Pick Your 2027 Health Plan With Therapy in Mind
The plan you choose this month sets what every therapy session costs you in 2027.
Maybe you already have a therapist. Maybe you are still looking. Either way, the monthly premium is the least useful number on the page.
Many employers hold open enrollment in October or November. Check your HR portal for your dates. Your choice usually stays in place for the full year.
Find the therapy line first
Every plan has a Summary of Benefits and Coverage. Ask HR for it if you cannot find it.
Look for the row labeled "outpatient mental health" or "behavioral health office visit." It will say one of two things:
A copay before the deductible. You pay a flat fee from the first session.
Subject to the deductible. You pay the full session rate until the deductible is met.
That one difference can change your yearly cost by thousands of dollars.
Know the words on the page
Premium: What you pay each month to keep the plan.
Deductible: What you pay each year before the plan starts sharing costs.
Copay: A flat fee you pay per visit.
Coinsurance: A percentage you pay after the deductible. At 20%, you pay 20 cents of every dollar.
Allowed amount: What your insurer decides a service is worth. It can be lower than what a provider charges.
Out-of-pocket maximum: The most you can owe in one year for covered care.
Compare two plans with your own numbers
Every plan sets its own rates. Nothing in this post is a quote, a typical rate, or a fee we charge. Get your real numbers from each insurer, then fill in this worksheet for every plan you are considering.
Yearly premium: the monthly premium times 12.
Sessions you plan to attend in 2027.
Deductible: what you pay before the plan shares costs.
After the deductible: your copay or coinsurance per session.
Add it up: the premium, plus the deductible, plus your share of the remaining sessions.
The cheapest premium does not always cost the least over a year. A plan with a higher premium and a flat copay can cost less than a plan with a low premium and a large deductible.
Add your other care to the worksheet too, such as prescriptions and doctor visits.
If your therapist is out-of-network
Many therapists are out-of-network, which means they do not have a contract with your insurer. The in-network copay does not apply. Some plans still pay you back.
Here is how it usually works:
You pay your therapist at each session.
You ask for a superbill, which is a receipt with the service and diagnosis codes your insurer needs.
You submit the superbill to your insurer.
The insurer pays you back a percentage of its allowed amount.
The percentage applies to the allowed amount, not to what you paid. If your plan allows less than your therapist charges, your reimbursement will be smaller than the percentage suggests.
Out-of-network benefits often have their own deductible. The insurer may ask you to meet it before it pays anything back.
Ask how the allowed amount is set
Two plans can both say they reimburse the same percentage and still pay you different amounts.
Some plans use usual and customary rates in your area. Others use a percentage of Medicare rates, which can be lower. Ask the insurer which method your plan uses.
FSAs and HSAs
Both let you pay for therapy with pre-tax money.
HSA: The 2027 limits are $4,500 for one person and $9,000 for a family. The money stays yours from year to year.
FSA: Offered through your employer. The IRS has not yet announced the 2027 limit. It was $3,400 for 2026, so check your HR portal. Some plans let unused money carry over, up to $680 from 2026 into 2027. Others do not.
Therapy generally counts as an eligible expense for both. Ask your plan administrator what documentation they need.
On a high-deductible plan, you may pay your full deductible before any coverage begins. An HSA helps most when you can fund it enough to cover that.
Questions to ask your insurer
What do I pay for a 45-60 minute therapy session in-network?
Does that amount count toward my deductible?
Do I have out-of-network mental health benefits, and is there a separate deductible?
What percentage is reimbursed, and how is the allowed amount set?
Are telehealth sessions covered the same way as in-person sessions?
Is there a yearly session limit?
Write the answers next to each plan you are comparing.
Healthcare is super complex, but armed with information, you can feel a bit more empowered to make informed decisions.
Pick the plan that fits the care you want in 2027, not only the one with the lowest premium.
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