price of therapy

[ChelseaAnn]

So, I've just started my transgender process, and I want to start therapy. But I have a few.questions.
First, my insurance for work doesn't cover transgender, gender dysphoria, etc. So, I was wondering if anyone knows a way around this? I have heard on some sites about the therapist naming it a personality disorder, which I would only have to pay $35 for once. I'm not sure if a therapist would be willing to do this though. Hormones are also not covered, but I've heard calling it a hormone imbalance also could work.
That issue aside, the main reason I'm going to therapy is to help me come out. So, my wife doesn't even know I'm going. I know all the confidentiality stuff, but how would I ho about keeping bills and such from my wife's eyes, especially since she checks the mail.
I'm not sure how to go about this, because our funds are limited as is, and my wife is careful about our account. I can't take extra money out to pay out of pocket.
Any ideas are appreciated.

[warlockmaker]

Its really difficult not to tell your wife if you are together and you can only hide it for a while. However, if you need to see a therapist without your wife knowing then "money orders" is a solution and you can work out the payment method with the therapist. If you dont have the money at all then the options are limited.

[King Malachite]

I agree that this will be very difficult if you can't take money out and your wife checks the mail often.  I'm thinking the best option for this is just to find ways to make extra money on the side to cover this and to pay using a prepaid debit card.

[Arch]

I've never received mail from my therapist, but I pay out of pocket with a check every week. If your therapist is willing to code you as depressed (or something other than trans), then insurance will often cover some visits. But then you would have the paper trail.

Honestly, this sounds like a rough situation. If you want to use therapy to help you come out to your wife, then you need to keep your sessions secret for long enough to get ready for that. Ordinarily, I would say to tell her, but that doesn't really work in this situation.

[ChelseaAnn]

Do therapists accept credit cards? I could open one up and bill it to a PO box.

[Emily Aster]

The one I go to takes credit cards, but I don't think all of them do. You'd have to call ahead and confirm first.

[Arch]

If you would have to get a P.O. box that you don't already have, that is an added expense. What about cash (or someone suggested a money order, which is a good idea)? I would talk to the therapist about payment options before the first visit.

[Jess42]

A therapist generally runs anywhere from $75 to $100 per session. The first session is the most expensive and can be from $120-$200 in U.S. dollars. A psychiatrist is a wee bit more expensive but less frequent sessions. $240-$300 for fist session and $90-$140 afterwards.

As for insurance woes. Are you depressed? This is often a condition that is common due to being transgedered. Usually you can make a self discovery in later sessions that you feel that you are transgedered. But you still may be depressed... Right.... Just sayin'. I pay cash to get cheaper rates because they get it immediately and also due to high deductables, so how they send it to the insurance company is beyond me.

Confidentiality agreements. If you are homocidal or suicidal and a couple of other things, a therapist can report it to authorities. For the most part though you have to sign a letter that allows them to share information with others. If you don't want them to share it with anyone, 99% of the time they are obliged not to. Of course subpeonas and such they have to hand over to authorities and so on. In other words your therepist will not tell your wife if that is a concerned.

The first session they will give you a letter explaining the rules what they can disclose and who they can disclose it to. Read the letter and ask any questions you may have conserning disclosure.

[ChelseaAnn]

Ok, just called the therapist I want to use. She's just about right up the street from me (I could walk to her office in 20 minutes). She takes credit cards, lets her clients choose a rate ($80 or $100), no questions asked. She explained all the confidentiality stuff to me, about how my wife doesn't have to know right away.

She also said she's conversationalist. From what I learned in college, that's a good thing. She said she's pretty much the same in and out of a session, and she'll give me feedback on everything.

Unfortunately, I can't afford weekly sessions, considering I can't exactly take extra money out from our account.

[Jess42]

You pick out the frequency of the sessions. It may take a little longer but at least you be getting there.

Once a month would raise suspicions?

[ChelseaAnn]

We take money out for ourselves bi-weekly. But my wife would notice extra. Besides, I don't want to add dynamite to the bonfire. To tell her I'm transgender AND I was stealing money from our account...

[Jess42]

We take money out for ourselves bi-weekly. But my wife would notice extra. Besides, I don't want to add dynamite to the bonfire. To tell her I'm transgender AND I was stealing money from our account...

