). These thoughts produce uncomfortable physical sensations (like a racing heart) and emotions (fear).

To get relief from this discomfort, you might engage in certain behaviors, such as avoiding the situation or seeking constant reassurance. While these actions provide temporary relief, they reinforce the original belief that the trigger is dangerous and that you are unable to cope. Over time, this cycle strengthens, making the anxiety more persistent and powerful. Breaking this cycle is the key to long-term management.

Step-by-Step Guide to Managing Anxiety

Learning how to manage anxiety involves developing a new set of skills. This isn’t about eliminating anxiety entirely – a certain amount is normal and even helpful – but about reducing its impact on your life. Here is a practical guide.

Step 1: Recognize Unhelpful Thinking Patterns

Anxiety is often fueled by cognitive distortions – irrational or exaggerated thought patterns that warp our perception of reality. Learning to identify them is the first step to changing them. Common patterns include:

Catastrophizing: Expecting the worst possible outcome. (e.g., “If I make a mistake in my presentation, I’ll get fired.”)
All-or-Nothing Thinking: Seeing things in black-and-white terms. (e.g., “If I’m not a perfect parent, I’m a total failure.”)
Mind Reading: Assuming you know what others are thinking, usually negatively. (e.g., “Everyone at this party thinks I’m awkward.”)
Fortune Telling: Predicting a negative future without evidence. (e.g., “I know I’m going to have a terrible time on this date.”)
Overgeneralization: Taking one negative event and seeing it as a never-ending pattern. (e.g., “I didn’t get the job. I’ll never find one.”)
“Should” Statements: Focusing on what you “should” or “must” do, leading to guilt and frustration. (e.g., “I should be exercising every day.”)

Start by noticing your thoughts throughout the day. When you feel a spike in anxiety, pause and ask: “What was I just thinking?” Try to label the thought pattern without judgment.

Step 2: Challenge Anxious Thoughts

Once you can recognize unhelpful thoughts, the next step is to challenge them. This process, central to CBT, involves acting like a detective and examining the evidence for and against your anxious thoughts.

How to Challenge Unhelpful Thoughts

Identify the Thought: Write down the specific thought that is causing you distress.
Examine the Evidence: Look for facts that support and contradict your thought. Feelings are not facts.
Consider Alternative Perspectives: Brainstorm other, more balanced ways of looking at the situation.
Create a Balanced Thought: Formulate a new thought that is more realistic and less distressing.

Questions to Test Your Thoughts

When you’re stuck in an anxious loop, ask yourself these questions:

Is there solid evidence for this thought? Is there evidence against it?
Am I confusing a possibility with a certainty?
Is this thought helpful? Does it help me achieve my goals or just make me feel bad?
What would I tell a friend who had this same thought?
What is a more balanced or compassionate way of looking at this?
Even if the worst happened, could I survive it? What would I do?

Review Your Responses

After challenging a thought, reflect on how you feel. Often, simply questioning the validity of an anxious thought can reduce its emotional intensity. This takes practice, but it becomes more automatic over time.

Step 3: Manage and Reduce Worry

Worry is the cognitive component of anxiety – the “what if” thoughts that spin in our minds. While some worry is productive (it helps us plan and solve problems), chronic worry is often repetitive and unhelpful.

Create a Daily “Worry” Period

Designate a specific time each day (e.g., 15-30 minutes) to actively worry. When a worry pops into your head during the day, acknowledge it and tell yourself, “I’ll think about that during my worry time.” This helps contain worry to a specific period instead of letting it consume your entire day. When your worry time arrives, let yourself think about all the things on your list. Often, you’ll find that many of the worries no longer seem as urgent.

Ask If a Worry Is Controllable

Divide your worries into two categories: those you can do something about and those you can’t.

Controllable Worries: If it’s a problem you can solve, make a plan. Break it down into small, actionable steps.
Uncontrollable Worries: If it’s something outside your control (e.g., what someone else thinks), practice letting it go. Acknowledging that you have no power over the outcome can be liberating.

