Your Therapist in Sugar Land gives 7 Reasons about Why Using Insurance For Therapy Isn’t A Good idea

Realizing you need therapy is a huge step, and starting it will likely be a huge milestone in your life. After all, what is more important than your mental health and becoming the best version of yourself?

42% of Americans have been to therapy at some point in their life and we know it works. But what is confusing sometimes is how to pay for it. Using insurance seems like the logical ideal, but it’s not always the best. 

Your Therapist in Sugar Land gives 7 reasons to avoid paying for therapy with insurance…

1.) Insurance requires a diagnosis. When a person uses their insurance for their mental health treatment the clinician has to provide a medical diagnosis to the insurance company, who then only approves sessions that they deem medically necessary. This can be problematic because many people who come for treatment are dealing with everyday problems that don’t relate to a specific diagnosis. For example, if you’re working through past trauma, you might want to work on better communication between you and your partner, or you might want to attend therapy just to work on self-improvement. Unfortunately, these are not “medical conditions” as defined by the insurance companies, so they’re not covered by insurance. 

Many patients wonder why I can’t tell the insurance company that they      have a diagnosis, but if I did that, it would be unethical to label you with a diagnosis you don’t have, putting my license at risk.

2.) It becomes part of your permanent record. If you visit a therapist and receive a diagnosis for the insurance company, it then becomes part of your permanent medical record. All of that information can be accessed by other insurance companies and it can be considered a preexisting condition down the road.

Also, when you are in therapy you’ll probably talk about private things, subjects and fears that you’ll want to keep between you and your therapist. But when you use your insurance, the therapist turns in your documented treatment, which is then required to be recorded on your permanent medical record by the insurance company. Any details and private information that your therapist has, your insurance company then has. Anyone working at your insurance company could have unlimited access to your therapy files.

3.) Insurance can determine your treatment. If the insurance company approves your treatment, they can also approve it for only a specific amount of time or number of sessions. You and your therapist won’t have a say in how often or how long you see each other for coverage. They might also have the right to review your treatment notes/records and monitor your progress to determine when treatment ends, regardless of what your therapist recommends.

Let’s say you come in with a treatable diagnosis such as anxiety or depression. Oftentimes there is a limited numbered number of sessions for each specific diagnosis. This may not fit your needs and may leave you unable to complete treatment if your allotted sessions run out. 

You may have to take a break from therapy as your therapist appeals for more sessions and waits for approval. When a therapist requests more sessions, they have to justify why more sessions are needed which requires them sending in the notes from their session to a nurse case manager who does not know you, to decide, based on what she reads, if you actually need more sessions or if you are good enough from the notes the therapist provides. 

4.) Delayed treatment. Finding a therapist who takes your insurance and has availability can take time. Insurance can delay your treatment. Also, you may not always get approval to get help from a therapist that specializes in what you need help with. For example, you may only have an option to use someone who treats depression, when you desperately need help healing from bipolar or trauma. That therapist may be able to help you but not to the level that someone who specializes in bipolar and trauma would be able to tend to your needs.

5.) Questionable quality. Are there fantastic therapists who take insurance? Absolutely. However sometimes highly skilled therapists accept insurance clients only as a way to give back to the community. Here’s why… In most major cities the going rate for a therapist session is $150-300. But most insurance companies will only pay $40-90 per session. That is a fraction of what therapists make with private pay clients and it requires a lot more paperwork and time spent on submitting claims. However, insurance companies do provide a steady flow of referrals, so some therapists are willing to take that major cut. These kinds of therapists could include someone new in town, someone just starting a practice without a lot of experience, therapists that don’t have good reviews, or therapists in low-income areas. This is not always the case, but something to consider.

6.) Sporadic sessions most likely aren’t covered. Some people need therapy to cope with triggers or specific events that don’t affect their daily life. For example, someone might struggle with anxiety or depression every time a certain event occurs, but day-to-day they feel great. It’s unlikely insurance will cover these sporadic sessions that you might need throughout your life.

7.) Insurance companies can back out. Insurance companies can withdraw approval with short notice or even before your sessions end. If your insurance company backs out you could owe your therapist hundreds of dollars.

I love my clients. And I want each one to get the help that they need, in the way that they need it. 

By not accepting insurance I do not have to label my clients, I can help them establish the treatment plan that best fits them, on the timeline that works for them too. 

I am able to keep their reported information within my own company and I am able to specialize in the area of care I provide for my clients (for me that is trauma, PTSD, and anxiety). I will always do what’s best for my clients and that is why I do not take insurance.

If you’ve done therapy in the past, or are considering starting therapy this year, let’s talk! 

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