Why You Should Avoid Using Your Health Insurance for Counseling

 

Why not use your medical insurance to pay for counseling? Isn't that what it's there for?

Perhaps.

However, health insurance for mental health care differs from other medical conditions. Sometimes your health insurance might not cover mental health concerns. You will have a mental health diagnosis on file if you use your health insurance for mental health - a mental health disorder/mental health sickness must be on the insurance claim for insurance to pay for treatment. This will be a permanent part of your medical record. To read the GoHealth Reviews, click here

Of course, you want to consider utilizing your health insurance for therapy, but there are some legitimate reasons why you might not want to.

Why isn't my counselor taking my insurance?

For very excellent reasons, many counselors refuse to accept health insurance. They want to devote their full attention to treating you. Getting health insurance requires a significant amount of additional labor and agreeing to work for a reduced rate.

The counselor might spend hours on the phone obtaining benefit information, obtaining authorizations, or following up on claims payments. The insurance company must pay the counselor after a month. The counselor is required to provide progress reports to the insurance company. In addition, the insurance company obligates the counselor to provide treatment records and other facts about your medical history.

It's not that counselors dislike insurance companies or don't want you to utilize your insurance (we have health insurance, too! ). Still, many counselors would rather spend their time and energy assisting clients than handling paperwork for insurance companies.

However, this isn't the only reason counselors may be out of network with your health insurance provider.

The other arguments are more compelling, and you should consider them BEFORE utilizing your health insurance.

Many counselors choose not to engage with health insurance companies to maintain their anonymity. Any information (claims, reports, or treatment plans) filed with health insurance departs from the security of their office and closed files. Your personal, private, and emotional information is outside of your counselor's office. In addition, any insurance company must deem you "ill" to reimburse or pay for counseling (both in and out of network).

You must have been diagnosed with a mental disease or condition. Insurance will not cover counseling sessions if you are not sick enough to establish a diagnosis. If you are diagnosed with a mental illness, your sickness will be recorded in your permanent medical record. Many counselors dislike the "medical model" of designating someone unwell. Thus, they refuse to accept insurance to focus on their client's strengths rather than labeling them as mentally ill.

Do you want to be labeled as mentally ill? First, find out your diagnosis if you already have a mental health diagnosis from previous counseling or psychiatric consultations. This may not be a worry if you already have a mental health diagnosis, but if not, you may not want this on your medical record.

Counselors also dislike disclosing information to others to maintain their confidentiality. Who knows how many individuals check and rubber stamp a claim as it moves through the system after filing it to the insurance company? If your insurance company pays for any counseling sessions (in or out of network), the insurance company can audit your records.

They can request copies of your counseling notes, evaluations, and other personal emotional information to see if you are genuinely "sick enough" to merit their payment. They can refuse treatment if they believe you are not sick enough or your counseling is not "medically necessary."

Furthermore, many therapy topics are not even covered by insurance at all. Typically, stress management and anger management are not included. Marriage counseling is not often covered. Specific medical/mental health issues may be prohibited. (such as attention deficit disorder or adjustment disorder). Even if your insurance covers your sickness or problem, they may limit the appointments they will cover (often as few as 20 per year) and establish a maximum amount they will pay each calendar year or in your lifetime.

Furthermore, counselors do not want someone from the insurance company dictating how to handle their clients. Insurance companies can choose what types of counseling are reimbursed, what diagnoses are permitted, and how many visits the client must make before they are healed. Therefore, many counselors prefer to deal directly with clients to meet their requirements rather than working via an insurance company.

Using your health insurance for counseling services may also impact your security clearance, life insurance rate, job, or future health insurance coverage.

For the reasons stated above, I propose you educate yourself on using health insurance for counseling. Then, of course, you may still file, but be an informed customer.

• Be an educated customer.
• Understand your mental health diagnosis.
• Discuss the diagnosis with your therapist.
• Inquire with your counselor about your therapy reports.
• Determine if you have or wish to have a psychiatric disease.

If you have clinical, severe depression, anxiety, or other disorders, you have most likely already been diagnosed.

However, if you are anxious, having marital issues, or trying to figure out your life purpose, your symptoms may be modest, and you may not want a mental health diagnosis on your records.

When you claim insurance from your health insurance company, your diagnosis becomes part of your permanent medical record, which can affect future life insurance, preexisting conditions, and the cost of private health insurance.