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Using Insurance‚Äč

Positives and Negatives to Using Insurance:

If you plan to use health insurance please be aware of the following information:

In Network:

  • Means that the insurance company has contracted with your therapist to provide services at a discounted rate and that you will only be charged a co-pay for services.
  • You may have a deductible that you have to pay in full before your insurance starts to pay.
  • Insurance companies have the right to audit charts so there is less confidentiality and privacy.

Out of Network:

  • The insurance company may cover % of the cost of services if the therapist provides a statement called a "superbill" that the client can submit to the insurance company for reimbursement. It is your responsibility to confirm if your insurance company will reimburse you and what the % will be.

Positives of Using Your Insurance:

  • Less out of pocket cost thus psychotherapy is more accessible.

Negatives of Using Health Insurance:

  • Decreased privacy and confidentiality that require a mental health diagnosis to justify that the treatment is medically necessary.
  • Increased paperwork, thus a paper trail is created which can be accessed during legal proceedings or by long term insurance companies.
  • You may have a limited amount of sessions and/or will need further authorization to warrant that the sessions are "medically necessary."

Using insurance when seeking couples therapy:

Using insurance for couples therapy is tricky. Your insurance company will require that I designate one person as the "patient" who will receive a mental health diagnosis. This conflicts with my clinical perspective as well as the ethical/legal standards established for marriage and family therapists indicating that the "couple" is the client. The word "patient" implies that ones is "sick" which conflicts with my perspective as I do not believe that you are " sick." If you choose to use your insurance I will open a chart for each person and each person will be required to obtain a diagnosis that is "medically necessary" to warrant the services.