If it's 80 dollars a session and you do 1 session a month that is about 20 dollars a week. I know som people that spend half that much a day for lunch. If you work and buy your lunch just order from the dollar menu and save the extra toward the therapy. If you bring your lunch to work just make up an excuse as to why you need to buy it instead.

Don't give up because there is always a way.

[ChelseaAnn]

Well, I figured a no-interest credit card would suffice for now, and I can pay it off with what I have for now, and once I come out I'll take care of the rest. It's not gonna be helpful for her to hear, but I doubt "we have an extra credit card" will compare to "I'm transgender". I don't think they're quite on the same scale.

[Jamie D]

So, I've just started my transgender process, and I want to start therapy. But I have a few.questions.
First, my insurance for work doesn't cover transgender, gender dysphoria, etc. So, I was wondering if anyone knows a way around this? I have heard on some sites about the therapist naming it a personality disorder, which I would only have to pay $35 for once. I'm not sure if a therapist would be willing to do this though. Hormones are also not covered, but I've heard calling it a hormone imbalance also could work.
That issue aside, the main reason I'm going to therapy is to help me come out. So, my wife doesn't even know I'm going. I know all the confidentiality stuff, but how would I ho about keeping bills and such from my wife's eyes, especially since she checks the mail.
I'm not sure how to go about this, because our funds are limited as is, and my wife is careful about our account. I can't take extra money out to pay out of pocket.
Any ideas are appreciated.

Your insurance may cover therapy/counseling for related reasons.  The therapist need not code for something disallowed by the plan.  I saw two therapists in that manner.

And my blockers were official due to an anomalous PSA measurement.  My hormone blood tests were for hormone imbalance and gynecomastia.

Use you insurance benefits to the greatest degree possible.  Save your money.  You could have some bigger expense down the road ... FFS, etc

[ChelseaAnn]

Well, the problem is the paper trail. Since my insurance sends me those "this is not a bill" summary things, my wife sees them. I'm not even comfortable telling my wife that I'm going to therapy, so that would be suspicious. Do you think there's a way my insurance would cover therapy without sending out stuff like that?

[Emily Aster]

Based on what you've said of your wife, I think it's best to just go ahead and tell her that you intend to see a therapist. Give her a half truth if you have to, like I need to discuss some things about my childhood or something, but tell her. It sounds like she's going to find out anyway and it'll be a lot less traumatic if it comes from you.

*EDIT
And it will be a lot less stressful for you since you won't have to always be on your guard, wondering if she discovered something.

[Arch]

A therapist generally runs anywhere from $75 to $100 per session.

Hmm, I don't know about other cities, but these prices are not typical for my neck of the woods. My therapist regularly charges $135 a session (including that longer first session), and the therapist my partner saw charged $130 a session. One of my friends was supposed to pay $120 or $125 a few years ago, but I think she had to go with the sliding scale because she made so little money. I have literally never heard of a therapist under $100 a session in my town unless the client was going through insurance, relying on a sliding scale (which some therapists do not offer), or getting some kind of subsidy or rate reduction.

For example, because of my own financial situation, my therapist offers me a reduced rate, but that's not his usual price--and I paid the regular price for a year and a half before my financial situation became untenable.

[JoanneB]

You may have to sacrafice convienience for someone "In network" with only the $35 co-pay.

IMHO your best and least costly option is to check out local TG groups. I wrestled with this beast for the better part of 50 years yet never done the "group thing". When I finally threw in the towel.... It was a life changer for me. Also others in the group can clue you in on TG friendly (at the very least) therapist, some of whom may be in-network.

My previous therapist coded my sessions as "Depression". Like is there a TG out there that isn't? He wasn't a Gender Therapist. But he had several of my group members as clients who were transitioning or beyond. My main goal then was the ton of baggage I was carrying around. The gender issues were tertiary. Plus he was the only TG friendly therapist known taking on new clients in less than a 3 hr drive.

These days, after having moved from the boonies back to the burbs of  Sodom & Gommorah (NYC) I am well within a reasonable drive to a slew of gender therapist. Unfortunately all out of network  and quite expensive