Out-of-Network Therapy After Suicide Loss: You May Be Covered

You did the hard part. You found a grief counselor who understands suicide loss, not grief in general. Maybe another survivor recommended them. Maybe you found them through a trained-clinician directory after weeks of dead ends.

Then you made the phone call, and heard the words that stop so many survivors cold. They don’t take your insurance. In our fifteen-plus years of facilitating our support group, this moment comes up frequently about the difficulty finding a grief counselor in your insurance plan.

Out-of-network therapy after suicide loss can feel like one more wall you can’t avoid running into. Out-of-network simply means the therapist has no contract with your insurance company, so you pay the full fee yourself and your plan may pay some of it back to you later. You are exhausted. You found the right person. And now there is a cost sitting between you and the help you want and need.

Out-of-network does not always mean unaffordable, and that is worth knowing before you give up on that therapist. Many survivors discover, once they actually check their benefits, that their insurance may cover a real portion of the cost. The paperwork is genuine. The phone calls are not fun. But for a lot of people, it is worth doing.

You are not alone in this. In our case, my wife Teri and I did go to out-of-network grief counselors. We did the paperwork and we did get some of the costs covered. We were able to choose who we wanted and we did get some reimbursement. It is something you might want to explore.

If you are in crisis right now, please call or text 988 for the 988 Suicide and Crisis Lifeline. They are available around the clock, and you do not have to be in immediate danger to call.

Why So Many Grief Therapists Don’t Accept Insurance

This is not a coincidence, and it is not a sign that an out-of-network therapist is less qualified.

According to a 2024 American Psychological Association survey, about a third of practicing psychologists do not participate in insurance networks. Of those who left or never joined, 82 percent named low reimbursement rates, 62 percent named administrative burden, and 52 percent named unreliable payments as their reasons.

An NPR investigation reported hundreds of therapists describing the same pattern. They join a network in good faith, then leave once the billing system starts eating the hours they were trained to spend with patients instead.

Therapists who understand trauma alongside grief and suicide bereavement specifically are often the ones in private practice for this reason. They set fees they can defend with their training, and they stay out of a system that would otherwise consume the time they need for the actual clinical work.

This is also why a long list of names in your insurance directory can be misleading. Providers often stay listed long after they stop accepting new patients on that plan, or stop taking the insurance altogether. Survivors sometimes call ten names before reaching someone who is actually available. Calling ahead, rather than trusting the directory, saves real time.

There is a federal law meant to help here. It is called the Mental Health Parity and Addiction Equity Act. It requires that if your plan covers out-of-network care for physical health, it must cover out-of-network mental health care on comparable terms, and the Centers for Medicare and Medicaid Services oversees that requirement.

Understanding Your Out-of-Network Benefits: What to Ask

Before anything else, call your insurance company’s behavioral health line, not the general member services number. It is usually a separate line printed on the back of your card under mental health or behavioral health.

Write down who you spoke with and the date. Then ask specifically:

• Whether your plan includes out-of-network benefits for outpatient mental health
• What your out-of-network deductible is
• What percentage of costs your plan covers once that deductible is met
• Whether there is a session limit per year
• Whether pre-authorization is required

Many survivors are relieved to learn a PPO-style plan often reimburses 50 to 80 percent of the session cost once the deductible is met. Others learn their plan covers little or nothing out of network, and that is genuinely useful to know before committing to weekly sessions you cannot sustain.

If the process of making that call feels like too much on top of everything else you are managing right now, that reaction makes sense. Exhaustion like this is one of the real roadblocks to healing survivors run into, small and practical rather than emotional, but a roadblock all the same. Many survivors in our group have described sitting on hold for an hour only to be transferred twice before getting a straight answer. You are allowed to take this one phone call at a time.

Some survivors ask a trusted helper to sit in on that call, help make sense of the policy details, or even handle the claims paperwork directly, if you are comfortable with that level of privacy around your care.

Ask, too, whether the therapist you are considering can verify your out-of-network benefits before your first session. Some practices use billing platforms that pull this information directly and hand you a clearer number before you commit to anything.

What a Superbill Is and How Reimbursement Works

Once you know you have out-of-network benefits, the process runs through a document called a “superbill”.

A superbill is not a receipt. A receipt tells you what you paid. A superbill tells your insurance company what it needs to evaluate a claim, and it includes your therapist’s name, license type, and National Provider Identifier number, the date of each session, the CPT service code, an ICD-10 diagnosis code, the fee charged, and what you paid.

