Does out-of-network mean therapy will be expensive?

Not necessarily. The Empire Plan has strong out-of-network mental health benefits, so the plan covers a meaningful share once your benefits apply. We verify the specifics for free.

How do I find out my out-of-network benefits?

The simplest way is to let us check for you. We verify your NYSHIP / Empire Plan benefits for free and explain what to expect before you begin.

Is online therapy covered out-of-network?

Yes. Under NYSHIP, telehealth is generally covered the same as in-person care, so your out-of-network benefits apply to secure video sessions.

How to Use Your Out-of-Network Benefits for Therapy (NYSHIP / Empire Plan)

Q: Do I have to pay upfront and file my own claims?

No. Because we accept assignment of benefits, we submit your claims and your plan pays the practice directly — so you don't front the full fee or chase reimbursement.

The short answer

Can I use out-of-network benefits for therapy with The Empire Plan?

Yes. The Empire Plan includes strong out-of-network mental health benefits, so you can see a therapist who isn't in your plan's network and still have much of the cost covered. We verify your out-of-network benefits for free, explain what to expect, and handle the billing for you — so you don't have to navigate claims or reimbursement on your own.

What "out-of-network" really means

An out-of-network (OON) provider is a therapist who isn't contracted directly with your insurance plan. It does not mean your insurance won't help pay. With The Empire Plan in particular, out-of-network mental health benefits are strong — the plan covers a meaningful share of the cost once your benefits apply.

How the cost usually works

Two things typically shape what you pay out-of-network:

Your deductible — the amount you pay before your plan starts contributing. Until it's met, you may pay more per session.
Coinsurance — after the deductible, your plan covers a percentage and you cover the rest.

The exact figures depend on your specific plan year, which is why a quick benefits check up front matters so much.

The part most people dread — and how we remove it

The usual downside of out-of-network care is the paperwork: paying the full fee upfront, filing your own claims, and waiting for reimbursement. We take that off your plate. Because we accept assignment of benefits, we submit your claims and your plan pays the practice directly — so you're not fronting the full fee or chasing checks.

How we make it simple

When you reach out, we verify your NYSHIP / Empire Plan out-of-network benefits for free, explain in plain language what to expect, and handle the billing from there. For a closer look at cost, see our guide on what therapy can cost with NYSHIP, or how to check your coverage.

Not sure what your out-of-network benefits cover?

We'll verify them for free and explain exactly what to expect before your first session.

Book a Consultation

This article is general educational information, not insurance, legal, or financial advice. Coverage and costs depend on your specific NYSHIP / Empire Plan benefits. We verify your exact benefits for free before you begin.

How to use your out-of-network benefits for therapy

What "out-of-network" really means

How the cost usually works

The part most people dread — and how we remove it

How we make it simple

Not sure what your out-of-network benefits cover?

More answers