Thinking of Using Insurance for Mental Health Treatment? – Why That May Not Be a Good Idea

We often want to keep our mental health treatment private. This goal may be undermined if we’re using insurance to pay for it.

At first glance, it might seem like a great idea to use insurance to pay for therapy. However, upon closer examination, you may see that there are many potential drawbacks.

And yet, sometimes you’re inclined to make compromises. Should you?

If you’re thinking about using insurance to pay for mental health treatment, consider some reason why that’s not a good idea.

Insurance Causes Concerns Regarding Privacy and Confidentiality

alpine outhouse with heart shaped window

One of the first things that a therapist will tell you is that you have a right to confidentiality. Unfortunately, using insurance to pay for mental health treatment can make this difficult. How so?

Insurance companies retain a right to audit your records. You never really know who looks at those details. In fact, you don’t even know who processes your claims.

Moreover, the safeguards put in place to protect your privacy can be breached. The more people with hands in the pie, the more likely a breach. This isn’t an issue when you pay for your own services.

Insurance Makes Too Many of the Decisions

The insurance company retains a lot of control over a patient’s mental health treatment. This impacts decisions you often want to make for yourself, such as the following:

Losing the Right to Choose a Therapist

The therapeutic relationship is critical to good mental health treatment. You need to have a therapist whom you trust. However, insurance might limit the providers you are able to see.

This goes beyond the issue of having to see someone “in network.” As part of the contract of accepting insurance, a therapist can’t be a specialist. Therefore, you can’t choose someone who meets the unique needs you might have in the treatment of depression, trauma, and other specific conditions.

Limited Length of Treatment

Insurance will typically limit the number of sessions. Unfortunately, your mind doesn’t suddenly fix itself on a clock. But the insurance company does not consider that you need more time to heal.

Additionally, there are often long wait times for providers who accept insurance. This can delay the start of treatment. Obviously, you need to see someone soon after identifying that you need help. Yet, going through the insurance company adds another step, which naturally adds additional time before you are connected with care and start getting the help you need.

You Get What You Pay For

A large portion of experienced mental health providers opt out of accepting insurance. They have established practices and, therefore, they don’t have to deal with the problems of insurance companies.

In turn, that means, when using insurance, it’s more likely you’ll see a provider with less experience.

Insurance Might Not Even Pay for Your Mental Health Treatment

hillside cabin on picturesque seaside hill

Some of these issues may seem worth dealing with to save money on therapy. However, there are a surprising number of ways that insurance companies end up costing you.

These include:

  • Insurance requires a diagnosis. Treatment won’t be covered without one. However, you might need help despite not meeting full diagnostic criteria for a mental health disorder. For example, marital problems aren’t a diagnosis and therefore wouldn’t be covered by insurance. Also, personality and character issues are not covered by insurance.
  • Insurance requires “medical necessity.” Even if you have a diagnosis, you might not be able to prove the “necessity” of therapy. Then, you’ll have to pay for services.
  • Insurance may deny your claim. Even if you meet all of the requirements for treatment, you still have to submit a claim. Sometimes, insurance companies deny these.
  • Consider your co-pay. It can be very high. It might not be worth it for all that you lose out on.
  • Your diagnosis becomes a pre-existing health condition. This may preclude you from getting insurance down the line.

Clearly, there are a lot of things to weigh before making a decision if you should use insurance to pay for mental health treatment or not. If you would like to discus the options that you have beyond using insurance to pay for your mental health service, feel free to contact me for a free initial consult where I can address any questions you might have.

2018-09-05T22:36:32+00:00

Leave A Comment