All therapists and psychologists start off excited to “treat the world” and, yes… accept insurance. Why?
Because of two reasons:
However, I have had many mentors in my 25+ years as a therapist in three different states tell me that they had never accepted insurance. I did not understand it. Back in 1987, as a new therapist, I thought ‘Maybe they don’t want to but I want to help anyone and everyone who wants help’. That was my way of justifying the use of it.
Eventually their wise advice came true when I had a meeting with a few well known insurance companies and found out some information! These are things your insurance company will not readily tell you yet most people are clueless about this. That is why I am writing this – it is your right as a therapy client to know and this information is still true today!
(1) Insurance companies will not typically cover and / or reimburse you unless you are diagnosed or labels with a “disorder”.
Maybe, if luck is on your side, your insurance company will allow something a bit vague such as “Adjustment Disorder” because it is usually a temporary phase and does not have a violent or threatening, intimidating connotation to it. Unfortunately, your insurance company has probably already caught wind of that industry trick by we therapists by now who are requiring a more specific (severe) diagnosis if you want them to pay you or for you.
(2) Whether you get diagnosed (labeled) with “Adjustment Disorder”, “Panic Attacks”, “Depression”, or anything else… it will go into your permanent record. You may think “so what” but… if you would ever like to purchase insurance for yourself, and seek other services, you can be rejected!
My husband, Mark, has been a life insurance agent for over two decades and sees this frequently – people who were treated and “labeled” with what would fall under a mental disorder or mental illness 10 years prior with no need since – be turned down for the coverage they want or completely turned down.
In fact, one recent client had sought coverage from his employer assistance program (EAP) because her child, age 14, had committed suicide. She was clearly and understandably troubled with grief and yet the insurance company labeled her with “Generalized Anxiety Disorder”. Because that was not one of the “covered services” (not a drastic or severe enough labels), they would not cover it, she was slapped with the rejected EAP bill of over $15,000 and a collection agency from hell who was making her life miserable and, at one point, told her to pawn her wedding ring to make a payment to them! Yet still, the label / diagnosis was placed in her permanent record and listed in the Medical Information Bureau which then turned her down for life insurance. In case you are unaware, everyone who has gone to any doctor has a file in the Medical Information Bureau.
(3) Nearly all therapists have a paper trail – notes about your progress. If the insurance company is going to pay for it – they have a right to look in your file 24/7/365 and by any representative of that company – and yes, even the secretary can have access!
They may claim this is “quality control” but they will have access to any of your “ghosts of the past”,, “dirty laundry”, and other information that the therapist was trying to protect from their “labeling” requirements. The person reviewing the file also has a right to STOP your treatment if they so choose even if the therapist disagrees in the sole interest of your well-being!
(4) Good and experienced therapists rarely take insurance.
Okay, I am not saying that there are NO good therapists or psychologists out there who do take insurance – there are! However, when comparing supply & demand, only those who are busy (which equates to successful in this case) will not accept insurance. Why? Because with all the headache of paperwork, submitting billings, arguing with insurance companies on your behalf, filling out more paperwork, resubmitting billings, etc…. for an average of 7 hours per month behind the scenes per client, this results in your therapist making minimum wage. Typically only those who need the clients will sign up for all of that hassle especially knowing that it is usually not in your best interest!
Therapists who are not full of clients will be happy to jump through the red tape just to make some money and get their name out there. However, once they are busy, almost always they will stop accepting insurance. How do I know? Because when I started out, that was me! I needed the clients and was going to accept insurance and was willing to stay up all day / night for a week to get all of their requirements completed pre-clients.
Where does this leave you?
No matter what you decide, it is important to know the above so you can make an informed decision when it comes to your short-term and long-term mental health goals and how it can affect you when you want to purchase items or receive services that are not directly mental health related.
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