Most of us are used to using insurance to pay for medical coverage. So it is natural to wonder if insurance will cover counseling.
We as a group feel strongly about your privacy and the quality of our work together. Using your insurance coverage has risks for you and doesn’t usually allow us to do our beset work.
Here are some very important things to consider before using your insurance for counseling.
1. Most insurance panels do not cover couples counseling. For the most part, any coverage for counseling is an offshoot of your medical insurance. And most insurance companies do not consider couple’s issues ‘medical problems.’
2. Some insurances do cover family counseling. But, in order to qualify for insurance reimbursement, one person must be diagnosed with a mental disorder. In couples and family work, having one person with a diagnosis tends to upset the balance and look like oner person is ‘more at fault’ for the relationship problems. We know it is rarely that simple …and ‘labeling’ one partner with a mental disorder diagnosis isn’t helpful to improving the relationship.
3. Life insurance, health insurance, and long-term care insurance can become quite expensive if you’ve diagnosed with a mental disorder. You will be asked at various times, “Have you ever been diagnosed with a mental disorder?” If you have used your insurance to pay for therapy, there will be a indicator in your medical records that indeed you have had a mental disorder diagnosis – which may affect you (negatively) in ways you did not expect.
2. Your confidentiality and privacy. In order to apply for insurance reimbursement, your mental disorder diagnosis, treatment plan, session progress notes and reports) must be sent to the insurance company. And our group of therapists worry about how confidential that information really is. We have heard that many employees at the insurance company have access to those records. We believe that your records and progress ought to be private – and between you and your therapist.
3. Also, there have been times when having a mental disorder on record with insurance companies may be requested by current and future employers, lawyers in divorce or child custody cases, and applications for law enforcement employment. This means other people – beyond the insurance company – may have information about your diagnosis.
Quality of Work: Insurance companies have placed great restraints on the quality of work, a therapist can provide. Due to the extremely low reimbursement rate for services, we as an entire practice can not survive on what insurance companies reimburse.
Typically, a therapist in a private fee-for-service practice, providing the type of depth work as we do, has a full-time caseload at about 20-25 clients per week. An insurance based practice needs 40-45 clients per week to earn a similar rate. We would not be able to provide the level of clinical competency we currently do, if we had to maintain a caseload of 45 clients per week. Our therapists would get burned out, and be unable to hold the quality of presence and energy needed for depth work.
We were able to create this as an externship position with therapists in training, seeking our clinical direction as a part of their development.
When using insurance for Couples Therapy: In cases of couple therapy, very few plans actually offer couples therapy, which means the treatment needs to be billed under one partners plan, and he/she must be able to be diagnosed with a Mental Health Disorder.
Additionally, when couples come to therapy for systemic relational issues, having one partner carry a diagnosis can make the treatment feel unbalanced. This is something to keep in mind if you feel it may be difficult for you both. Especially if any issues arise around custody or divorce.
If you wish to use in-network coverage – check with your provider to see if they cover couples therapy. If they do, then the above issues don’t apply.
Direction of the Clinical Work: Insurance companies are trying harder than ever to limit the frequency and amount of sessions allowed. For lasting, permanent healing, long-term work is often needed. Insurance companies come form a place of medical diagnosis and focus on acute symptoms. Relational dynamics and hurtful attachment patterns, often caused from years of suffering, are not healed in 12-26 sessions. Therefor, the clinical work has more substance, and lasts longer than the band-aid approach that companies want to reimburse for.
When you speak with your insurance company, find out if they have limitations on the amount of sessions you can have each year. In certain cases, you may have to advocate for the treatment you may need.
Out-of-Network Reimbursement: We do understand however, that paying out of pocket for mental health services is not always a possibility and that the choice is ultimately up to the client. For this reason we will write receipts for reimbursement for client’s with out of network benefits. Please contact your insurance company to determine what reimbursement they will provide.
Reduced Fee Services: We have structured our practice to provide low fee/ affordable services for clients who choose to work with a junior therapist, in our training program.
We hope you will consider using our services. We are a great community of therapists and we only want the best for our clients.