How to Pay for Therapy Without Insurance Coverage

Alma is not an emergency service. If you or someone you know needs immediate help, please refer to our list of crisis resources. Caring professionals are available to provide you with support and understanding.

Please Note: To receive in-network mental health care through Alma, you will need to be covered by one of the following insurance companies. For more information about paying for sessions, please visit the articles below:


At Alma, we understand how challenging it can be to find affordable mental health care. We want to remind you that not only is it acceptable to talk about your finances with your provider, it’s encouraged!

Openly discussing how you plan to pay for sessions may not be your favorite topic, but it is far better to talk about it than avoid seeking care all together. Your long-term wellness outweighs the brief discomfort you may experience during the conversation. Remember, money is a reality for your provider, too! They don’t want therapy to be a financial burden on you either. Try your best to be direct and honest about your concerns and limitations.

Getting started

So, you’ve decided to start seeing a therapist, but you discover that your insurance doesn’t cover mental health care. The information below can help you figure out why. 

Why doesn’t my insurance cover therapy sessions?

There are various reasons why your insurance may not cover your sessions, even with a provider who participates in Alma’s insurance program. We’ve outlined some of the most common scenarios below; however, it is best to communicate with your insurance company directly to verify any information about your benefits.

1. Your provider is not in-network with your insurance plan.

If your provider is “out-of-network,” that means they do not have a contract with the insurance company your plan is associated with. For example, your provider may be credentialed with Aetna, but you are insured through Blue Cross Blue Shield.
Typically, seeing a provider who is out-of-network will cost more than seeing someone in-network because insurance companies will cover a higher portion of visits for in-network care.
There may be instances where the amount you pay is comparable or only slightly higher for sessions with a provider who is out-of-network. Make sure to communicate with both your insurance company and your provider to understand the cost of your sessions.

2. Your benefits have not yet started, or they have ended.

If you have recently changed your insurance, there may be a gap in coverage between your previous plan ending and your new benefits kicking in.. To confirm your coverage details are accurate, it is important to verify the start and end dates of your benefits with your insurance company.

3. The insurance plan on file with your Alma provider is not your primary policy.

If you have insurance policies with multiple companies, your primary policy kicks in first, paying an insurance claim as if it was your only source of coverage. Your secondary policy then picks up all or some of the leftover cost.
For example, if you have coverage under a plan from your employer in addition to a spouse’s or parent’s plan, your plan through your employer will be primary and the other plan will be secondary. Your primary insurance plan should be the one you give to your Alma provider.

What are my options outside of using insurance to cover mental health care?

If your insurance does not cover mental health care or if you’re having trouble finding a provider who accepts your insurance, there are ways to help reduce your cost of care:

1. Flexible Payment Scales and Other Ways to Find Care at a Lower Cost

  • Providers sometimes offer therapy on a sliding scale, which is care priced according to each client’s unique financial situation. It is often a temporary rate that may increase over time with a client’s ability to pay. This fee structure exists to help make therapy more affordable for clients without health insurance or those who can’t afford their copay or deductible.
  • If you find a provider who is a good fit but are worried about cost, don’t hesitate to ask them whether they offer payment on a sliding scale. Alma providers typically list this information on their profiles. While it is at the discretion of each provider to offer and set a sliding scale, you can always reach out to Alma’s Client Matching team at for additional help finding a therapist who meets your needs.
  • You can also access more affordable care by:
    • Seeing if your provider employs interns who may offer services at a more affordable rate. Oftentimes, these interns still have extensive experience and are being trained by their supervisor.
    • Scheduling fewer sessions. Based on what your provider recommends, you may be able to develop a plan that requires fewer sessions. While once a week is traditional, oftentimes providers are willing to meet every other week to help reduce costs.

2. Leverage Government and Community-Funded Resources

  • Federally qualified health centers (FQHCs) are community-based health care providers that receive government funding to provide primary care services in areas that lack access to mental health resources. FQHCs are a great option if you are struggling to afford care because they qualify for increased reimbursement beyond the benefits that are typically provided by Medicare and Medicaid.
    • The vast majority of nearly 1,400 FQHCs provide mental health care integrated into a setting similar to how you would see a general practitioner. You can check to find an FQHC in your area using this Find a Health Center website.
  • The Substance Abuse and Mental Health Services Administration has a tool that can help you find local mental health resources through your state mental health and substance abuse agencies.
  • Care may be offered at a facility that is funded by your state, licensed by a state agency to provide treatment, accredited by a national treatment accreditation organization*, or mental health treatment facilities administered by the U.S. Department of Veterans Affairs.
  • Be sure to check the website of each state-funded facility for referrals to reputable resources in your community.

3. Find Training Programs at Local Colleges and Universities

  • Many colleges and universities have clinics where you can see a therapist-in-training under the supervision of a professional. Care at these clinics is typically offered at a much lower rate than the usual cost of seeing a licensed provider.
  • In a 2012 study conducted in Sweden, student therapists practicing under supervision were found to be as effective as professionals in using cognitive behavioral therapy** to treat patients with anxiety disorder and depression.
  • Try an online search for “low-cost therapy programs” in your region if you are unsure of what universities are close by. If you’re aware of a college or university with a psychology, psychiatry, or behavioral health department, call and ask whether it has a low-cost therapy program that is open to the public.

*Examples of a national treatment accreditation organization include The Joint Commission or NCQA

**Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing cognitive distortions and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems.

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