Understand the Truth About Using Health Insurance for Counseling
As a counselor, it’s one of the most common questions I get asked: “Do you take health insurance?”
I did for many years. And often, it was the most difficult thing my large practice dealt with. Forms, diagnosis codes, more forms, rejections, more forms, treatment plans, more forms, appeals, phone calls to insurance companies, more forms. It was difficult, time-consuming, and frustrating.
But I continued to take insurance. Even while the amount they paid me kept going down and the amount of work required kept going up. I told myself I was doing it for my clients’ benefit.
Until I began to realize, this isn’t really a great benefit for my clients either.
My name is Dr. Lonnie Bryant, and I want to share some truths about health insurance you may not be aware of. Because while you can choose to use your insurance, you cannot undo the potential negative consequences.
Truth #1 About Health Insurance Benefits: Medical Necessity
Did you know that for health insurance to cover your counseling sessions, the treatment must be considered medically necessary? They won’t pay based on your desire to improve your life or marriage. Wanting help dealing with stress is not a medical necessity. And neither is premarital counseling.
To be medically necessary, the counseling must address at least one mental disorder. In other words, you must be assigned at least one mental health diagnosis.
Before submitting a bill to the insurance company, your counselor has to establish psychiatric symptoms and match them to a diagnosis. And that information goes on your medical records and in your treatment plan.
Sure, HIPPA offers some protection. However, once you receive a diagnosis and your insurance company gets involved, it is forever a part of your medical records.
Truth #2 About Health Insurance Benefits: Your Diagnosis
So, what does receiving a mental health diagnosis mean for you?
For some, it may not mean much. But for clients who have certain jobs, or who would like to get a certain job in the future, it can mean a lot.
After receiving a mental health diagnosis, you will forever have to check “yes” when asked if you have sought treatment for a psychiatric disorder. This question often pops up on job applications. Answering yes can negatively impact your ability to be considered “fit” enough for certain jobs.
You won’t want a mental health diagnosis if you have or would like to have a career in any of the following areas:
- Law enforcement
- Firefighters
- Military
- Government jobs
- A career involving background checks or security clearance
- Pilots
- Healthcare workers
- Transportation jobs, such as bus driver, truck driver, and taxi driver
And I’m sure there are a few others I am not aware of.
In addition, if you ever apply for life, health, or disability insurance, a mental health diagnosis can drastically raise your rates. Or even get you a rejection letter.
Truth #3: You Lose Your Confidentiality
For an insurance company to pay benefits, they require bills and paperwork. This includes you signing a release, which means you give them access to any and all of your records.
What does this mean for you? It means the insurance company can request your very confidential session notes and treatment plans. And your counselor must provide them.
Once an insurance company receives your information, you lose your privacy protection. Your confidential information is uploaded to a national medical information database, which centralizes information for over 700 insurance companies.
After it is uploaded, your information is available to any of your healthcare providers.
So, if you want your counseling sessions to remain confidential, you want to carefully consider utilizing insurance.
Truth #4: It May Not Be as Helpful as You Think
Benefits and coverage vary greatly. So, it is important to understand what insurance will cover and what it doesn’t. Often, the coverage is not as great as you think.
Things to consider include:
- Do you have to meet your deductible first? If so, how much is it?
- What is your co-pay or percentage per counseling session?
- Is there a limit on the number of sessions?
- Are you required to get approval from your primary care physician?
Often, if you have a high deductible you must meet and are limited on the number of sessions, you will get very little help from them.
Are you ready to start your journey to a better life?
In summary, to keep your counseling sessions 100 percent confidential and avoid potential negative consequences, I no longer accept insurance.
You can, however, use a health savings account, such as FSA and HSA, to pay for counseling.
Have questions? I invite you to call (682) 365-2099 today to schedule your COMPLIMENTARY 20-minute phone session.
During the consultation, we will both ask questions and get to know each other. If we agree we are a good fit, we can schedule your first session.
Today is a great day to get on the road to recovery!!