Does out-of-network reimbursement require a mental health diagnosis on file? Yes. Insurance companies will not process a claim without a diagnosis code. That hesitation is not something to push past quickly if you feel it. A diagnosis on an insurance claim becomes part of your medical record, and some survivors worry about how that could matter later, for life insurance applications or other contexts. That is a real tradeoff, not an overreaction. Some survivors decide the tradeoff is not worth it and pay fully out of pocket instead, without involving insurance at all. Either choice is reasonable, and it is worth saying directly to your therapist if this is weighing on you.

From there, the process usually looks like this. Your therapist gives you a superbill, often monthly. You complete your insurer’s claim form, typically available through their online portal. You submit both, by portal, fax, or mail, depending on what your insurer accepts. Weeks later you receive an Explanation of Benefits describing what was covered and what reimbursement, if any, is coming.

Submit superbills regularly instead of saving them for the end of the year. Doing this moves you toward your deductible faster and gets money back to you sooner. Most insurers also set a timely filing deadline, often 90 days to a year after the date of service, so a superbill that sits in a drawer for too long can become unusable.

You do not have to absorb all of these complex processes in one sitting. Read the part that answers what you need to know right now, and come back to the rest only when you actually feel ready for it. Do what you have the energy for today.

Services That Can Help You Submit Your Claims

Navigating this yourself is entirely possible. Plenty of survivors do it with nothing more than a folder and some patience. But there are third party services built specifically to take the paperwork off your plate, and it is worth knowing they exist.

I want to be careful about something first. I have not personally used any of the three named below. This is not a recommendation!

These are examples of what is out there, and any of them may or may not be a fit for your situation. You do not need to compare all three carefully. Picking any one of them, or asking your therapist which they have seen work, is enough. Read current reviews, ask your therapist whether they have worked with the service, and check the current fee structure before signing up for anything.

Reimbursify

Reimbursify is an app you or your therapist can use to submit out-of-network claims digitally. Its own pricing page shows your first claim filed for free, and $3.99 per claim after that, or a ten-claim bundle for $29.99, unless your therapist is on one of Reimbursify’s paid practice plans that covers the fee for you.

Mentaya

Mentaya handles the whole process on your behalf once you connect an account with your therapist. It verifies your benefits, submits claims automatically after each session, and follows up on denials. Mentaya charges roughly 5 percent per claim, and reports clients recover an average of 62 percent of what they paid, though your actual number depends entirely on your specific plan.

Thrizer

Thrizer works a little differently. Instead of you paying the full session fee and waiting weeks for reimbursement, its Thrizer Pay feature can let eligible clients pay only their estimated out-of-pocket portion at the time of the session, with Thrizer advancing the rest to the therapist and collecting reimbursement from your insurer afterward. Availability depends on having enough insurance history for Thrizer to estimate your responsibility.

Whichever path you choose, or whether you skip all three and file everything yourself, one thing is worth knowing. If your plan keeps denying valid claims, or reimburses far less than the plan’s own documents promised, you can file a complaint with your state’s Department of Insurance or the federal Employee Benefits Security Administration. The mental health parity protection law described above gives you real grounds to push back when mental health claims are treated worse than medical ones.

Medicare and Medigap Plan G

If you are on Medicare, some of this is different, and it is worth understanding before you start your search.

Original Medicare Part B

Original Medicare Part B covers outpatient mental health therapy at 20 percent coinsurance(what you have to pay) once your annual Part B deductible is met, but only when your therapist accepts Medicare.

A therapist who accepts Medicare but not what is called assignment can charge up to 15 percent above the Medicare-approved rate, on top of your coinsurance. A therapist who has opted out of Medicare entirely is a different situation. Medicare generally will not reimburse anything for that visit.

Medigap Plan G

Going without ongoing sessions because of cost is part of why grief can stall out entirely for some survivors. If you carry a Medicare Supplement plan, often called Medigap, and specifically Plan G, it may change this math considerably. Plan G pays the 20 percent Part B coinsurance that Medicare itself leaves to you, which applies to mental health therapy the same as any other covered Part B service. Once your annual Part B deductible is met, a covered session with a Medicare-accepting therapist could genuinely cost you nothing out of pocket. Plan G also covers what are called excess charges, the extra amount a non-assignment provider is allowed to bill, something no other currently available Medigap plan does.

Plan G will not cover your annual Part B deductible itself, and neither Medicare nor Medigap helps at all with a therapist who does not accept Medicare in any form.

