Counseling Across State Lines & Insurance Coverage

If you are looking into online counseling, one rule sits underneath everything else: Counseling takes place in the state where you are physically located at the time of your appointment.

Not where you live. Not where I am. Where you are sitting when we meet.

That single rule shapes which counselors you can see, and it shapes whether your insurance will pay.

Where I Am Licensed

I am fully licensed in Ohio, Georgia, Indiana, and Florida. Ohio is my home state and where I see clients in person.

I can work with you when you are physically located in any of those four states, whether you live there or are there temporarily.

If you travel somewhere I am not licensed, I am not able to hold a session while you are there. This comes up more often than people expect, with vacations, work travel, and visits to family. If you know a trip is coming, let me know and we can schedule around it.

The Counseling Compact

There have been significant changes in recent years regarding counselors' ability to work across state lines.

The Counseling Compact was developed to make it easier for counselors to provide services in participating states without obtaining a completely separate license in every state. A small but growing number of states are currently live in the Compact, which means eligible counselors can apply for the privilege to practice with clients located in those states.

Most states have joined the Compact on paper, but far fewer have finished the work of actually issuing privileges. That gap is where most of the confusion comes from.

I participate in the Counseling Compact for Georgia and Indiana, in addition to holding full licenses in both states.

This is a positive change that may, with continued advocacy and development, help make counseling more accessible across the country.

What About Insurance Coverage?

The guidelines become more complicated when insurance is involved.

Insurance companies generally require your counselor to be fully licensed in the state where you are physically located in order for services to be eligible for coverage. A Compact privilege alone may not be enough, even though it allows the counseling itself to take place legally.

There is a second issue people often do not expect. Being licensed in a state is not the same as being in-network with plans in that state. Insurance networks are contracts negotiated state by state, and the same company operating in two states can function as two separate entities with separate provider agreements.

That is why a familiar name on your insurance card does not always mean I am in-network with your plan.

My insurance contracts are Ohio-based. If you are located in Georgia, Indiana, or Florida, counseling with me is generally private pay. That does not mean you have no options. I am glad to check your out-of-network benefits before you commit to anything, and I can submit out-of-network claims on your behalf.

Because plans and requirements vary so much, verifying your individual benefits ahead of time is worth the time it takes.

A Note About Medicaid

I participate in Medicaid only in Ohio.

Whether a session is covered while you are located outside Ohio depends on your specific Medicaid plan and on my being licensed in the state where you are. Ohio Medicaid runs through several different managed care plans, and they do not all handle this the same way.

If you have Medicaid and a trip is coming up, tell me before we schedule and I will verify coverage with your plan first. That way you are not finding out afterward.

Understanding Your Options

Is it complicated? Yes.

Licensure, the Counseling Compact, insurance coverage, and the state where you are physically located all affect your options for care. Most people have no reason to know how these pieces fit together until they need to.

The more information you have, the better equipped you are to understand your options and make decisions that are right for you.

If you have questions about your particular situation, please call and we can talk it through before you commit to anything.

All Heart Counseling 216-606-8533

In-person counseling in Beachwood, Ohio

Online counseling in Ohio, Georgia, Indiana, and Florida