There are 3 things you could lose when you use health insurance…

1. You could lose privacy
2. You could lose control
3. You could lose peace of mind

You could lose privacy

In the past, therapists only needed to provide a diagnostic code to insurance companies. They require a thorough description of your problems, history, family life, work life, and so on. Insurance companies almost always require a psychiatric diagnosis, which then becomes a permanent part of your medical history, accessible along with your non-psychological records, to any physician or hospital you authorize. This information can also be viewed by employees of both the insurance company, managed care company and sometimes by your employers. This all puts your privacy at risk.

You could lose control over your healthcare

Insurance and managed care companies can decide if they think your treatment is “medically necessary.” Even if you or I feel like you need help, they can deny paying for it. Company representatives who do not know either you or me, and who may be working in another state, often with the benefit of little psychological training, are empowered to make decisions about the type and amount of testing and therapy that is appropriate for you; insurance companies rarely cover an unlimited number of sessions, so that you may have to quit therapy or suddenly begin paying a much higher fee, if you wish to continue beyond their willingness to reimburse your costs.

You could lose peace of mind.

Using your insurance company to pay for therapy can cause your premiums to go up after making a claim(s). Life and disability insurance may be affected as well. In addition, future employers may receive background checks that include your history in therapy if you use insurance.

What costs should I expect if I use my insurance?

We have developed this list of specific questions to ask you insurance company so you can get an accurate answer to this question. Insurance companies often directly increase you out of pocket expense by:

1. Imposing an annual deductible you must pay before they begin to reimburse
2. Increasing the size of your co-payment for each visit.
3. Reducing the number of visits allowed per year, or hiding your costs by labeling them “co-insurance” (which means you pay, not them).

The indirect means of reducing benefits paid to you include: requiring “pre-authorization” for every 5 visits, requiring clinical information be supplied to them before they “authorize” continued therapy, making “customer service” difficult to find and time-consuming to use, and refusing to pay for service until you appeal.

What costs can I expect without health insurance?

If you are contemplating long-term, ongoing therapy, your costs might be as high as your monthly car payment for a while. If your therapy turns out to be brief, your out-of- pocket costs actually may be very small. If your in-network benefits are not much different from your out of network benefits, the actual difference between the two may be minimal. The insurance questions listed above should help you figure this out. I will be glad to help you find the best solutions for your personal situation.