A high-deductible version of Plan G also exists, trading a lower monthly premium for a higher threshold before coverage kicks in, which tends to make less sense for someone expecting regular ongoing sessions than the standard plan.

Medicare Advantage

Medicare Advantage, sometimes called Part C, runs through a private plan rather than Original Medicare, and usually restricts coverage to that plan’s own network. If a specialist you want to see is not in that network, it is worth calling your Advantage plan’s behavioral health line to ask whether any out-of-network exception exists before assuming there is none.

When Insurance Covers Nothing: What Else Is Available

If you are uninsured, or your plan simply does not include out-of-network mental health coverage, you still have real options, though they ask for more flexibility from you.

Ask any therapist directly whether they offer a sliding scale based on income. Many private-practice clinicians build this in deliberately.

If you have an Employee Assistance Program through work, check whether it covers a set number of therapy sessions. It is often a handful of free visits, useful as a bridge while you sort out longer-term coverage.

Community mental health centers offer sliding-scale care and often carry real trauma training, even when they cannot promise a suicide-bereavement specialist specifically. A therapist who understands trauma broadly is still meaningfully better than facing this alone.

Many county and state governments fund their own behavioral health departments, sometimes called county mental health services or something similar, and these often provide therapy on a sliding scale based on income, regardless of insurance status.

Religious and faith-based organizations run comparable programs. Catholic Charities agencies and Jewish Family Service agencies, searchable through the Network of Jewish Human Service Agencies, both offer grief and bereavement counseling on a sliding scale to anyone in the community. You do not need to belong to that faith to use these services.

If you are not sure where to start looking, there are some other calls that can point you in the right direction.

• 211, a free national helpline, connects callers to local health and human services, including mental health and grief support, county by county.
• Calling a local hospital and asking to speak with the social work department is another real option. Hospital social workers keep referral lists for exactly this kind of community resource, and many will talk with you even if you are not currently a patient there.
• The SAMHSA National Helpline at 1-800-662-4357 is free, confidential, and available around the clock, and it exists specifically to connect people with affordable local mental health resources, not only for people in acute crisis.

There is something underneath all of this worth mentioning. Many survivors feel a quiet guilt about spending time and money on their own care after a loss like this. The person they lost is gone, and caring for themselves can feel almost disloyal, or like proof that something is more broken than they thought. Neither of those things is true. Getting yourself real support is not weakness. It is the same clear thinking you would apply to any serious problem, and you would never begrudge someone else that.

Getting the Right Support Is Worth the Paperwork

Finding the right therapist after a suicide loss already asks a lot of you. Finding out that person does not take your insurance can feel like the system asking for one thing too many.

But out-of-network therapy is rarely as closed a door as it looks from the outside. Many survivors discover real money coming back once they make that one uncomfortable phone call and actually check. The process takes attention. It is not usually impossible.

Take whatever piece of this post that you can work on today. Ask your therapist what help they can offer with the documentation. Look into whether a claims service might carry some of the effort for you. Call your insurer and ask the specific questions above, rather than assuming the answer is no before you know it.

If you are still working through whether a specific clinician is the right fit for suicide loss specifically, Suicide Loss and Therapy: How to Know If a Clinician Will Help walks through what to look for. And Finding a Grief Counselor After Suicide Loss covers the directories and screening questions in more depth than this post does.

The right support is worth finding, and out-of-network therapy after suicide loss does not have to mean choosing between the right care and the care you can afford.

Posts You May Also Like

• Finding a Grief Counselor After Suicide Loss: A Practical Guide – Step-by-step guidance on locating and screening a grief therapist with suicide bereavement training, including directories and specific questions to ask.
• Suicide Loss and Therapy: How to Know If a Clinician Will Help – How to evaluate whether a therapist is genuinely equipped for suicide grief, and what a strong early alliance actually feels like.
• Self-Care After Suicide Loss: Caring for Yourself When Everything Hurts – Why spending on your own care after a loss like this is not disloyalty, and what basic self-care looks like when everything feels impossible.
• Mental Health and Suicide Loss: What the Research Actually Shows – What research shows about the elevated mental health risks suicide loss survivors carry, and what that means for prioritizing your own care.
• Healing Journey Checklist for Survivors of Suicide Loss – A practical framework for noticing where you are in healing and what kind of support might help right now.
• Life Insurance After Suicide Loss: What Survivors Should Know – Another financial piece of the aftermath, this one explains how the suicide exclusion clause works and what to do if a life insurance claim gets denied.

PRINTABLE GUIDE PDF

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