By Alanna Apfel
We often find that life isn’t what we expect it to be. I grew up in a frum, warm home, got married just after graduating from Stern College, began a successful career in finance, and had two daughters — and I never anticipated finding myself divorced in my early thirties. For most of us, when private school tuition and the cost of living are exceptionally high, adding on an extra expense for therapy for ourselves or our children may seem untenable. I’ve discovered that it is possible to get insurance to reimburse you, almost in full, for out-of-network therapy, anywhere from $150–$350 per session. As a patient advocate, I help therapy patients, individuals, couples, and children negotiate with their insurance plans to get these reimbursements.
Over the last few decades, and even more so since the COVID-19 pandemic began, psychotherapy has become increasingly more mainstream and less taboo for the average American. And for good reason. We live in a world where the focus on wellness and fitness has become part of the baseline of popular American culture. Although not shared with the same pride as a daily juicing routine, owning a Peloton bike, or an annual membership to The Gym or Equinox, mental health is a critical piece of our overall well-being. Meditation and mindfulness are the new fashion, with apps galore to guide those seeking inner peace and to achieve a daily state of Zen. Motivational coach Tony Robbins powerfully reminds us that our quality of life is not dictated by material wealth, but by our emotional state: “The quality of your life is where you live emotionally.”
Anxiety. Mania. Depression. Trauma. Personality disorders. ADHD. Loss. Bipolar disorder. Fear. Mood disorders. PTSD. Eating disorders. Addictions. Victims of abuse. Suicidal ideations. Psychosis.
Mental health challenges come in all shapes and sizes. Each one of these emotions and emotional experiences brings with it its own set of challenges in people’s daily lives. They can manifest in the ways we relate to ourselves, to our friends and loved ones, and even in the workplace amongst colleagues, bosses, and support staff. Whether it’s feeling anxiety over what people think of us because of our innate desire for others’ approval and acceptance, the overwhelmingly painful feelings that we are not enough, not loved, or unworthy of love, feelings of loneliness and isolation, the struggle to feel safe and trust others after experiencing trauma, struggling to live happily in reality, instead of in a perpetual state of disappointment over the way we wish things would be, or feeling stuck, hopeless, helpless, paranoid, or trapped, human emotions and the human psyche are complex.
The moving words in the prayer of Unesaneh Tokef, recited on both Rosh Hashanah and Yom Kippur, took on new meaning for me this year as I prayed for my clients who are struggling this year with mental health related challenges and traumas. “Mi yi’shalev, u’mi’yit’yasar — who shall be serene and who shall be tormented.”
Sadly, mental health struggles have the power to suck the joy out of day-to-day life, hinder our ability to be fully present in each moment, and prevent us from connecting with our friends, spouses, and children in a meaningful way. For many, it can be an invisible, lonely, and debilitating struggle. These are brave souls who are working through the pain, and who are processing difficult emotions so that they can lead a happy life in a beautiful state.
For many, seeing a therapist feels like a luxury that is unaffordable. People generally see their therapist once a week, sometimes more often, and the expense can add up quickly. Whether you (or a loved one) have been in therapy for years, have begun therapy in the last few weeks or months, or are interested in starting therapy now, I am here to help you afford therapy with a qualified and experienced therapist, and afford to stay in it as long as you need, without depleting your cash flow or savings.
We all share a human need to contribute. I feel grateful for the opportunity to help and advocate for others. I am passionate about people taking care of their mental-health needs through therapy, when appropriate, because I have experienced firsthand how it has supported me and others through even the most challenging times. Making therapy affordable so people can get the therapy they need with an experienced, qualified therapist brings me great joy and fulfillment. I am honored to be a part of helping people on their journey towards mental and emotional health, and towards living a life with healthy, meaningful relationships.
My passion is to advocate for mental-health reimbursements, where I help psychotherapy patients (individuals, couples, and children) who are covered under an employer-sponsored PPO plan to negotiate with their insurance plan to compel insurance to cover and reimburse the patient for out-of-pocket / out-of-network therapy. (Although many plans cover out-of-network therapy, it is generally at a very low rate ($50–70 per session) and is a benefit that is only accessible for a few months of the year once the deductible has been met.) Although my passion is clearly to advocate for mental-health reimbursements, I have successfully advocated for hospital claims as well.
In the months that I have been advocating, my clients have received anywhere from $5,000 to $45,000 a year in reimbursements, depending on the cost and frequency of therapy, with reimbursements ranging anywhere from $150–$350 per session. (Reimbursements under these cases are generally not subject to the deductible, which means reimbursements are received all year long.) I negotiated a case recently where a mother and her 10-year-old daughter were each seeing their own therapist, out-of-network specialists, due to the nature of the case. The daughter had successfully completed cancer treatments a few months prior and was struggling with anxiety and behavioral challenges, while her mother was struggling with her own anxiety and how to best support her daughter through a situation she could not relate to. I negotiated with their insurance plan, Aetna, to cover each therapist up to a $25 copay so that insurance is reimbursing the family $300 per session for one therapist and $250 per session for the other therapist, saving the family over $2,000 per month. Before the case was negotiated, the family was receiving no reimbursement because the out-of-network deductible had not been met. In another recent case, a father struggling with depression and mood disorder was paying $250 per session, multiple times a week, for psychotherapy. After negotiating with his plan, Anthem Blue Cross, Anthem is reimbursing him in full, $250 per session. (Although he had met his out-of-network deductible by the time I negotiated the case, Anthem was reimbursing only $70 per session until January, when the deductible would reset and reimbursements would have again dropped to $0.)
If you are currently in therapy, or are thinking about starting to work with a therapist, I welcome the opportunity to help you make therapy affordable.
Although my journey has not been one that I anticipated, it has been an incredibly rewarding one. To those of you who may be struggling with mental-health challenges, I wish you a year of good physical health, refuas ha’nefesh, happiness, and fulfillment, and a year in which we can see the blessings Hashem bestows on us daily.
Alanna Apfel can be reached at 323-510-6405 or firstname.lastname@example.org.