What you should know about using insurance for mental healthcare
PROS
of using insurance for mental healthcare
Financial Assistance:
One of the primary advantages of using insurance for mental health counseling services is the financial relief it offers. Mental health treatments can be expensive, and insurance can help to mitigate the financial burden, making therapy more accessible to a broader range of individuals.
Consistancy with Care:
When mental healthcare is affordable to an individual they are more likely to be consistent with treatment and maintain the frequency of appointments necessary to aid in their recovery.
Privacy Protection:
Insurance providers are bound by strict privacy regulations, such as the Health Insurance Portability and Accountability Act (HIPAA). This helps protect the confidentiality of individuals seeking mental health services, ensuring that their sensitive information is handled with utmost care.
CONS
of using insurance for mental healthcare
Limited Provider Options:
While insurance plans offer access to a network of providers, this can also mean limited options. Individuals may find themselves restricted to a smaller pool of therapists, potentially limiting the likelihood of finding the perfect match for their unique needs and preferences.
Diagnosis + Confidentiality Concerns:
Insurance companies require a diagnosis for service coverage. Diagnoses become part of an individual’s permanant medical record. Some diagnoses can impact employment (some government jobs, overseas positions, roles that interact with sensitive information, roles that engage in high intensity activities, etc.) . Some diagnoses can also impact other benefits you may wish to apply for or maintain, such as disability or life insurance.
Although insurance companies are obligated to protect client confidentiality, some individuals may still be concerned about the privacy implications. The process of filing claims and the potential for employers to access mental health records can raise concerns for those who value utmost discretion.
High Deductibles and Co-pays:
Many insurance plans come with high deductibles and co-pays for mental health services. This can result in significant out-of-pocket expenses before the individuals sees any financial benefit from using insurance benefits.
Treatment Limitations:
Insurance plans may impose limitations on the number of sessions covered or the types of treatments eligible for reimbursement. This can pose challenges for individuals requiring long-term therapy or alternative therapeutic approaches not covered by insurance.
Provider Implications:
Mental healthcare therapists are among the lowest paid healthcare workers by insurance companies. Insurance companies reimburse mental health providers at a reduce rate, depending on a number of factors, such as number of therapists in the region, type of credential, specialties and certifications, ZIP code, etc.
A Third Option:
Filing out-of-network:
If your preferred provider does not accept your insurance, a third option would be to file for out-of-network benefits with your insurance. Your preferred therapist can create a “Superbill” for you to submit to your insurance company each month. If your plan has out-of-network benefits, you will either receive a reimbursement from your insurance company or your payments for therapy will be applied to your deductible (helping you reach your deductible quickly, and thereby be able to use your insurance benefits).