My Most Commonly Asked Question: "Do You Accept Insurance?"

A question I get a TON, is β€œdo you accept insurance?”

 I don’t.

You might be thinking β€œWell that sucks, because I pay for insurance so I want to use it.” I totally get that.

But I also think it’s important that you understand what happens when you use your insurance to cover therapy & relatedly, why I’ve chosen not to accept it directly:  

1.     The insurance company requires at least one diagnosis.

Not all of my clients qualify for a diagnosis or want a diagnosis to become part of their medical record. Unfortunately, insurance companies still engage in practices that promote stigma. When it comes time to renew your insurance or switch plans, your premiums could rise as a result of that diagnosis, potentially costing you more.

2.     Our work together is valuable.

Let me preface this by saying that some therapists that choose to accept insurance are excellent. However, most therapists start accepting insurance to build their practice quickly. The going rate for therapy is typically between $100-$250 per session. Most insurance companies pay therapists between $40-90 per session, and this is often not even paid on time. So why would a therapist take insurance if they are getting paid less and having to jump through hoops? Because they have to in order to maintain a steady flow of referrals. I know the value of my work, my training, and the results clients see when they come to see me. I don’t have issues with client retention, and most of my clients find my rates to be reasonable and on point with the current market.

3.     It compromises confidentiality.

When you are a provider who accepts insurance, insurance companies can request your notes at any time to deem whether treatment is β€œmedically necessary.” I find this really invasive to clients who are trusting me with sensitive and personal information.

4.     Treatment is out of your control.

When you utilize insurance for therapy, the insurance company typically approves only a certain number of sessions you are allowed. Obviously, the person assigning this number of sessions does not know you personally, or understand your individual needs. Therapy is not predictable and working under a time-limit can add stress to the therapeutic process.

5.     My clients are committed.

Clients who are willing to make the investment in therapy are often more committed, and as a result, achieve better results. When you take therapy seriously, you see the investment pay off in every area of your life. There is nothing worth more (literally and figuratively) than personal growth & happiness.

 While I choose not to directly accept insurance for the reasons listed above, some insurance companies actually offer decent out-of-network provider benefits. This means that you may be able to receive full or partial reimbursement for our work together, while still allowing for privacy and control. This really depends on your specific insurance plan, so I recommend calling directly to find out about your out-of-network provider benefits.  

If paying out of pocket is not an option for you financially, then I want to be clear that using insurance for therapy is better than no therapy at all.

I wish that therapy were more accessible financially and will be doing another post this week about what options there are if cost is a main barrier for you.

Mary Beth Somich, LPC

Private Practice Therapist, Coach, Podcast Host & Course Creator. 

https://yourjourneythrough.com
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When Cost Is A Main Barrier To Therapy.

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