Health insurance protects people from paying medical bills out of their own pocket. However, some people and families are unable to afford health insurance or are not eligible to receive it.

Statistics from the United States Census Bureau state that in 2018, 27.5 million people did not have any form of health insurance.

If a person or family does not have insurance, it means that they may be unable to pay medical bills if they require treatment. This could potentially lead them into debt.

Nearly 1 in 5 U.S. adults have a diagnosed mental health condition. It is likely that many more do not have a diagnosis and are living with emotional or behavioral conditions that do not fall in the sphere of a diagnosis. These people may require some form of therapy to support them.

For those who do not have insurance, the prospect of needing to pay for therapy may be daunting and not feasible. However, in the U.S., there are some options for cheaper or free therapy should a person require it.

This article will discuss some therapy options that may be available to people and families without insurance.

Therapist consoling teenage patient during the session.Share on Pinterest
Several organizations offer therapy at a reduced rate or on a sliding fee scale.
Photography by Monica Pardo

Medicaid is a type of public health insurance for U.S. citizens from low income households. A person who meets certain criteria may be eligible for Medicaid.

The types of treatment that Medicaid covers can vary by state. Also, factors such as the reason for needing therapy and the type of therapy a person needs will play a part in whether or not Medicaid will cover it.

Learn more about Medicaid here.

People who do not have insurance and are unable to afford therapy may consider approaching a sliding scale therapist.

A sliding scale therapist will consider the circumstances of the individual and calculate a fee based on this. This fee will be lower than what the therapist usually charges.

Instead of a one-time fee, a person may be able to set up an affordable payment plan with the therapist.

Training clinics are often at a university, where graduate students can gain practical experience to become psychologists or therapists.

As the student is not yet fully qualified, a person may be able to approach these clinics for therapy at a cheaper rate.

If a person lives near a university, it may be worth calling their psychology department to see if they have a training clinic.

Some U.S. states have free or low income mental health services. Similar to training clinics, these services may recruit students who are training to be psychologists, mental health counselors, or social workers to provide support that is free or low cost.

These clinics may be able to help with things such as medication management, and they may also be able to provide treatment for mental health conditions such as depression and anxiety.

A federally funded health center is a healthcare facility that is community based. This means that they receive funding from the Health Resources and Services Administration (HRSA) to provide care and treatment for people in underserved areas.

According to the HRSA, these centers must provide care on a sliding fee scale. Therefore, this may be an affordable option for people in more rural areas.

There are several therapy services that a person can use to talk with a licensed therapist online, either on the phone or via webcam or text.

Online therapy services can be an accessible and affordable alternative to traditional therapy.

In fact, a 2016 review of online services that provide psychiatric help suggests that this method is more cost effective than receiving similar treatment in person.

However, prices can vary quite a bit and not all services accept insurance. Some also offer memberships with a specific number of sessions or messages every week or month, while others may charge per individual session.

Online therapy is available through many apps and websites, some of which match people with a licensed therapist based on their needs. Many providers also offer virtual therapy for individuals who prefer online counseling over in-person therapy.

There are several services that offer free online therapy for individuals with conditions like depression or anxiety.

Some services may provide virtual group sessions, self-guided worksheets, or access to online forums to connect with peers. Others may provide a free assessment or trial session with a licensed therapist.

While these services could be a good option for people on a limited budget, it might not be ideal for those who need more intensive support.

When looking for a therapist, a person should be upfront in stating that they do not have insurance. They can then ask if the therapist offers any discounted rates.

Some therapists are happy to provide discounted rates for people without insurance if they pay upfront with cash. This is because it means that they get the payment immediately, instead of having to sort the paperwork relating to the insurance.

People looking for mental health support may be able to access free local support groups or join an online forum. These tend to be peer-to-peer support without intervention from a mental health professional.

Some research notes that online support groups may be useful for people with depression. This method may lead to improvements in daily functioning and help reduce feelings of isolation.

Although support groups may provide some positive benefits, they do not replace the professional help that a licensed therapist can provide.

Group therapy is a type of psychotherapy in which one or more therapists work with multiple clients simultaneously.

Group sessions usually consist of around 5–15 participants and are conducted by a mental health professional, such as a psychologist or social worker. Groups can be online or in person, and they typically focus on a specific mental health condition, experience, or model of therapy.

Group therapy is generally more affordable than individual therapy and is often covered by insurance. Some people may also find it beneficial to connect with others who share similar experiences.

On the other hand, it does not provide the same individualized attention as one-on-one sessions, which may not make it a good fit for those who need additional support.

Additionally, it may not be as flexible for those with a busy schedule, and some may not feel comfortable sharing with a group of people.

The American Group Psychotherapy Association offers a tool to search for certified group psychotherapists on their website. Most mental health care practitioners can also provide referrals for local groups, along with resources for online group therapy.

There are many apps available that are designed to support mental health. Many provide tools and activities to help control stress, while others may involve practices like journaling, mindfulness, or meditation.

Most mental health apps are free to download but require a paid subscription to access all of the features and resources.

These apps are convenient, flexible, affordable, and easy to use. They can also be a good choice for people looking to work on stress reduction techniques or coping mechanisms on their own schedule.

However, these apps should not be used as a replacement for treatment from a mental health professional. Additionally, those concerned about privacy should be sure to look for an app that offers secure messaging and is HIPAA-compliant.

There are many hotlines that a person can call or text in case of a crisis, many of which offer free, confidential support 24/7 from a trained volunteer.

While there are many free hotlines and mental health resources available, a few that may be useful include:

  • National Suicide Prevention Lifeline: call 800-273-8255
  • National Domestic Violence Hotline: call 800-799-7233
  • National Sexual Assault Hotline: call 800-656-4673
  • Eating Disorders Awareness and Prevention: call or text 800-931-2237
  • Gay and Lesbian National Hotline: call 888-843-4564
  • Substance Abuse and Mental Health Services Administration Helpline: call 800-662-4357

Warmlines are phone lines that offer mental and emotional support from peers. Unlike hotlines, they are not intended to be used during a crisis or emergency situation, and some may be limited to people from certain areas.

Here are some warmlines that are available:

  • Clear Warm Line: call 800-945-1355
  • CARES Warm Line: call or text 844-326-5400
  • Compassionate Ear Warm Line: call 866-927-6327
  • Peer Support Line: call 877-733-7563

If a person cannot find a therapy option that fits their budget, they may need to consider reevaluating their expenses.

For example, they could write down all their incoming and outgoing expenses for 1 or 2 months, then review this and see whether or not they can cut back on some outgoing expenses.

Alternatively, if possible, a person or family may consider creating a savings account specifically for therapy.

People who do not have health insurance may find it difficult to afford therapy and may need to seek low cost or free alternatives.

There are several organizations that offer therapy at a reduced rate or on a sliding fee scale. A person who requires therapy may want to consider these options to gain access to mental health support.