Comment by PragmaticPulp | Hacker News Reader

Comment by PragmaticPulp | Hacker News Reader

> The average cost of an in-person ADHD CBT session in the US is $200-300 ($10k-$16k/year).

This is not true at all. If anyone is considering ADHD therapy, please do not let such misleading figures dissuade you.

For anyone with insurance, the average cost of a therapy session is often as little as a $15-25 copay. You could get 4-6 in-person, personalized therapy sessions with an experienced provider for the same price as the annual fee of this app, depending on your insurance.

Even self-pay therapists don't charge $200-300 unless you look at the most expensive cities like NYC [1]. The average self-pay cost is going to be closer to $125 in most regions, though providers often have what's called "sliding scale" charges for low-income patients that go much lower.

The $10K-$16K per year figure is also extremely misleading. In the United States, the annual out-of-pocket maximum for an insurance plan is capped at $8,700 for an individual in a given year [2]. Mental and behavioral healthcare is covered as an essential health benefit [3]. It's not possible to spend $16K per year on any services unless you attend providers that don't accept insurance, which is exceedingly rare. Don't let any apps scare you away from professional services by quoting unbelievably high numbers.

If anyone is considering therapy, please visit your health insurance website and check the cost. Don't be discouraged by anyone trying to sell you alternatives. For most people with insurance (including government health insurance in the United States), several sessions are going to be cheaper than this app and will also provide more personalized, in-person care.

[1] https://blog.zencare.co/therapy-fees-private-practice-by-cit...

[2] https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...

[3] https://www.healthcare.gov/coverage/mental-health-substance-...

YMMV; I have never successfully gotten ADHD CBT reimbursed by insurance. The $8700 is only for in network care and there are no reputable in-network providers that specialize in ADHD in my town.

I went to two in-network LMFTs that listed ADHD as a field they treated and they were complete shit. It was basic talk therapy with generic organizational suggestions like "have you considered keeping a todo list"

I went for 6 weeks with each just to make sure it wasn't just them establishing a baseline (and 6 weeks of copay was cheaper than a single visit to an out-of-network provider). In retrospect, the 6 hours of lost time was not worth it even if the visits had been free.

I have paid over $10k out-of-pocket in a single calendar year ($220 per session) to a therapist that actually helped and $0 was reimbursed by my insurance. I do live in an expensive area (SoCal) but not NYC expensive.

[edit]

None of this is saying I think the App from TFA will be useful; just refuting that everyone who is insured can get ADHD CBT treatment covered by insurance.

> YMMV; I have never successfully gotten ADHD CBT reimbursed by insurance.

The situation has changed significantly under the ACA now that behavioral health is covered as an essential health benefit.

But you do have to go through your insurance company's website to find the in-network providers. As you said, you can't simply pick a therapist and then try to seek reimbursement later.

Some of the cash-only therapists are great if you can afford them. Some therapists strike out on their own as cash-only after building a reputation and a loyal client base. However, it's not a guarantee of success as cash-only also attracts a lot of people who simply want to maximize profit and not deal with insurance, so YMMV.

I agree that there are terrible cash-only therapists. After my two poor experiences with in-network therapists, I asked around in the local area to other people with ADHD and there were two positive recommendations, both of which were cash only.

My meds are 100% covered (though I had to have my psychiatrist file some extra paperwork to get anything that wasn't Adderall or Ritalin) , so at least there's that...

The classic CBT (although not ADHD focused) book by David Burns is $8 on Amazon

That implies that it is easy to find a therapist who will accept insurance, which is not at all the case for many people.

Finding therapists who accept insurance is such a large problem in so many US cities that there are entire startups working to fix that (one example: https://headway.co/). $200-300/session is a low estimate for people in those markets.

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