Deciding to start therapy is a big step. Then comes the hard part: finding someone. Between license letters, insurance networks and waitlists, it’s easy to give up before you begin. This guide walks you through what matters, what to ask and how to make sense of the cost.
Part 1: What to look for in a therapist
A valid New York license
In New York, therapists are licensed by the State Education Department. Common licenses include:
- LMHC: Licensed Mental Health Counselor
- LCSW: Licensed Clinical Social Worker
- LMFT: Licensed Marriage and Family Therapist
- Psychologist (PhD or PsyD): therapy and psychological testing
- Psychiatrist (MD) or psychiatric nurse practitioner (PMHNP): diagnosis and medication
You may also see MHC-LP or MFT-LP. These are therapists who have completed their graduate degree and are gaining the supervised clinical experience hours required to become fully licensed.
Experience with what you’re facing
Look for someone who regularly works with your concern and your age group, whether that’s anxiety, trauma, a teen who’s struggling, or a relationship. Ask what approaches they use.
A good fit
Research consistently finds that the relationship between you and your therapist matters as much as the method. After a session or two, ask yourself:
- Do I feel heard and respected?
- Do they understand my culture, identity and values, or are they open to learning?
- Do I leave with something useful, even if it’s just more clarity?
It’s okay to switch therapists. A good therapist won’t take it personally.
Practical fit
Location, evening and weekend hours, and in-person versus telehealth all affect whether you can stick with it.
Questions to ask before your first session
- Do you take my insurance? What will I pay per session?
- Have you worked with people dealing with what I’m dealing with?
- What does a typical session look like?
- How will we know if therapy is working?
- Do you offer evening, weekend or telehealth appointments?
Part 2: Navigating insurance
Under federal and New York law, most health plans must cover mental health care comparably to medical care. Here’s how to use your benefits:
- Find the behavioral health number on the back of your insurance card. Mental health is sometimes managed by a separate company.
- Ask about outpatient mental health benefits: your copay or coinsurance, whether you have a deductible and how much is left, and whether you need a referral or prior authorization.
- Check in-network vs. out-of-network. In-network therapists cost you much less. Out-of-network care may be partly reimbursed if you submit a receipt (a “superbill”).
- Write it down. Note the date, the representative’s name and a reference number.
Lighthouse is in network with many plans, including Aetna, Anthem, Cigna/Evernorth, EmblemHealth, Fidelis Care, Healthfirst, MagnaCare, MetroPlusHealth, NYSHIP, UMR, UnitedHealthcare/Oxford and 1199SEIU. Lighthouse is also credentialed with several Medicaid managed care plans. Our team can help verify your benefits. See Billing & Insurance.
Common insurance questions
Does Lighthouse accept Fidelis Care?
Yes. Lighthouse is in network with Fidelis Care. Call us with your member ID and we’ll confirm your coverage and what you can expect to pay.
Do you accept Medicaid?
Lighthouse is credentialed with several Medicaid managed care plans, such as Fidelis Care, Healthfirst and MetroPlusHealth. If you have Medicaid through a managed care plan, call us and we’ll check whether your plan is accepted.
Do I need a referral to see a therapist?
Most plans don’t require a referral for outpatient therapy, but some do. Check with your plan, or ask us and we’ll help you find out.
What if my plan isn’t on your list?
Call us anyway. Plans change often, and we can talk through options such as out-of-network benefits, self-pay rates or our sliding scale.
Part 3: Understanding the cost of therapy
- Copay: a flat amount you pay each session, like $20 or $40.
- Deductible: what you pay before insurance starts paying. Until you meet it, you may pay the full session rate.
- Coinsurance: a percentage of the session cost you pay after your deductible.
- Self-pay: paying directly without insurance. Some services, like couples therapy, are usually self-pay because insurance generally doesn’t cover them.
Know your rights: if you’re paying out of pocket, the federal No Surprises Act gives you the right to a Good Faith Estimate of your expected costs before you start.
Many people put off therapy because of cost. Ask about your options: insurance, self-pay rates, and whether a group might be a more affordable fit. At Lighthouse, you can also ask about our sliding-scale options.
Finding a therapist for your child or teen
Look for experience with your child’s age group, a plan to involve you as a parent, and someone your child feels comfortable with. Learn about our child therapy and teen therapy.
Teen groups now forming at Lighthouse
- The Open Door, an LGBTQ+ affirming teen group · Valley Stream · Submit an inquiry
- Teen Girls’ Group · Bronx · Submit an inquiry
Small, therapist-led groups where members practice coping skills and feel less alone. Learn about our groups.
Let us help you find the right fit
Tell us what you’re looking for and we’ll check your insurance and match you with a therapist.
Sources
This article is for general education and isn’t a substitute for professional care.
