Insurance
...and Why You May Not Want to Use It
Most insurance plans have a mental health component. Contact the Behavioral Health Administrator of your insurance plan to determine whether you have a choice of therapists or whether you are restricted to a specific panel. If you are planning to pay for your therapy through your insurance I can provide you with a "Superbill" which conforms to insurance industry standards for reimbursement. I find, however, that when possible, people prefer to avoid using their insurance plan for mental health issues. Let's take a look at several of the reasons why:
- Medical Necessity. In order for insurance to pay for psychotherapy, it must be deemed "medically necessary." This means normal struggles with life's difficulties do not qualify as medically necessary, and issues like relationship counseling, problems with work, family problems, general unhappiness, and stress and anxiety, are usually not covered under standard insurance policies.
- Over Pathologizing. When you use insurance to pay for psychotherapy we are required to diagnose you with a "medically necessary" mental condition that becomes part of your medical records. The threat lies in the fact that down the road this diagnosis may have a negative impact on your eligibility to obtain life, disability, or medical insurance; in some cases for employment or child custody; and could become a weapon used against you in a lawsuit.
- Insufficient Services. When you use insurance to pay for psychotherapy your insurance company has total authority to withhold approval of additional sessions and under the "medical" model mentioned above, your progress in therapy is expected to conform to industry treatment standards for your mental condition. What this often means is that, although your insurance plan may allow for 20 visits per year, your insurance company may restrict you to less than 10 visits because your mental condition is not considered significant enough to require ongoing treatment. On the other hand, if you are diagnosed with a more pervasive condition, while it may qualify for 20 or more sessions, this is the type of diagnosis that runs the risk of having a negative impact on you down the road.
- Potential Threats to Your Confidentiality. When you use insurance to pay for psychotherapy we must reveal to your insurance company certain information about you in order to be reimbursed. We have no control over that information after it is turned over to your insurance company and two potential threats to your confidentiality now exist: 1) a lot more people now have access to your most personal information, and 2) your personal information is stored in super computers that house vast amounts of information and are vulnerable to viruses, break-ins and unauthorized access.