Using Your Insurance for Therapy in Ohio: A Gentle Guide for Open Enrollment and the New Year
Thinking about starting therapy can bring up a lot of questions, and one of the biggest is often, "Will my insurance cover it?" Insurance can feel confusing, especially during open enrollment, when there are so many plans, terms, and deadlines. If you feel unsure, you are not alone.
In this gentle guide, we will walk through key Ohio open enrollment dates, what the law says about mental health benefits, and the questions to ask so you can feel more confident, whether you are in Mason, Columbus, Cleveland, Cincinnati, or elsewhere in Ohio.
Key Open Enrollment Dates in Ohio
If you buy your own health insurance through the federal Marketplace, the Ohio Department of Insurance says open enrollment for 2027 runs from November 1, 2026, through January 15, 2027. To have coverage start on January 1, 2027, you need to enroll by December 15, 2026. HealthCare.gov also notes that people who enroll from December 16 through January 15 can have coverage start February 1.
The Ohio Department of Insurance adds that Ohioans who bought Marketplace coverage for 2026 and want to keep coverage must select a plan for 2027 during open enrollment. If you get insurance through work, your employer sets its own enrollment period, so check with your HR team.
Does Insurance Cover Therapy?
It depends on your plan. According to the Ohio Department of Insurance, insurers must treat mental health and substance use disorder benefits generally like other health benefits. That means things like copays, deductibles, and visit limits for mental health generally can't be more restrictive than for other health care.
The department also explains that most plans you buy for yourself or your family, including those sold through HealthCare.gov, must include mental health benefits. Many employer plans include mental health coverage too, but not all are required to.
Words to Know: Copays, Deductibles, and Coinsurance
Mental health benefits come with the same kinds of costs as other care:
Copay: a set amount you pay at the time of a visit
Deductible: the amount you pay for care before your insurance starts to pay
Coinsurance: a share of the cost you pay after your deductible is met
Every plan is different, so the amount you pay will depend on your specific plan.
If you plan to pay for therapy without using insurance, you have the right to receive a Good Faith Estimate of your expected costs.
Questions to Ask Your Insurer or HR
The Ohio Department of Insurance suggests questions like these when you look at your mental health benefits:
Are there specific diagnoses or services covered in my plan?
Are there deductibles or copays for the service I am seeking?
What happens if I use an out-of-network provider?
Do I need prior authorization or a referral?
What should I do if I am denied services?
You can usually find answers in your plan documents, by calling the number on the back of your insurance card, or by asking your HR office. The Ohio Department of Insurance's Mental Health Insurance Assistance Office can also help at 855-438-6442.
Thinking About Timing Before the New Year
The Ohio Department of Insurance notes that health plans often have an annual deductible. If you have questions about how your costs may change in the new year, your insurer is the best place to check. Starting therapy is a personal choice, and the right time is whenever you feel ready.
Checking Your Coverage With Sukoon
Insurance details vary from plan to plan, so we can't promise coverage or a specific cost. The best next step is to contact our office, and our team will help you understand your options. You can also visit our rates and insurance page. Most of our patients receive 60-95% reimbursement rates back from their insurance.
We offer individual therapy and a full range of therapy services at our office at 5720 Gateway Blvd, Suite 104, in Mason, OH. We also offer online therapy for clients located in Ohio through a secure video platform.
Take the First Step Toward Peace of Mind
"Sukoon" means "peace of mind." Questions about insurance shouldn't stand between you and the support you deserve. Reaching out is a strong and brave step.
Book an Appointment or call us at (513) 643-5341 with questions about insurance and fees. Let's take that step toward clarity and calm today.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
