Find an Emblem Health Therapist
Medically reviewed by Gabriela Asturias, MD on June 24, 2024EmblemHealth covers outpatient therapy across all its plans—HIP HMO, GHI PPO/EPO, Medicaid, Marketplace, and Medicare Advantage—but copays, telehealth rules, and provider networks differ by plan. This step-by-step guide shows you how to confirm your exact benefits and book an in-network Emblem Health therapist, Emblem Health psychologist, or an Emblem Health psychiatrist this week.
How EmblemHealth Mental-Health Coverage Works
| Plan | In-Network Therapy / Psychiatry Cost* | Key Points |
|---|---|---|
| Medicaid (Health Insurance Plan of NY) | $0 copay | Unlimited medically necessary visits |
| Essential Plan 1 (Marketplace) | $15 copay per visit | One combined deductible; no visit cap |
| Select Care Gold (Marketplace HMO) | $25 copay after deductible | Same rate for therapy & psychiatry |
| City of NY GHI Senior Care | $15 copay per visit | Applies to retirees’ mental-health visits |
| EmblemHealth Medicare Advantage | $0–$35 copay office & virtual | Copay shown in Evidence of Coverage |
*Always open your own Summary of Benefits or Medicaid member handbook; numbers above are 2025 averages.
EmblemHealth Mental Health Coverage highlights
- Unlimited visits. No annual limit when treatment is clinically needed.
- No referral required. You can book directly with a mental-health clinician.
- Telehealth parity. Video visits pay the same as in-person; payment parity extended through 2025.
- Teladoc option. Most plans include Teladoc therapy/psychiatry—often at $0–$25 copay
EmblemHealth Mental-Health Providers Types
| Clinician Type | What They Do |
|---|---|
| Therapist / Counselor (LCSW, LMFT, LPC) | Talk therapy, coping skills, family sessions |
| Psychologist (PhD, PsyD) | Psychological testing, trauma-focused modalities |
| Psychiatrist (MD/DO) | Diagnosis, medication management |
All three license types appear in the online directory and the Teladoc platform—each bills at the same copay tier shown in your plan.
Real-Life Use Case: How Maira Found a Therapist That Takes EmblemHealth
How Maira Found an EmblemHealth Therapist in 3 Days—At No Cost
Maira, a 30-year-old from Queens, needed mental health support. Here’s how she found care quickly using her EmblemHealth plan:
- Day 1: Maira logged in at emblemhealth.com, navigated to Find Care → Behavioral Health, and saw eight in-network therapists within five miles. She filtered for telehealth, CBT, and evening availability. Three providers remained—all accepting new patients.
- Day 2: Using the cost estimator, Maira confirmed her Essential Plan 1 covered Teladoc video sessions at $0 and in-person visits at $15.
- Day 3: She booked a 7 p.m. video session with Ana Rivera, LCSW, an in-network therapist. Her copay: $0.
- Day 10: After two sessions, Ana recommended an SSRI.
- Day 12: Maira scheduled a 30-minute consult with a Emblem Health psychiatrist through Teladoc for the next morning. Cost: $0.
Total time from search to first therapy session: 3 days. Total out-of-pocket cost: $0.
Step-by-Step: How to Book Therapy with EmblemHealth
- Log in or call Member Services Go to emblemhealth.com or call the number on your member ID card. Say, "I’d like help finding a mental health provider."
- Search the provider directory Use filters to narrow your results by ZIP code, telehealth or in-person care, specialty (e.g., anxiety, trauma, couples therapy), language, and evening or weekend availability.
- Verify the provider is in-network Look for the “In Network” label—this ensures your sessions will be covered by EmblemHealth.
- Estimate your cost Use the “Estimate Cost” tool to check your out-of-pocket fees. Depending on your plan and visit type, most sessions range from $0 to $40.
- Choose telehealth for faster access Teladoc providers often have same-week availability, and virtual sessions may be covered at no cost under many plans.
- Book your appointment and complete intake forms Submitting forms online in advance helps verify coverage and speeds up the process.
Telehealth Options
| Platform | Services | Typical Cost |
|---|---|---|
| Teladoc for EmblemHealth | Video therapy & psychiatry, 7 a.m.–9 p.m. | $0–$25 (many plans $0) |
| Audio-only (phone) | Allowed if video isn’t possible | Same cost share |
Virtual visits count toward any deductible and out-of-pocket max just like office visits.
Cost Breakdown
| Setting | Medicaid | Essential Plan 1 | Select Care Gold | GHI Senior Care | Medicare Advantage |
|---|---|---|---|---|---|
| Office therapy (45 min) | $0 | $15 | $25 after ded. | $15 | $0–$35 |
| Teladoc video therapy | $0 | $0 | $0–$25 | $15 | $0–$35 |
| Initial psychiatry eval | Same as therapy for each plan | Same | Same | Same | Same |
What you can do if you cannot find an appointment within 10 days
If you’re having trouble finding a mental health appointment within a reasonable timeframe, here’s how to take action:
1. Keep a Call Log For each provider you contact, write down:
- Date of the call
- Name of the staff member
- The next available appointment they offered
This record is essential if you need to request an exception or file a complaint.
2. Call EmblemHealth Behavioral Health Customer Service: Use the number on your EmblemHealth ID card and ask for Behavioral Health Customer Service. They can help you check for cancellations or search across neighboring ZIP codes for sooner availability.
3. Request a Network Adequacy Waiver: If no in-network provider has an appointment within 10 business days, you have the right to ask for a network adequacy exception. EmblemHealth may authorize care with an out-of-network provider at in-network rates to ensure timely access.
4. File a Grievance: If delays continue, submit a grievance through your EmblemHealth member portal or by calling Member Services. By law, they must respond within 30 calendar days.
Frequently Asked Questions
Does EmblemHealth cover therapy? Yes. All EmblemHealth plans pay for outpatient therapy and psychiatry with no yearly visit limit. Copays range from $0 (Medicaid, many Teladoc slots) to $40 (some Marketplace office visits).
How do I find an EmblemHealth therapist near me? Log in → Find Care → Behavioral Health, enter your ZIP, and filter by “Accepting patients” or “Telehealth.”
What’s the difference between an EmblemHealth therapist and an Emblem Health psychologist? Therapists (LCSW, LMFT, LPC) provide counseling. Psychologists (PhD/PsyD) can also run psychological tests. Both bill at the same copay tier.
Are EmblemHealth psychiatrists accepting new patients? Many are—especially via Teladoc. Use the telehealth filter and look for “Accepting patients.”
Will my virtual visit count toward my deductible? Yes. Telehealth sessions apply to the same deductible and out-of-pocket maximum as office visits.
Find care for Emblem
Remember, recovery is possible. With early intervention, a supportive network, and the right professional care, you can overcome the challenges of Emblem and build a fulfilling life. We are here to help you find care.
