Find a Highmark Therapist
Medically reviewed by Gabriela Asturias, MD on June 24, 2024If you have Highmark Blue Cross Blue Shield, mental health care is covered—no matter your plan type. Whether you're on Complete Blue PPO, my Blue Access Marketplace, Highmark Wholecare (Medicaid/D-SNP), or a self-funded employer plan, all include outpatient therapy and psychiatry with no annual session limits. Note that coverage details vary: copays typically range from $0–$40, and many plans offer free virtual visits through Well360 Virtual Health (Amwell) or Teladoc. This guide simplifies the process so you can find an in-network Highmark therapist, psychologist, or psychiatrist—and book your first appointment this week.
How Highmark Mental-Health Coverage Works
| Plan Type | Typical Cost for In-Network Therapy & Psychiatry* | Key Points |
|---|---|---|
| Medicare Advantage (e.g., Complete Blue PPO) | $40 copay per visit | Same rate for therapy & meds |
| Wholecare D-SNP (Medicare + Medicaid) | $0 copay for all outpatient mental-health visits | Medicaid pays what Medicare doesn’t |
| Marketplace Silver PPO/HMO | $20 – $40 copay after deductible — $0 for some urgent MH visits | No visit limit |
| Employer PPO/HMO | Most charge $20 – $40; some waive telehealth copays | Check your SBC |
| High-Deductible & HSA plans | 20 % after deductible, then the standard copay | HSA dollars cover early-year bills |
*Always open your own Summary of Benefits—employers can customize.
Plan highlights
- Unlimited sessions. If the clinician says they’re medically necessary, Highmark keeps paying.
- No referral. You can schedule directly with a mental-health specialist.
- Telehealth costs the same—or less. Virtual visits run under your “Outpatient Mental Health” benefit, so whatever you’d owe in the office applies online as well. Many Marketplace and employer plans drop the copay entirely for Well360 Virtual Health.
- Nation-wide Blues network. Moving or traveling? Use BlueCard to see in-network therapists in any state.
Highmark’s in Network Mental-Health Provider Types
| Provider Type | Typical Role |
|---|---|
| Therapist / Counselor (LCSW, LMFT, LPC) | Weekly talk therapy, coping skills, family sessions |
| Psychologist (PhD, PsyD) | Psychological testing, trauma-focused modalities |
| Psychiatrist (MD/DO) | Diagnosis, medication management |
All three license types bill under the same outpatient mental-health benefit, so your copay (or $0) is identical.
Real-Life Use Case: How Jordan Found a Highmark Therapist in 3 Days — and Paid $0
Day 1: Jordan (34, Pittsburgh) logs into highmark.com → Find Care & Costs → Behavioral Health. He sees nine in-network therapists within 10 miles. He applies filters: Telehealth, CBT, and Evening hours. Three therapists remain—all accepting new patients.
Day 2: Jordan uses the cost estimator:
- $0 for Well360 video sessions
- $25 for in-person visits (Marketplace Silver Plan)
Day 3: He books a Thursday 7 p.m. virtual session with Devon Lee, LCSW, a Highmark in-network therapist. Copay: $0
Day 10: After two sessions, Devon recommends exploring medication.
Day 12: Jordan schedules a 30-minute psychiatry consult via Well360 for the next morning. Copay: $0
Total time from search to first session: three days. Out-of-pocket so far: $0.
Step-by-Step: Booking Therapy Through Highmark
Sign in or call. Open highmark.com (or the Sydney Health app) or dial Member Services; say “Behavioral Health.”
Search the directory. Filter by ZIP, telehealth vs. office, specialty, language, and evening/weekend hours.
Confirm network status. Look for “In Network – UnitedHealthcare Choice Plus” or the local Blues phrase—your cue you’ve found a covered Highmark therapist.
Check your cost. Click Estimate Cost; you’ll see the exact copay/coinsurance before you book.
Choose speed or locality. Telehealth (Well360/Amwell or Teladoc) often offers next-day slots; office visits may take a week or two.
Complete intake forms. Online questionnaires speed insurance verification.
Telehealth Options
| Platform | Services | Typical Cost |
|---|---|---|
| Well360 Virtual Health (Amwell) | Therapy & psychiatry video, 7 a.m.–9 p.m. | Member pays the same cost share as an office visit; many plans waive it |
| Teladoc (select Medicare & D-SNP) | Therapy & psychiatry | Often $0 |
| Phone-only (DE, NY, WV) | Allowed if broadband unavailable | Same copay |
Virtual sessions count toward any deductible and out-of-pocket maximum just like office visits.
Cost estimates
| Setting | Medicare Advantage | Wholecare D-SNP | Marketplace Silver | Employer PPO |
|---|---|---|---|---|
| Office therapy (45 min) | $40 copay | $0 | $20–$40 | $20–$40 |
| Well360 video therapy | $0–$40 (plan-specific) | $0 | Often $0 | Often $0 |
| Initial psychiatry eval | Same as therapy | $0 | Same as therapy | Same as therapy |
What to do if you cant find an appointment within 10 days:
- Document every call. Write the date, name, and “next available” date.
- Ask for Behavioral Health Care Management. Highmark reps can hunt cancellations across ZIP codes.
- Request a network-adequacy waiver. If no in-network slot within 10 business days, Highmark can green-light an outside provider at in-network rates.
- File a grievance online. The plan must answer in 30 days—often sooner.
Frequently Asked Questions
Does Highmark cover therapy? Yes. All commercial, Marketplace, Medicaid, and Medicare Advantage options include outpatient therapy and psychiatric visits with no session cap. Copays range from $0 to $40 depending on your plan.
How do I find therapists that take Highmark near me? Sign in → Find Care & Costs → Behavioral Health → filter by ZIP, telehealth, and availability.
What’s the difference between a Highmark therapist and a Highmark psychologist? Therapists (LCSW, LMFT, LPC) provide counseling; psychologists (PhD/PsyD) can also perform psychological testing. Both bill under the same outpatient mental-health benefit.
Are Highmark psychiatrists accepting new patients? Many are—especially through Well360 Virtual Health. Use the telehealth filter and “Accepting patients” tag.
Will my virtual visit count toward my deductible? Yes. Telehealth sessions apply to the same deductible and out-of-pocket max as office visits.
Find care for Highmark
Remember, recovery is possible. With early intervention, a supportive network, and the right professional care, you can overcome the challenges of Highmark and build a fulfilling life. We are here to help you find care.
