One of the first questions we hear in initial phone calls with potential clients is “Do you take xyz insurance?” It’s an unfortunate truth that your financial resources may ultimately limit the providers you can work with. If there are a lot of mental health professionals in your area, it may seem like a no-brainer to let your insurance narrow down your list of therapists to call. However, once you’ve found an in-network provider that you like, that may not be the end of your journey to find the right care for you.
Every therapist has a unique toolkit of modalities and treatment approaches at their disposal; we believe you will receive the best care when decisions about treatment are completely up to you and your therapist. Insurance companies put a lot of limitations on the kinds of care you can receive, even within your network, and sometimes the terms of paying for those services with insurance have other unwanted consequences.
In the course of helping our clients navigate the maze of insurance challenges and receive the care they need on their own terms, we’ve found that there are 3 major limitations you may face while seeking in-network mental health services. Keep reading to find out what they are and learn about some alternatives that might open up more options for you.
1.Insurance companies limit other priorities in your search for a therapist
Think about what qualities, credentials and capabilities are important to you in your search for a mental health care provider. It’s important to find someone who is not only highly trained in the areas you are looking for support in but also shares common values with you. You will ultimately achieve better outcomes with a therapist who connects with you as a person first and foremost before they consider you as a client; someone who aligns with your values. Without this trusting relationship in place, it will be difficult for you to open up and fully engage with your treatment.
It’s totally possible that you may end up with a therapist you love who is also in your network. But what’s important is that you avoid letting that one factor distract you from the criteria that matter most, both during your search and at the moment you make your final decision. The best approach is to define your priorities, cast your net wide and narrow your list to a few providers that you love. Go ahead and ask about insurance upfront, but don’t write off a therapist you like without exploring other payment options with them first. We’ll get into more about that at the end!
2.Insurance companies limit you to "inside-the-box" treatments
You are definitely not alone in any thoughts, feelings or behaviors that might be telling you it’s time to seek professional help. We as a society do not learn to take care of our mental health in the same way we learn about other wellness concerns, and in most cases, there are more people out there facing the same issues than you might think. However, what’s unique about all of our clients is the treatment modalities and approaches that work for them.
Just like any other healthcare specialty, certain approaches are well-researched and backed by the institution of traditional Western medicine. They are typically more focused on solving problems than preventing them, and these are the ones your insurance company is likely to cover. However, there are plenty of alternative modalities that we have seen great results with. Alternative practices tend to be better for preventative care, and they don’t receive the same attention from research institutions that pharmaceuticals and “inside-the-box” Western practices do. Most insurance companies will only approve treatments that are focused on “fixing” a diagnosable condition. We don’t believe you should have to wait until you are miserable to seek care. Again, these decisions are best made between you and your therapist, not your insurance provider.
3.Insurance companies limit your privacy
You are probably familiar with HIPAA (Health Insurance Portability and Accountability Act), which protects your medical records and care plan information from being disclosed without your knowledge. We take HIPAA compliance seriously, but what you might not know is that your insurance provider is considered a “covered entity” that has access to your information, which you consent to when you agree to your healthcare plan. This means they can see your diagnosis code, often your treatment plan and sometimes other documentation that your therapist keeps on file.
Depending on the kind of care you are seeking, there are several cases in which you might not want your insurance company to have access to your records. For example, we have worked with parents who do not want their child’s diagnosis information to be on their medical records for the rest of their life as well as professionals in certain occupations who do not want their employer to potentially find out about their mental health condition through the insurance provider. The good news is that some insurance plans will reimburse payments for out-of-network care, so you may be able to get some or all of the cost covered by insurance while maintaining 100% privacy.
Let’s plan your care and payment method together
At The Centered Life, we’ve set up a few different ways to help our clients afford mental health care with the level of privacy they desire. We are in many of the major insurance networks, and we also assist our clients with seeking reimbursement for out-of-network care. To recap, the two major reasons we like out-of-network coverage are that you get more flexibility in finding a therapist you love and your privacy is guaranteed. We also offer single-payer care for those who don’t want to use insurance at all.
Our admissions coordinator Savannah is a fantastic resource for all of your insurance-related questions, get in touch with her to start the conversation.