Interrupt the Cycle of Worry

When you catch yourself worrying, try to interrupt the pattern. Get up and move, call a friend, focus on a task, or engage one of your senses. The goal is to shift your focus away from the repetitive thoughts.

Talk About Your Worries

Voicing your worries to a trusted friend, family member, or a therapist can provide a new perspective. Saying them out loud can often make them seem less daunting. At Sanare Counseling Group, our therapists provide a safe space for this kind of exploration through Therapy.

Step 4: Practice Mindfulness and Grounding Techniques

Mindfulness is the practice of paying attention to the present moment on purpose, without judgment. Anxiety often pulls us into worries about the future or regrets about the past. Grounding techniques anchor you in the here and now, interrupting the anxiety cycle.

5-4-3-2-1 Coping Technique

This simple technique uses your senses to bring you back to the present. Wherever you are, pause and silently identify:

5 things you can see.
4 things you can feel (e.g., your feet on the floor, the texture of your shirt).
3 things you can hear.
2 things you can smell.
1 thing you can taste.

Basic Mindfulness Meditation

Find a quiet place to sit comfortably.
Close your eyes and bring your attention to your breath.
Notice the sensation of the air entering and leaving your body.
Your mind will wander. This is normal. When it does, gently and without judgment, guide your focus back to your breath.
Start with just 5 minutes a day and gradually increase the time.

Step 5: Address Avoidance Behaviors

When something makes us anxious, our first instinct is often to avoid it. While this brings short-term relief, it reinforces the anxiety in the long run. It teaches your brain that the feared situation is indeed dangerous and that you are incapable of handling it.

Confronting Feared Situations

Make a List: Create a ranked list of your feared situations, from least scary to most scary. This is called a fear hierarchy.
Start Small: Begin with the item on your list that causes the least anxiety.
Plan the Exposure: Decide how you will face this fear. For example, if you have social anxiety, a low-level item might be making eye contact and saying hello to a cashier.
Stay in the Situation: Remain in the situation until your anxiety naturally decreases. Don’t flee. Riding out the wave of anxiety teaches your brain that the feeling, while uncomfortable, is not dangerous and will pass.

Continuing to Face Avoided Situations

After your first success, move up your hierarchy to the next item. Practice regularly. Each time you face a fear without negative consequences, you weaken the connection between the situation and the anxiety response.

Tips to Improve Quality of Life

Beyond these specific techniques, certain lifestyle habits can build your resilience to anxiety:

Move Your Body: Regular physical activity is a powerful anxiety reducer.
Prioritize Sleep: Aim for 7-9 hours of quality sleep per night. Anxiety and sleep have a reciprocal relationship; poor sleep can increase anxiety, and anxiety can disrupt sleep.
Eat a Balanced Diet: A diet rich in whole foods can support stable moods. Limit caffeine and alcohol, which can trigger or worsen anxiety.
Stay Connected: Maintain relationships with supportive people. Social connection is a buffer against stress.
Engage in Hobbies: Make time for activities you enjoy that help you relax and de-stress.

When to Seek Professional Help

While self-help strategies are incredibly valuable, sometimes they aren’t enough. It may be time to seek professional help if:

Anxiety is causing significant distress or interfering with your work, school, or relationships.
You are struggling to control your worry on your own.
You are using alcohol or other substances to cope.
You are experiencing physical symptoms that are concerning.
You feel depressed or are having thoughts of self-harm.

The therapists at Sanare Counseling Group are trained in evidence-based methods to help Columbia residents manage anxiety. We offer specialized Anxiety Treatment for adults and also provide dedicated support through Teen Counseling. Reaching out is a sign of strength and the first step toward regaining balance.

Summary and Next Steps

Anxiety is a common and treatable condition. By understanding what it is, recognizing its symptoms, and applying targeted strategies, you can significantly reduce its hold on your life. This guide provides a framework for challenging anxious thoughts, managing worry, staying present, and facing your fears. Remember to be patient and compassionate with yourself as you practice these new skills. Change takes time, but with consistent effort, you can find a path to a calmer, more balanced life.