What, you don't take insurance?!?!?!

When telling people about the counseling services I offer I am often asked if I accept health insurance as a means of payment for my services. The response I tend to get when I say “No” is a baffled look and the question, “WHAT, you don’t take insurance?” 

It is true, I do not take insurance. 

There are a number of reasons for which I do not directly accept and bill insurance. The main reason is because dealing with health insurance is a nightmare, both for the provider (me) and for the patient (you). 

Why?

 Because when a mental health provider directly bills your insurance for counseling or psychotherapy services, your insurance requires a lot of personal information about you to ensure that you have a “medical necessity” which requires the need for mental health and counseling services. 

“Medical necessity” means that you have a mental health diagnosis that is severe enough to be impacting your daily functioning, meaning your ability to get your day to day things done (eg. work, school, social interactions, activities of daily living such as bathing, eating, etc). This means that a therapist directly billing your insurance needs to make a strong justification for what your diagnosis is and how it impairs you from being a functional individual.

Most insurance companies also require treatment plans which itemize the issues we are working on in therapy and the goals we have set to help you resolve the issues you are working on in therapy. 

Lastly, some insurance carriers only authorize a certain number of visits and require reauthorization by asking the therapist to share more of your personal information with the health insurance provider each time you need more sessions. 

Sound complicated and intrusive enough yet?

It is. 

One main reason I don’t accept insurance is due to my desire to protect my clients’ privacy as much as possible. My second main reason is because my clients are not so sick that their day to day functioning is impaired in a significant way. Most of my clients are educated, high functioning, successful people who are simply having a hard time right now and just need a caring, neutral, third-party to meet with to discuss their thoughts and feelings, and with whom to uncover other underlying hidden strengths. 

And I’m not the only one who doesn’t accept insurance. The reality of the situation is that more and more therapists are moving away from directly accepting and billing insurances. However, as therapists we know that sometimes using insurance can really help the financial aspect of any type of treatment. Therefore, most therapists, myself included, offer a monthly Super Bill to their clients who request them for reimbursement purposes. 

A  Super Bill itemizes the services rendered, how much you paid for your services, and a diagnosis that is sufficient enough for the insurance carrier to pay you back a portion of the fees you paid for your services. Most often those of us who offer Super Bills to our clients refer to ourselves as “Out of Network” providers, meaning, we are outside of your insurance company’s preferred provider network, but that some of the fees for our services might be reimbursable to you directly through your insurance provider. This is typically only applicable to people who have PPO type insurance plans. Please note, it is ultimately your responsibility to understand your insurance benefits and to make sure what percentage of the therapist’s fees will be reimbursable. 

If you are considering counseling services, don’t let the cost of the services scare you away. Insurance is a great resource to have, and can be helpful, but in reality, investing in our overall wellbeing is a more cost effective way of managing our health. A part of that wellbeing includes investing in a really good counselor with whom you connect who can help you on your current journey though life. After all, it is more important to invest in your health early on rather than experiencing greater struggles later on in life. 

To summarize: 
If you are interested in counseling services, you could ask your insurance carrier to refer you to someone who is covered by your insurance plan, but remember, that counselor will have to share a lot of personal information about you to justify your need for counseling services. 

Keep in mind, sometimes paying more out of pocket for someone who you really connect with that is outside of your network can really make a big difference in how the therapeutic process works for you. 

So, find out what your benefits are, crunch the numbers, and then, go out and pick that really amazing therapist with whom you really connect and let your healing process begin.

If you are ready to make change, contact me today for your free initial phone consultation: 
408-502-6790.