Why are many people choosing to use out-of-network therapists?
Updated: Sep 23, 2020
According to Beverly Pedroche (AboutTherapy.BlogSpot.com as cited on iTherapy.com), there are several reasons NOT to Use Your Insurance for Psychotherapy...
So, you’re interested in getting some therapy and you have insurance. Perhaps you’ve even selected a therapist. What else is there to think about other than scheduling, right? Well, keep reading…
A Psychologists’ Perspective
I believe that the duration of treatment (number of sessions), what is addressed in treatment, and the type of treatment provided should not be dictated by your insurance company/people who have never met you and may not even be medical professionals. These decisions should be made jointly by you and your therapist. Unfortunately, insurance can become a hindrance to obtaining effective, specialized mental health treatment.
A Clients’ Perspective
As the recipient of therapy, here are just some of the reasons to consider not using your insurance for therapy.
Control of treatment.
You may choose the professional who you believe is the most competent to treat you. If you use your insurance, you are often restricted to seeing providers on the insurance company’s list, many of whom have long wait lists. Additionally, insurance will often dictate your number of sessions and even what specifically can be treated. By not utilizing your insurance, you and your therapist can make these decisions together, based upon your needs.
Avoid interruptions to treatment.
When visits are preauthorized by insurance companies, often only a few sessions are granted at a time. When these sessions have been used, your therapist must justify the need for continued treatment and this process can lead to an interruption in your treatment. There are times when additional sessions are not authorized, leading to unexpected out-of-pocket expenses for you or an end to the treatment, even if goals have not been met.
Your insurance company may request details about your treatment, and can even request the entire medical record. Your treatment becomes part of your permanent medical record. In summary, you lose control of your information, who accesses it, and how it will be used.
Not carrying a mental health diagnosis on your medical record.
Insurance companies typically require a mental health diagnosis in order to receive reimbursement. Psychiatric diagnosis can negatively impact you (i.e., denial of insurance when applying for disability or life insurance, higher deductibles and copays, etc.). Furthermore, you may wish to address non-psychiatric issues such as improving communication skills or coping with the stress of a new job. These non-diagnosable issues are not usually reimbursable.
Other Options to Paying Out-of-Pocket
If you can not afford the full out-of-pocket fee of a therapist, another possibility is to explore options for reduced-rate or sliding scale fee therapy. Many therapists have a select number of “slots” for individuals who need sliding scale fees or reduced rates. Don’t hesitate to ask. Another possible option is to utilize pre-tax dollars, such as your Flexible Spending or Health Savings Accounts to pay for therapy. Finally, most counties have a community mental health center and some universities offer more affordable psychotherapy that is provided by interns or post-doctoral students who are supervised.
If You Need Help, Get Help!
If utilizing your insurance benefit is the only way to receive therapy, by all means do so! I am certainly not proposing to never use insurance for treatment. I am simply encouraging you to consider all options and make an informed decision that is right for you given the information that I have shared with you today.