The ONE thing you give up when you use insurance for mental health
Wait, wut?
Once again, the group gave me the responsibility to calculate how much we owed to split a check 5 ways. I couldn’t find a calculator on my phone so I downloaded a new calculator app.
But I stopped in my tracks when I was prompted to give this calculator app permission to view my phone book….wait wut?
The only thing that needs access to my phonebook is my phone app. That is the natural order of things.
And I’m sharing this random story to tell you: The only person that needs records of your mental health is you. Not the government, employers, or random auditors.
The biggest thing you lose when you use insurance is CONTROL
There are many reasons why I would advise not to use insurance but the one phrase that summarizes them all is: The Loss of Control
Let me break it down into 5 ways you lose control:
1. You may not get to choose if you can even participate in therapy.
Most HMOs and PPOs require “preauthorization” before you can even look for a therapist. This means you have to call the insurance company and justify why you are seeking therapeutic services if you want to be reimbursed.
By the way, the insurance representative may or may not be a mental health professional so your life rest on their judgement.
Also, the insurance company gets to choose if you continue to do therapy or if they will not renew after they approve several sessions.
2. You may not get to chose when you can start therapy
If your insurance company give you permission to pursue therapy you will be limited to the list of providers that they give you.
They will reduce your reimbursement if you choose someone who is not on the list.
Your insurance panel accepts a limited amount of therapist on their board and they work those therapist pretty hard. So, get ready for a long waiting list.
**Let me just say that those therapist are heros. They can end up working over 50 hours a week and only make $50,000 year. They have to also deal with billing different insurance companies with different requirements and forms. They are constantly having to dispute reimbursements and are subject to random audits. If you have a therapist that accepts insurance give them a hug, they deserve it.
3. You may not get to choose who you work with.
Choosing a therapist on the list is like rolling a dice. You might chose a great therapist that you connect with or you may have to just deal with them and hope you can get something out of therapy.
Remember the factor that predicts the best outcomes in therapy is therapeutic alliance. If you can feel a meaningful connection with your therapist you are in good shape, if not…run.
4. You may not get to choose how you do therapy.
In case you go with an agency, just know some agencies are funded by a grant or specific governmental contract to provide you therapy at a low cost.
For that reason, there are some restrictions on where therapy can happy and how it looks.
I’ve seen some agencies that are only allowed to do therapy in your home. Some agencies train all of their therapist to use only one specific modality.
5. You do not get to keep your information private.
Your private information can potentially pass through many hands besides your therapist. It can be reviewed by a supervisor, an auditor, an administrator, peer reviewers, etc. All of these people may read your treatment, diagnosis, notes and assessments.
In order to approve therapy insurance companies require clinicians to give a mental health diagnosis.
A mental health diagnosis may negatively impact you in the following ways:
- Denial of insurance when applying for disability or life insurance;
- Company (mis)control of information when claims are processed;
- Loss of confidentiality due to the increased number of persons handling claims;
- Loss of employment and/or repercussions of a diagnosis in situations where you may be required to reveal a mental health disorder diagnosis on your record. This includes but is not limited to: applying for a job, financial aid, and/or concealed weapons permits.
- A mental health diagnosis can be brought into a court case (ie: divorce court, family law, criminal, etc.).
Insurance isn’t all bad
Let me just say, you need insurance. You need insurance for medical needs. And there are some cases where using your insurance for mental health might be a good idea.
3 Reasons insurance is a good thing
1. If funds are limited and insurance is the only option, then go for it
Do not put money above your mental health. Find a way to be healthy! If it means insurance, DO IT. If it means skipping out on expensive coffee, DO IT. Even if it means, downgrading your phone provider to get an extra $80/month DO IT. Love yourself and make sure you are taking care of your mental wellbeing.
2. If you find your ideal therapist and they accept your insurance
If you found your ideal therapist and they accept your insurance, well, you beat the game. Collect your trophy and wait at the exit. It is a win, win when you can find a therapist you will love and they take your insurance. Although…for the sake of the therapist and for the sake of your control, you might still want to ask them if you can pay privately and protect your information.
3. Specialized programs and services for children
Depending on the needs of your children and where you live, some of the best mental health resources for your child is usually connected a program, grant or service offered by their school. Sometimes it works out to have your children assessed and treated through school systems. Yes, it may mean a loss of control but you have to weigh the pros and cons. Granted, as a parent, you are allowed to have your private practice therapist work with your school as well. Work with your school and therapist to figure out how to navigate that.
In this article, I discussed the one thing you give up when you use insurance for mental health. The one thing you loss is control. I reviewed 5 different ways you lose control when you use insurance for your mental health. I also review 3 reasons why insurance is not a bad thing.
