January, Insurance, & Mental Health: Let’s Talk About What’s Actually Happening

Every January, we see the same thing happen.

Clients who were settled into their mental health care, paying a copay or coinsurance, finally feeling some stability, and suddenly they get a notice, a bill, or a charge that feels overwhelming and frustrating.

And it is frustrating.

If you’re feeling confused, stressed, or even a little angry about how insurance is impacting your mental health care right now, you are not alone. We see this every year, and we want to take a moment to explain what’s happening and help make sense of a system that is often unnecessarily complicated.

The January Deductible Reset 

Most insurance plans operate on a calendar year.

That means:

  • In January, your deductible resets

  • Until that deductible is met again, you are responsible for the full “allowed amount” set by your insurance company (Yes, insurance sets the rate!)

  • Once the deductible is met, your plan usually returns to copays or coinsurance

So even if nothing about your care changed (same provider, same frequency, same plan) your out-of-pocket cost often changes dramatically in January.

This isn’t because your therapist raised their rate.
It isn’t because something was coded incorrectly.
And it isn’t because the practice you work with suddenly decided to charge more.

It’s simply how insurance is structured.

Why this hits mental health especially hard

Mental health care isn’t usually a one-time visit.

It’s ongoing. Relational. Consistent. And for many people, it’s essential, not optional.

So when deductibles reset, people are suddenly faced with:

  • Paying the full session rate for a period of time

  • Deciding whether they can afford to continue care

  • Feeling pressure to pause or stop something that was actually helping

That decision is rarely just financial. It’s emotional, too. 

Money stress is real stress. Financial strain impacts mental health. This is not lost on us.

The truth about deductibles

One piece that often gets missed in these conversations is this:

A deductible is money you will pay somewhere throughout the year.

You may pay it:

  • Gradually, through healthcare visits

  • All at once, if something unexpected (or expected, like a birth!) happens

  • Across multiple providers (medical, mental health, labs, etc.)

Insurance doesn’t necessarily make care cheaper, it spreads the cost differently and often delays when support actually kicks in.

That doesn’t mean the system feels fair or accessible. It often doesn’t.  Though understanding this piece can help people make more informed choices instead of feeling blindsided.

Our role as a practice (and what we can and can’t control)

At Honey, we chose to accept insurance because we believe mental health care should be more accessible, not less.

At the same time, we don’t set:

  • Deductible amounts

  • Allowed rates

  • When or how benefits reset

  • How quickly insurance reimburses providers

We are navigating this system with our clients, not against them.

Our goal is always to:

  • Be transparent

  • Answer questions honestly

  • Help people understand their options

  • Look for solutions where we can

That may include conversations about payment plans, spacing sessions differently for a period of time, or helping clients think through next steps.

This is not “us vs. you”

And it’s not really “us vs. insurance” either.

It’s all of us trying to make sense of a healthcare system that was not designed with mental health, or human nervous systems, in mind.

If January feels heavy, discouraging, or confusing, please know your frustration makes sense

We believe mental health care matters.
We believe people deserve clarity.
And we believe that honest conversations, even about uncomfortable topics like money, are part of ethical, respectful care.

If you have questions about your benefits, your options, or what support might look like right now, we encourage you to ask. Not because we have all the answers, because we are on your team, navigating this together.

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