Using Insurance for Therapy (Part Two)
Updated: May 2, 2019
Psychotherapy is a delicate and personal relationship. With your therapist, you will be sharing private and intimate information. Given this, there can be some unique challenges in using insurance to help pay for therapy.
I wrote a previous blog about confidentiality and your insurance company: Using Insurance for Therapy, Part One. Here I will be talking about the potential challenges with your therapist interpersonally if you use insurance to help pay for therapy.
One challenge is that you will deal directly with your therapist about insurance. Using insurance introduces a sometimes complicated business arrangement to your relationship. Consequently, discussions around insurance may intrude into the therapy session.
In contrast, when you make an appointment to see a new dentist, you will speak to a receptionist, not the dentist. The receptionist will ask you detailed questions over the phone about your insurance. When you arrive for your first appointment, the receptionist will make a copy of your insurance card and give you several insurance forms to fill out. If there are problems with your insurance at your dental office, an admin person will contact you to discuss.
This scenario differs from seeing a psychotherapist because most therapists do their own billing. When you first call, the therapist will ask you about your payment situation. If you are using insurance, then there will be more details to discuss.
When you come for your first appointment with your new therapist, there will be forms and procedures to go over around using insurance. Your therapist will discuss the limits on your confidentiality when you use insurance.
Once your therapy gets going, most of the time there aren’t problems with insurance companies. But there can be. For example, insurance companies can deny claims. In that case, your therapist will need to talk about this with you and enlist your help with the insurance company. If the claim problems cannot be resolved, the therapist would need to pass the bill on to you.
There are other challenges. Insurance can stop paying for therapy if, for instance, they determine that services are no longer "medically necessary." This can feel jarring to a client if he/she doesn't want to stop or to pay out-of-pocket. Insurance companies can also case manage and/or audit records, which can also feel uncomfortable to a client.
As you can see, psychotherapy and insurance can make “strange bedfellows,” as the expression goes. A very unfortunate situation is if there are problems with insurance, which can cause hard feelings for the client and even trigger a premature ending.
So before using insurance for therapy, I invite you to check in with yourself. Can you tolerate dealing with financial matters with your therapist without taking it personally? Can you separate possible problems with insurance from the therapy relationship? If your insurance fails to pay a claim, are you willing to make the phone calls necessary to resolve the situation? Are you willing to pay the therapist out-of-pocket for unpaid claims, again without this damaging the therapy?
If you answer yes to these questions, then using insurance may be workable for you. But if you cannot say yes, then think twice. It doesn't make sense to save money by using insurance only to end up upset and hurt if insurance intrudes upon the process. In that case, consider seeing a therapist through private pay. Some therapists can offer you a sliding scale fee if the regular fee is cost-prohibitive.