Free & low-cost therapy

• “Do you offer a sliding scale or reduced fee?”
• “What would a session cost for someone on my income?”
• “Do you keep any lower-cost spots?”
• “Could we meet every other week to make it affordable?”

Health centers set sliding fees based on what you can afford, so they may ask about your income, and sometimes for proof such as a pay slip. Private therapists may simply ask what you can pay.

If you’re not using insurance and you book at least 3 business days ahead, providers generally must give you a good faith estimate of expected charges. You can ask for one before you book.

Counselors are expected to explain fees and billing, including what happens if you can’t pay.

Health centers serve communities regardless of ability to pay. In fiscal year 2024, nearly 1,400 health center organizations ran more than 15,500 sites and served over 31 million patients on a sliding fee scale.

They offer care to people of all ages, with or without insurance. Many also offer behavioral health care. You can search for one on HRSA’s website.

Certified Community Behavioral Health Clinics (CCBHCs) are required to serve anyone who asks for mental health or substance use care, regardless of ability to pay, where they live, or age. This includes care designed for children and youth.

If you have no insurance or limited coverage, the SAMHSA National Helpline (1-800-662-4357) can refer you to your state office for state-funded treatment, and to places with sliding fees or that accept Medicaid or Medicare.

As of October 2026, Open Path lists a one-time $65 membership, then sessions of $40 to $70 for individuals, $40 to $80 for couples and families, and $30 with student interns where available. It compares these with typical market rates of $80 to $200.

There are no ongoing membership fees. Session fees are paid to your therapist.

• Is it a registered nonprofit, and is the fee clear?
• Are the therapists licensed in your state?
• Can you see profiles and choose who you see?
• Is there anyone near you, or offering video, with openings?

Check any therapist’s license on your state licensing board’s website. See “Finding a therapist who fits”.

Medicaid is the single largest payer for mental health services in the U.S. Mental health parity rules apply to Medicaid managed care, alternative benefit plans and CHIP.

If your income has dropped, it’s worth checking whether you now qualify. Your state Medicaid office can tell you.

Medicare Part B covers individual and group psychotherapy and family counseling when it helps your treatment. After the Part B deductible, you usually pay 20% of the Medicare-approved amount.

You pay nothing for a yearly depression screening in primary care if your provider accepts assignment.

An EAP offers free and confidential assessments, short-term counseling, referrals and follow-up for personal or work problems.

How to use it

• Ask HR or check your benefits site for the number
• Ask how many free sessions you get
• Ask for a referral for longer-term help if you need it

Insurance words, what plans must cover, and how to appeal a denial are explained in “Paying for care & your rights”.

211 is a free, confidential service that connects people to local resources, including mental health, substance use, housing, food and paying bills. You can call 211 or search at 211.org.

Colleges and universities often offer mental health services through a campus counseling center. School counselors, psychologists and social workers can help younger students and connect families with outside care.

Veterans, service members and their families may be able to get free counseling. See “Veterans: getting care & support” for VA care and Vet Centers.

Some faith communities and local nonprofits offer counseling or support groups at little or no cost. See “When faith and therapy meet” for how faith and professional care can work together.

Call or text 988, or chat at 988lifeline.org. It’s free, confidential and open 24/7. For Spanish, call 988 and press 2. Veterans can call 988 and press 1, or text 838255.

Text HOME to 741741 to reach a trained crisis counselor, free and 24/7, in the U.S.

Call 1-800-662-4357 (TTY 1-800-487-4889), free and 24/7, in English and Spanish. They can point you to state-funded programs and sliding-fee services. It’s a referral line, not counseling.

Find A Helpline (findahelpline.com) lists free, confidential helplines in over 175 countries. In the UK, NHS talking therapies for anxiety and depression are free, and you can refer yourself if you’re registered with a GP.