It’s truly remarkable that many insurers are now covering specialized OCD care at NOCD. For a long list of reasons, access to care for serious mental health disorders—including OCD—has lagged far behind that of physical ones. Even compared to other mental health conditions, access to specialized care for OCD has been limited. Expanding that access is essential to everything we do at NOCD. In fact, it’s the reason we exist.
The gold standard treatment for OCD is called exposure and prevention response (ERP) therapy. With ERP, the core teaching is focused on accepting—not suppressing—your OCD fears. Working with a licensed therapist who specializes in ERP is critical to overcoming OCD, given the personalization and complexities that come with both building and navigating an individual’s treatment plan.
Despite this, ERP has never been very accessible in the past. Outside of NOCD, it’s often expensive to work with a licensed mental health professional who specializes in treating OCD with ERP, costing people hundreds of dollars out-of-pocket per visit. (You can read about why that is here.)
That’s why it’s nearly impossible to overstate the impact and value of accessing ERP with insurance – again, it hasn’t always been that way. It’s been a long and worthy journey to get specialized OCD in more people’s reach by making it more affordable.
Why ERP has historically not been covered by insurance
Most health insurance companies misattribute costs caused by untreated OCD to other conditions, since many providers misdiagnose OCD. In fact, a staggering 96% of people with OCD don’t surface in claims data due to misdiagnosis and mistreatment.
When OCD is misidentified, patients receive the wrong care and don’t address the root condition, making it nearly impossible for them to get better. This alone is a major and unacceptable problem – but on top of that, misdiagnoses mean that incidences of OCD are strikingly underreported.
That means that insurance companies aren’t seeing the true scope of the problem or the significant number of people affected. OCD is instead seen as more of a rare condition that doesn’t affect their population much – which we know is inaccurate because OCD affects an estimated 1 in 40 people in the US alone.
Essentially, these misdiagnosis and miscoding issues have masked the true prevalence and cost of untreated OCD on health insurers globally.
How misdiagnosed OCD has led to a lack of insurance coverage that still exists today
The consequences of misdiagnosed and misidentified OCD are enormous. Many health insurers don’t pay for the specialty rates required from ERP therapists, because their disconnected data prevents them from seeing the real need for OCD treatment or the true cost savings opportunity in treating OCD effectively. They instead offer ERP specialists much lower “talk therapy” rates.
The reason ERP therapists need specialty rates in the first place is because specializing in ERP requires extensive training far beyond what’s received to practice most other methods of therapy. Deep knowledge and understanding of OCD are also required because of the complexities of the condition.
Due to this extensive training and the work needed to treat OCD, the number of licensed clinicians falls far short of what is needed – meaning there are a limited number of providers who qualify as legitimate OCD specialists. Meanwhile, the need for their services is high.
Given the massive positive, life-changing impact ERP therapy has on a person with OCD, licensed therapists trained in ERP are truly worth more than several hundred dollars per hour. But, because health insurers have historically not been able to see the true size and need for OCD specialty care in their populations, they have let their ERP therapists leave rather than adjust their rates.
The lack of in-network ERP specialists leads people with OCD to turn to other methods of care that are covered by their insurance (often non-specialized therapy that’s not meant for OCD and can actually make OCD worse), meaning that they often don’t truly address OCD at all.
The cost of ERP in private pay setting vs. the cost of ERP covered by insurance
This minimization of OCD’s prevalence has also forced many ERP therapists to go out of network and charge higher cash-pay rates that are commensurate with the specialized treatment they offer. The cost of working with an ERP-trained therapist is around $350 (or more – even upwards of $500) per session, and most often, these costs are paid fully out-of-pocket.
That’s why in the past, it was rare to find an ERP specialist who accepted insurance at all. At NOCD, our mission is to help more people receive ERP from a qualified OCD specialist. We’ve been attacking this problem at its core, starting by connecting the data that allows us to show the returns of effectively treating OCD at a population level to insurance plans nationwide. Our goal is to show the large need for effective OCD treatment so that people don’t have to pay out-of-pocket costs for necessary care.
This has led us to partner with some of the nation’s leading insurance plans – including UnitedHealthcare, Cigna, Humana, Blue Cross Blue Shield plans, and many more – so members can receive OCD treatment through their behavioral health plan benefits. It’s one of the first times that ERP therapy has ever been insurance-backed.
As a result, most of our members using in-network insurance only pay a small copay of $0 to $50 a session.
We’re also giving more people the opportunity to receive much-needed treatment by training licensed therapists to specialize in ERP, thereby expanding our reach. Our therapists work side-by-side with world-renowned OCD leaders who have designed some of the world’s top OCD treatment programs. These leaders build our protocols at NOCD and actively manage them today, and they conduct rigorous training in OCD and ERP – evidence-based therapy that’s been proven to be the most effective treatment for OCD. All of this ensures that our members get the best care.
Ultimately, our revolutionary process may offer more people with OCD the chance to access ERP therapy without barriers to treatment, give payers the viability needed to see the true impact of treating OCD and allow OCD specialists the opportunity to receive reimbursement equal to their impact.
How can you access effective OCD treatment through insurance?
If you’re looking to find an affordable and effective way to manage OCD, book a free 15-minute call with our team to learn more about working with a NOCD therapist.
We’re here to do whatever we can to make your recovery easier and want to make getting care as easy and transparent as possible. You can check if NOCD accepts your insurance here, and if you need more information about navigating health insurance, we’ve created this guide to help you.
If your health insurance does not cover evidence-based, effective, affordable OCD treatment yet and does not have strong out-of-network benefits, don’t despair: there are actions you may be able to take to get the care that you deserve.
Even if you’re not using insurance, our members find that their out-of-pocket costs are significantly less than what specialists charge in their area. In fact, ERP therapy for our members is typically less than half the price of standard, in-person ERP therapy you’ll find outside of NOCD, even though we offer more service than most ERP therapists. We also work with members paying out-of-pocket to manage costs in a way that meets their needs. Please book a free 15-minute call with our team to discuss your options.