How to Start Therapy in Richmond With Private Insurance (Without Losing Your Mind)

January 20, 2026

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Key Take Aways

1. Starting therapy is often harder than therapy itself. If the logistics feel overwhelming, that’s not a personal shortcoming. It’s a systems issue, and you deserve support navigating it.

2. You do not have to choose between quality care and using insurance. Skilled, relational therapy can be both insurance-based and deeply human, especially when a strong team is handling the behind-the-scenes work.

3. You don’t need the perfect plan or the right words to begin. Therapy starts with curiosity and conversation, not readiness or certainty. The first step is simply reaching out.

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If you’ve been thinking about starting therapy but keep getting stuck on the logistics, you’re not alone. For many people, it’s not the idea of therapy that stops them. It’s the process. Insurance portals are confusing. Provider lists are outdated. Everyone seems booked. And the emotional energy it takes to figure all of that out can feel like more than you have to give.

This is not a personal failure.

It’s a systems problem.

Here’s a simpler, more human way to think about getting started with therapy in Richmond, VA - especially if you plan to use private insurance.

A RICHMOND REALITY CHECK

Over the past few years, many therapists in the Richmond area (and around the country) shifted to exclusively online care. While telehealth remains an important option, we are hearing from more and more people who want the opportunity to leave their homes and sit with another human being in the same room.

Finding in-person therapy that accepts insurance, especially for specialty areas like working with kids, teens, and couples, can be challenging. Long waitlists are common, and many people assume they have to choose between affordability and quality.

That assumption isn’t true.

At Aspen Grove Wellness, we are deeply committed to being an insurance-based practice, because we believe therapy should be accessible and sustainable. The reality is that accepting insurance requires an enormous amount of administrative work behind the scenes - credentialing, claims submission, delayed payments, and constant follow-up. It takes a strong, values-aligned team to navigate that complexity while keeping patients at the center of care. But that is work we willingly take on so you don’t have to.

STEP 1: Start with who you want to work with, not your insurance portal

Insurance directories often create the illusion of choice without much clarity. They are frequently outdated, incomplete, and disconnected from how therapy actually works.

Many people find it more grounding to begin by looking for a therapist or practice whose values, tone, and approach resonate with them, then confirming insurance coverage afterward. You are allowed to want therapy that feels relational, thoughtful, and aligned with who you are.

If you have ever tried searching through Psychology Today or your insurance portal and walked away feeling like you failed, you are not alone. What often goes wrong is not the therapy itself, but the lack of attention paid to the therapeutic relationship. Decades of research tell us that the therapeutic alliance - how you feel with your therapist - is the strongest predictor of positive outcomes, regardless of theoretical orientation.

In a nutshell: Fit matters.

STEP 2: Understand what “using insurance” actually means

One of the most common questions we hear is:“What will therapy actually cost me with insurance?”

The honest answer is that it depends.

Private insurance typically involves one of three cost structures:

• A copay

• Coinsurance

• Meeting a deductible before coverage applies

The only way to get the most accurate, up-to-date information is to call the member services number on the back of your insurance card and ask what your out-of-pocket cost will be for:

• 90791 (initial intake session)

• 90837 (53-minute follow-up therapy session)

Your cost depends on several factors:

• Whether your deductible has been met for the current plan year

• When your plan year resets (Not all plan years correspond with the calendar year. Some people's deductibles restart in July, November, etc.)

• Whether your plan uses copays (usually a flat amount per session) or coinsurance (usually a percentage of the insurance company's negotiated rate with the individual practice)

Common misunderstandings we see:

• Deductibles are often misunderstood. Insurance companies view them as part of your benefit structure and require providers to collect payments applied to them.

• Copays vs coinsurance vary widely by plan and are your responsibility for each session after your deductible has been met for the year.

• “Covered” vs “in network” matters. In-network means the provider is credentialed with your insurance. Out-of-network care usually requires you to pay upfront and seek reimbursement yourself, often after meeting a much higher deductible.

  
  

Many people assume they have to go out of network to find experienced therapists because that’s what social media algorithms tend to show. That assumption can add unnecessary financial stress.

HOW WE SUPPORT YOU WITH INSURANCE AT ASPEN GROVE WELLNESS

We genuinely want to walk alongside you in this process.

Unfortunately, insurance companies only provide final cost information after a session has occurred and a claim has processed. That information comes in the form of an Explanation of Benefits, which you also receive. Because of how inconsistent and contradictory advance information from insurers can be, we do not collect payment until that first claim has processed. We never want therapy to become an added stressor in your life.

Our administrative team, affectionately known as the Wizards, is always happy to:

• Help you understand your benefits

• Walk you through calling your insurance company

• Explain exactly which questions to ask

• Advocate with insurers when issues arise

• Lean in with kindness first. Always.

  
  

STEP 3: Reaching out does not require the perfect message

One of the biggest barriers to starting therapy is the belief that you need the right words. You don’t. A simple message is enough:“I’ve been thinking about starting therapy and don't know where to start.” That is a complete and valid starting point.

We often hear:

• “I’ve been thinking about this for a while…”

• “I didn’t know if it was bad enough…”

• “I am open to therapy, but I don't know how…”

Please know this. When those messages land in our inbox, they are received with care and respect. It is a deep honor to be invited into someone’s life during a vulnerable season. Our response is curiosity, not judgment.

STEP 4: The first session is not a commitment

Starting therapy is not a contract to stay forever. It is a conversation.

The first session is for:

• Getting to know one another

• Assessing goodness of fit

• Talking about what brings you in

• Beginning to build a shared understanding

It is not for:

• Instant results

• Having everything make sense

• Jumping into interventions on day one

A first session has gone well when someone exhales and says, “I feel understood,” or “Maybe this could help.”

That’s enough.

WHAT HAPPENS DIFFERENT WHEN YOU REACH OUT TO ASPEN GROVE WELLNESS

When you contact our practice, you are connected with Ky, our Patient Care Coordinator. Ky is your point person from first outreach through your first session.

He takes time to understand what you’re looking for and makes individualized therapist recommendations based on both your needs and a deep understanding of our clinical team. He helps with paperwork, insurance coordination, scheduling, and follow-up, acting as executive functioning support so you don’t have to carry it all yourself.

We are a comprehensive team. While our therapists will be the ones you are meeting with face-to-face each week, every person at Aspen Grove Wellness participates in that work together, interdependently, and in service of something greater.

If a first match doesn’t feel right, we support thoughtful conversations, repair when possible, and transitions when needed. Everyone is on the same side.

At Aspen Grove Wellness, starting therapy is meant to feel human, relational, and steady. A place where you are welcomed with care, not rushed through a process.

IF YOU'RE CONSIDERING REACHING OUT

If something in you is curious, unsure, or quietly hopeful, that matters. You don’t have to have it all figured out. You don’t have to be ready. You don’t have to do this alone.

If you’d like to talk it through with a real human who understands and cares, you’re welcome to reach out and connect with Ky by calling 804-404-2181 or emailing us at info@youraspengrove.com.

Asking a question is a perfectly good place to begin. Curiosity is enough to start.