Should I use insurance or pay privately for my counseling?

Many people have insurance that includes mental health as a benefit.  When you decide you would like to see a licensed therapist you will want to consider the benefits of utilizing your insurance versus paying privately for therapy.

When you utilize your insurance it may cost less money as there is usually a smaller co-pay.   But there is important information that is not clear about the potential negatives.  When a person uses insurance they are giving up certain rights to their confidentiality.  The insurance companies have a right to ask for your diagnoses, your therapist’s notes describing the sessions, and they can also have conversations with your therapist for the purpose of continuing to authorize your services.

Another negative is that based on your diagnosis, you can, in the future, be denied certain insurance benefits because you, for example, have been diagnosed with depression, and then the insurance company may consider it a pre-existing condition.  A pre-existing condition could also be problematic in the future when applying for other insurances, short term disability, or reapplying for the same insurance.

The other potential negative is that the therapy can be time-limited, and your insurance company gets to determine what type of therapeutic approach that your therapist can use in the session.  The type of therapy you prefer may not be covered by your insurance company at all, for example couples therapy or family therapy. You may have a set number of visits per year, and when that number of  sessions has been met you may have to stop therapy or switch to paying out of pocket entirely for the benefit year.

The benefits of private pay are that information shared by you in therapy is confidential, except in very rare circumstances where mandatory reporting is essential*.  This information will not be shared with your insurance company.  There will be no worry that a diagnosis may come back to haunt you in the future. You can determine how long your therapy lasts and what type of therapy you would like to receive.  It is also great when you can call your therapist down the road to resume work together without jumping through lots of paperwork and red tape.  Many people I have spoken to cannot find a therapist who has time to meet with them who is in their network or do not have open appointments for at least 30 days. Also, local mental health centers or insurance providers may have a clinician that is approved for your insurance, but their caseload is so high that it makes it challenging to provide the quality of care you deserve and expect.

When choosing a therapist keep all of this information in mind before you move forward and make the decision to bill therapy through insurance or choose to pay privately.  Give us a call and we will talk more about this if you have any questions.

*Feel free to ask your therapist about mandatory reporting circumstances if you have any questions.