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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 estimate your out of pocket cost
Therapy and medication management may cost different amounts
How to check your mental health benefits
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
Common questions about therapy insurance and cost
Final thoughts

The Short Answer: Usually, Yes

Yes, many health plans cover therapy, but covered does not mean free. Your cost depends on your exact plan, the treating clinician’s network status, the service, and any deductible, copay, or coinsurance. Marketplace plans include mental health treatment, including counseling and psychotherapy. Coverage details still vary.

Before your first visit, confirm three things: whether your clinician is in network for your specific plan, whether the deductible applies to that appointment, and what you may owe. A practice accepting an insurer does not mean every clinician participates in every plan.

This guide explains how to check those details for therapy in Maryland. If you would rather get help with the next step, ask Sanare about care and a benefits estimate. An estimate is not a guarantee of claim payment.

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. Your plan may charge a copay, coinsurance, or the insurer’s negotiated rate until a deductible is met. In network care is usually the most predictable 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 for a covered visit. The amount can differ between therapy and medication management, so ask about each service separately.
Deductible. The amount you pay for covered care before the plan begins sharing more of the cost. Ask for the annual deductible, how much has already been satisfied, and the remaining deductible. If the deductible applies to behavioral health, you may owe the negotiated rate until the remaining amount is met.
Coinsurance. A percentage of the allowed amount that you pay after any applicable deductible is met. The plan pays the rest of the covered allowed amount.
Out-of-pocket maximum. For covered in-network benefits, this is the plan-year limit on eligible cost sharing. Premiums, noncovered services, and out-of-network charges do not generally count toward that limit. Check your plan documents and the HealthCare.gov explanation.
Prior authorization. Some plans require approval before certain services. Ask whether your specific appointment requires it before scheduling.

Ask which cost-sharing rule applies to your visit rather than estimating from the insurer name. A copay and a deductible can affect different services within the same plan.

How to Estimate Your Out of Pocket Cost

An eligibility response can confirm that coverage exists, but it does not always tell you the exact final cost of a claim. To get the most useful estimate, ask for each of these items:

Whether the treating clinician is in network for your exact plan
Your behavioral health deductible for the current plan year
How much of that deductible has already been satisfied
The remaining deductible
The copay or coinsurance for outpatient psychotherapy
The copay or coinsurance for psychiatric visits and medication management
Whether telehealth uses the same benefits as an in person visit
Whether a referral or prior authorization is required

If a deductible applies and has not been met, your estimated responsibility may be the insurer’s allowed amount for the visit until the remaining deductible is satisfied. After that, a copay or coinsurance may apply. If the deductible does not apply to outpatient mental health care, the plan may begin with a copay instead.

Benefits reset on the plan’s renewal date, which is not always January 1. A cost estimate is based on the information available when benefits are checked. The final explanation of benefits from the insurer determines how the claim was processed.

Therapy and Medication Management May Cost Different Amounts

Do not assume one mental health copay covers every type of appointment. A plan may process psychotherapy, a psychiatric intake, and a medication follow up under different benefit rules. The clinician, visit type, and services documented on the claim can affect the result.

Ask the insurer or practice for separate estimates for:

An initial therapy appointment
An ongoing therapy session
An initial psychiatric evaluation
A medication management follow up
A visit that includes both medication management and psychotherapy, when clinically appropriate

If you are considering both services, review our medication management and psychiatric care information and ask the care team to verify each benefit separately.

How to Check Your Mental Health Benefits

There are two ways to start. Timing depends on the insurer and whether the practice needs additional information. 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?”
“What is my behavioral health deductible, how much has been satisfied, and how much remains?” “What will I owe for an ongoing therapy session?” “What will I owe for a psychiatric intake and a medication management follow up?”
“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. Ask the practice to check available benefits for your clinician and visit type. The response may include an estimate or may need staff review. An eligibility check does not guarantee payment or establish the final cost of a claim. 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. Confirm the exact plan and clinician network. Our CareFirst therapy page is a starting point, not confirmation of your benefits.
Cigna. Use the behavioral health contact on your card and ask which network administers the benefit for your plan.
Aetna. Ask whether your chosen clinician participates in your specific product and whether the deductible applies to the service.
UnitedHealthcare / Optum. Confirm both the behavioral health network and the individual clinician. Do not assume every provider at the practice is in network.
Maryland Medicaid. Ask the practice to verify current eligibility and participation for the appointment. Our Maryland Medicaid therapy overview can help you prepare questions.

The takeaway: the major plans Marylanders carry almost all cover individual outpatient therapy. Your specific copay, deductible, network, and covered service still need to be checked before the visit.

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, the plan may reimburse part of the allowed amount 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, ask about the claim submission deadline and keep your receipts. Submitting a superbill does not guarantee reimbursement.

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 check available benefits and explain the estimate before care begins. Final responsibility depends on how the insurer processes the claim. What working with us looks like on the insurance side:

Ask us to confirm participation for your exact plan and treating clinician. Insurer names alone do not establish network status
We verify available benefits before your intake and explain the current estimate, including any deductible, remaining deductible, copay, or coinsurance that the plan reports
Virtual therapy in Maryland, with telehealth benefits checked for your plan
Ask about current self-pay fees and whether payment arrangements are available, including for couples work
Ask about superbill availability and any payment assistance. Confirm reimbursement and payment-account eligibility with your insurer or plan administrator
Ask about current appointment availability for the service and clinician you need

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.

Common questions about therapy insurance and cost

Is therapy free with insurance?

Not necessarily. A covered appointment can still leave you responsible for a copay, coinsurance, or an amount that counts toward your deductible. Ask whether your outpatient mental health benefit applies before or after the deductible. Do not assume the answer is the same as for a routine primary care visit.

Does insurance cover the first therapy appointment?

Ask specifically about an initial assessment as well as ongoing therapy. Give the insurer the clinician’s name and the visit type supplied by the practice. Confirm network participation, whether authorization or a referral is needed, and the estimated responsibility for each type of appointment. Save the date and reference number for the insurer’s answer so you can refer back to it.

Does insurance cover psychiatry too?

Psychiatric services may be covered, but do not reuse a therapy estimate for a psychiatric intake or medication follow-up. Ask for a separate benefit check for that clinician and service. If you are deciding where to start, our guide to therapy versus medication management explains the different appointments without assuming you need both.

What if I do not have insurance or want to pay myself?

Ask for the practice’s current self-pay fee and any available payment arrangements before booking. If you are uninsured or are not using insurance, you can generally request a written Good Faith Estimate of expected charges. CMS explains when these estimates apply. This is different from an insurer’s benefits estimate.

What if my benefits check needs staff review?

A pending result is not confirmation of coverage or a denial. Ask what information is missing and wait for clarification about your exact plan and clinician. You can contact Sanare for help with the next step without deciding which insurance term applies on your own.

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. Checking the specific benefit, clinician, and appointment type is more useful than assuming either that therapy is unaffordable or that insurance will pay everything. A useful first step is asking for a benefits check for your chosen clinician and appointment type. 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.

Get a clearer cost estimate before you begin

Check therapy benefits first, then use the Get Care form if you would like help finding the right service and clinician.

Check My Therapy Benefits Ask About Getting Care

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.