Health Insurance for Therapy? You decide... Pro and Cons

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Orlando Counseling Providing Anxiety, Trauma and Relationship Therapy

Life is getting difficult and you've tried many things to help you feel better, but nothing really seems to be working.  You're at the point where you're thinking about calling a counselor. But first, you want to know if you should use your health insurance for therapy.

First, let me qualify. As an anxiety and trauma therapist providing counseling in Orlando, I help adults who are struggling with anxiety, trauma, or relationship problems. I do not accept insurance for various reasons, but I do have many clients ask me about health insurance during our first phone conversation. So I decided to write a blog post as a resource for folks trying to decide if they should use their health insurance for counseling.

In this article, I will talk about the pro and cons of using your health insurance for counseling. In my next article, I will talk about the ins and outs (in-network and out-of-network) when it comes to using your health insurance for counseling. 

Cons for using health insurance for counseling

Diagnosis

If you use your health insurance for your therapy, the counselor is required to give you a mental health diagnosis. Without a diagnosis, the client does not meet medical necessity for receiving treatment. This is problematic for individuals that are going through a tough time and just need some support from a professional. If you want to use insurance, the counselor is required to give you a mental health diagnosis.

This is also a problem for couples that want therapy. The counselor will have to identify one of the adults as the primary client, give that person a mental health diagnosis, and frame the couples therapy as supportive to the primary client's diagnosis and treatment.

All of this leads me to the next point to consider, which is confidentiality. Not only will someone be required to get a mental health diagnosis, that diagnosis becomes part of the client's permanent medical record.

Confidentiality

When you use your insurance for counseling, your mental health care is not private. Your therapy records then become accessible by your insurance company. Your insurance company has permission to review your medical records, which includes your diagnosis and your treatment. 

When you are applying for insurance and are asked questions about your mental health, you will be required to disclose that you received treatment for a mental health diagnosis, because that diagnosis is part of your permanent medical record.

Number of Sessions 

Some health insurance companies have limits on the number of sessions they will cover for mental health care.  I've seen the number limited to only four sessions. If you are seeking treatment to help overcome childhood trauma, you will certainly need to meet with your therapist more than four times.

Even if the insurance company doesn't have a predetermined limit to the number of sessions, after reviewing your records, they can decide "you're doing better" and determine that therapy is over because your clinical notes indicate you're improving.

Now, moving on to the benefit...

Pro (yes, this is intentionally singular) of using your health insurance for counseling

Out of Pocket Cost

The obvious benefit to using your insurance is that it can keep out-of-pocket costs down. If your counselor is a preferred provider for your insurance company, your out-of-pocket cost can range from $0-$60 per visit, depending on your plan. That is a huge savings considering counseling in Orlando can range from $100-$150 per session.

Using (or not using) your health insurance for mental health care boils down to what is important to you. If keeping costs down is your primary objective, then using your health insurance is a great way to do that. If having more control over your mental health care and confidentiality are important to you, then paying out of pocket for therapy may be of greater benefit to you.

In my next article, I dive into the ins and outs (in-network benefits and out-of-network) of using your health insurance for mental health care.

This article is not an exhaustive list. Please provide more insights into pros and cons of using health insurance for counseling in the comments below.

Other articles that might be of interest to you:

Ins and Outs (in-network and out-of-network) of Health Insurance for Therapy
10 Questions to Ask your Orlando Therapist before the First Appointment
Free and Reduced Fee Counseling in Orlando
How to Find a Therapist in Orlando

 


Lauran is an anxiety and trauma therapist providing counseling in Orlando, FL. She also specializes in helping people heal old broken relationship patterns that keep them from finding, creating, and keeping healthy relationships with partners, friends, and family. Lauran uses a down to earth approach infused with cutting-edge therapies that go beyond traditional talking to help clients feel calm in their body and mind and find peace within themselves.