Why it helps to sort out cost first
When medical bills are already arriving, adding another expense can feel impossible, and some people put off emotional support for that reason alone. Knowing the cost up front tends to make the decision easier, whichever way it goes. It also means you can focus on the work of therapy rather than wondering what the next statement will say. If the wider financial strain of cancer is weighing on you, Financial Stress and Cancer looks at that side.
Using health insurance
The American Cancer Society (ACS) notes that most health insurance plans pay for some counseling, but coverage may be limited, and some policies pay for only a set number of sessions. Plans may also restrict which counselors you can see, since they contract only with certain providers, and you will want to check your copay. A short call to the member services number on your card can answer most of this. Questions worth asking include:
- Do I have outpatient mental health benefits, and is the psychologist I am considering in network?
- What will I pay per session, and is there a yearly limit on sessions?
- How much of my deductible and out-of-pocket maximum has my cancer care already used, and do those amounts apply to mental health visits?
- Are telehealth sessions covered the same way as in-person sessions?
- If I see someone out of network, will my plan reimburse any of the cost, and what paperwork does it need?
If your plan is Blue Cross Blue Shield PPO, Dr. Lehmann is listed as in network, but individual plans differ, so it is still worth confirming your own mental health benefits, copay and any session limits. Write down the date, the name of the person you spoke with, and what they told you. During treatment, when there is a lot to keep track of, a simple note can save a second call.
Paying privately and your right to a Good Faith Estimate
Some people choose to pay privately, whether because they have no insurance, their plan does not cover a provider they want to see, or they prefer not to involve their insurer. The federal No Surprises Act, which took effect on January 1, 2022, gives people in this situation a specific protection. According to the Centers for Medicare & Medicaid Services (CMS):
- If you do not have or do not use health insurance, providers usually must give you a Good Faith Estimate of how much your care will cost.
- You get the estimate when you schedule care at least 3 business days in advance, or when you ask for one.
- You may be able to dispute your bill if it is at least $400 more than the estimate.
- You can submit a complaint if you believe a provider is not following these rules.
For therapy, it is reasonable to ask for the estimate before your first session and to keep a copy. Because therapy is often ongoing, you might also ask how the estimate accounts for the number of sessions you expect, and when an updated one would be provided.
Dr. Lehmann's fees, as currently listed
Dr. Lehmann's practice currently lists the following. Fees and policies can change, so please confirm the details with the practice before you book:
- Private pay: $220 per clinical hour.
- Insurance: in network with Blue Cross Blue Shield PPO.
- Reduced fee: reduced-fee services are available on a limited basis. Ask whether a spot is open.
- Payment: cash, check, HSA cards, Mastercard and Visa.
- Late cancellation: please give 24 hours' notice. Missed sessions or cancellations with less notice are billed $90 unless the cancellation is due to illness or an emergency.
That last point matters during treatment, when side effects can be unpredictable. The Fees & Insurance page and the cancellation policy have the full details. If travel is tiring, telehealth sessions are an option for clients physically located in Michigan at the time of the session.
If cost is a barrier
Cost does not have to rule out support. ACS suggests asking your cancer care team whether the hospital or clinic where you are treated offers free counseling, and whether they know of local services that adjust fees based on income or are offered at low or no cost. For caregivers, ACS notes that some employers offer free counseling through an Employee Assistance Program (EAP), and that it is reasonable to ask counselors whether they offer sliding-scale rates.
Community programs can fill gaps as well. Gilda's Club Metro Detroit in Royal Oak describes itself as a free cancer support community (248-577-0800), and Cancer Support Resources in Oakland County and Michigan lists more options. Some people combine a free group with a smaller number of individual sessions.
Making the decision
It can help to think about cost over a stretch of time rather than one session at a time. Ask how often sessions usually happen at the start, whether frequency can change as treatment eases or intensifies, and how you will both decide when to space sessions out. Some people set a natural checkpoint, such as reviewing after the first several sessions whether therapy is helping enough to justify the expense. Others budget for a defined period, such as the months of active treatment or the first season after it ends. Hidden costs count too: parking, gas, time off work and the energy a trip takes on a hard day. Being open with a therapist about what you can afford is a normal part of planning care, not an awkward request.
Once you know what therapy would cost, the question becomes whether it is the right kind of help for you now. Questions to Ask Before Starting Therapy for Cancer-Related Stress can help with that conversation. To learn how Dr. Lehmann works with people affected by cancer, see cancer-related emotional support.