Insurance & Therapy
What they don’t tell you. What you need to know if you are or are thinking about using your insurance for therapy.
When therapy can cost on average $100-200 per session, our first instinct is to use insurance, like we do with other appointments. However, here are some of the draw backs and things you need to know about using insurance for therapy. It could impact your identity and future, choices, privacy, and finances with unexpected costs.
using insurance - what you need to know
Identity & future impact
In order for insurance to pay for therapy services, they require the clinician to diagnose a disorder, otherwise they will not pay for therapy services. This could potentially impact you in the future such as an increase in life insurance costs and failure of admission into the military.
Choice
Using insurance for therapy services can limit your choices on aspects such as:
what therapist you use
how many sessions you have
what type of therapies you can recieve
Privacy
When you use your insurance, the insurance companies have access to your private information such as:
your therapy appointment notes
Diagnostic and other assessments
treatment plans
diagnoses
Unexpected costs
When using insurance, you usually don’t have to pay upfront, unless you have a copay (you pay $20-50 when you arrive at your appointment). Then, insurance dictates what they are going to cover, and sometimes, they do not cover the full cost of therapy, you don’t know about it, and you can get unexpected bills for hundreds of dollars. So if you do use your insurance, make sure to talk to them about your coverage.
In-Network VS Out-of-Network Providers
When you use insurance for therapy, you can either have a therapist who is an in-network or out-of network provider.
In-network providers - are paneled with insurance companies and are pre-approved to provide potentially discounted services. Meaning, if you contact your insurance company, they will give you a list of in-network providers, and it is likely you do not have to pay the full cost of the services. You do not pay for services at the time of the appointment unless your plan requires a copay, which can typically range from $30 to $50. You may get a bill later on, whether you do or do not have a copay, saying that you still owe money, because the insurance company does not have to cover the full cost.
Out-of-network providers (also called OON) - are not paneled with that insurance company, and you usually pay for services at the time of the appointment. Then, you can apply to get reimbursement (money back) from your insurance company. Companies like Mentaya can check your benefits instantly before you start therapy services, so you can know immediately what you’ll be expected to pay and how much money, if any, you get back. (I am not sponsored by Mentaya and get no benefit from mentioning them here. I just use their company for clients who want to use their OON benefits.)
Summary
All in all, there are pros and cons to using insurance. I’m not advising you to make a certain decision; I just want you to be aware of what it means to use insurance for therapy, as I did not know this information before becoming a therapist. Therapy is an investment and can be worthwhile once you find a good fit. When we think of wellness, sometimes we just think of the physical, but wellness requires attention to the mind and spirit, in which a therapist can provide support and expertise.
Until next time,