Lyra

How Lyra coverage works

Lyra partners with employers to provide mental health support. Your specific benefits depend on your employer plan.

Common elements include:

• A set number of covered therapy sessions per year at no cost to you

• Continued care with a Lyra network provider after your covered sessions, often with copays or cost sharing

• Access to Lyra coaching, digital tools, and specialized programs depending on your plan

• Referrals into in network treatment centers or higher levels of care when needed

Some providers accept Lyra for all services, while others accept it only for therapy or coaching. Always ask the provider what your plan covers and what you will owe.

Why people choose to use Lyra benefits

• Simple access to vetted mental health providers without long wait times

• Sessions often start at no cost depending on your plan

• Access to specialized programs your employer may provide through Lyra

• Guidance from Lyra care navigators if you need a higher level of care

Tradeoffs to be aware of

Using Lyra may limit you to its network of providers and programs. If you prefer a provider who is not in Lyra’s network, you may need to pay out of pocket or use your main insurance plan’s out of network benefits. Some plans limit the total number of covered sessions per year.

Your rights when using Lyra

If you are responsible for any out of pocket costs, you still have legal protections. Under the No Surprises Act, you may request a Good Faith Estimate for services that are not fully covered. If your final bill is four hundred dollars or more above the estimate for any one provider or facility, you may start a patient provider dispute process within one hundred twenty days of the bill. (CMS)

What to ask providers before you start care

• Do you accept my Lyra plan for this service

• How many covered sessions do I have and what happens when I use them

• What will my out of pocket cost be after my covered sessions end

• Will I receive a written Good Faith Estimate if I owe any self pay amounts

• If I need a higher level of care, can Lyra refer me and what will be covered

If your coverage runs out or you prefer to pay privately

Some people choose to transition to private pay if:

• They prefer to stay with the same provider after sessions run out

• They want care that is not included in their Lyra plan

• They want more flexibility in scheduling or treatment style

If you choose self pay, ask for the cash rate, available discounts, payment plans, and an itemized receipt.

Typical costs and how to research them

Costs vary by provider and location. If you will be paying privately for any part of your care, you can use health care cost lookups to see typical local pricing or compare it to your Good Faith Estimate.

Recommended resources:

• FAIR Health Consumer cost lookup. (FAIR Health)

Discounts, payment plans, and financial assistance

Many mental health providers offer private pay discounts, sliding scale rates, or payment plans once Lyra benefits are used. For medication costs, visit patient assistance resources from national organizations. (NAMI)

A note on medical financing. Read terms carefully. Deferred interest offers can carry large charges if the balance is not paid in full by the promotional deadline. (Consumer Financial Protection Bureau)

Taxes, HSAs, and FSAs

Out of pocket mental health care is usually an eligible medical expense for tax purposes and can often be paid with HSA or FSA funds. Confirm with your plan and tax advisor. See IRS guidance for allowable expenses. (IRS)

Good Faith Estimate checklist

If you will owe anything out of pocket:

• Request the Good Faith Estimate in writing

• Keep a copy for your records

• If your final bill is four hundred dollars or more above the estimate for that provider, you may file a dispute within one hundred twenty days. (CMS)

If your Lyra plan includes referrals to out of network care

Some employer plans allow reimbursement for out of network services once Lyra sessions are used or if a needed service is not available in the Lyra network. If so, ask:

• Does my plan include out of network benefits

• What documentation do I need

• Will I need an itemized receipt or superbill

• How do I file a claim

How to verify and get started

• Log in to your Lyra account to view your specific benefits

• Contact the provider and confirm they accept your Lyra plan

• Ask how many covered sessions you have and what happens once they are used

• Request a Good Faith Estimate for any services that will require self pay

• Ask about payment plans or financial aid if needed

Find programs that accept Lyra

Use our directory filters to view facilities that list Lyra insurance. Always confirm your benefits directly with the provider and Lyra before starting care.

Helpful external resources

• Good Faith Estimate and patient provider dispute information, CMS. (CMS)

• Consumer guide to the Good Faith Estimate and four hundred dollar dispute threshold, CMS. (CMS)

• FAIR Health Consumer medical cost lookup. (FAIR Health)

• IRS Publication 502, medical and dental expenses. (IRS)

• NAMI tips on paying for care and medication assistance. (NAMI)

• CFPB alerts on medical credit cards and financing risks. (Consumer Financial Protection Bureau)