Should you use insurance? Risk v. Benefit

Sometimes, there are more risks than benefits to using insurance in counseling. You’re probably thinking, "Why shouldn't I use my insurance?" The answer isn't necessarily so black-and-white. It is best you understand the risks and benefits of using health insurance therapy before making a decision that may have negative consequences. The Benefits Your insurance can pay for a good portion of your therapy. Your insurance may pay for all of your therapy! You pay for your premiums and have the right to use your benefits whenever possible. The Risks Most insurance panels won't pay for relationship issues, such as communication skills, parenting skills or pre-marital counseling unless there are symptoms resulting from the relationship issues, such as anxiety or depression. They base claims on "medical necessity" and will only pay for therapy if you qualify for a mental disorder diagnosis, such as Major Depressive Disorder, Bipolar Disorder or an Anxiety Disorder, which must be disclosed to your insurance panel for reimbursement. The insurance company requires the focus to be on alleviating the symptoms associated with the diagnosis instead of the goals you are hoping to accomplish in therapy. The diagnosis then tends to be the focus of your therapy. Your level of privacy is compromised. If you are trying to apply for life/disability insurance/private health insurance, these companies require access to any prior health information, which can impact your premiums as well as whether or not you'll even qualify for the insurance. Your therapy may have to be discussed with an insurance case manager to justify why continued sessions are necessary. This means the insurance company decides whether they will continue to pay for your therapy. If the insurance company believes your treatment isn't meeting medical necessity, they can decide to stop paying for treatment, even if you believe your treatment isn't completed. Your insurance company may require you to have an assessment for medications or they can cease to authorize sessions. This may not be necessary for the issues you're working on. In a court proceeding, medical records could get subpoenaed, including your mental health records. What This Means to You If you want to keep your issues private and the paper trail to a minimum, you want to look at the risks and benefits of using your insurance to subsidize your therapy and decide if it is the right way to pay for your counseling. Therapy can seem like it will become very expensive. Generally, this isn't true. Many clients experience some improvement fairly quickly--within 8 to 20 sessions.