Paying for Therapy--Should I Use Insurance?

A major concern people have about counseling is the fees. Therapists may charge anywhere from $75 to $150/hour. That is a lot of money! Then, if you're going weekly or even twice a week, it can add up quickly. You have insurance and you pay a lot for your premiums. So, you may be asking, "Why shouldn't I use my insurance?" It is best you understand the risks and benefits of using health insurance therapy before making a decision that may have negative consequences. Let's look at what using insurance may mean for you:

The Benefits

•Co-payments tend to be very low.
•Some insurance plans may relieve you of a co-payment altogether!

The Risks

•You must qualify for a mental disorder diagnosis, which would have to be disclosed to your insurance panel. The diagnosis becomes the focus of your therapy, rather than the reason you contacted your therapist in the first place.

•If you are trying to apply for life/disability insurance/private health insurance, your company will need to have access to any prior health information, which includes whatever mental disorder diagnosis provided during your therapy. This can effect eligibility and premiums.

•Depending on your plan, insurance panels may have case managers consult with your therapist to get ongoing sessions authorized. This case manager will ultimately decide whether your therapy is a "medical necessity." If they decide your therapy doesn't meet the criteria for "medical necessity," they can terminate your treatment benefits, possibly prematurely.

•Insurance companies may recommend you go in for a medication evaluation to determine if it would be beneficial to your treatment, even if it's not part of the treatment plan you and your therapist have agreed upon.

What This Means to You

Only you can determine whether the calculated risks to use insurance would be beneficial or not. If you want to keep your issues private and the paper trail to a minimum, look at the risks and benefits of using your insurance to pay for your therapy and determine if it is the right course of treatment for you.

While therapy can be an expensive venture, for many people, their therapy is fairly short-term, usually anywhere from 8 to 20 sessions, depending on the presenting issues, how much those issues are impacting your life and how hard you are willing to work to overcome the problem.

Whatever you decide, look at your options, what you want to get out of treatment, and ask your therapist about your options. Do your own research and make educated choices.

Is My Problem Therapy-Appropriate?

I hear this question a lot. New clients will call and start off our conversation with, "I know you probably have more important clients with more critical issues, but I don't know where else to turn." It always amazes me how people don't believe their issue is important enough to seek help themselves.

Well, here is some reassurance. People cope differently in reaction to situations. Something that may stress one person out may easily roll off of your back. In turn, you may find yourself having difficulty dealing with a particular situation, but you see others sail through the stress with ease.

Regardless, if you're finding you're having difficulty dealing with a particular issue or relationship, and the inability to cope with the problem is impacting your ability to carry out your normal daily routine, then it's time to do something about it. You have a right to be happy within your life, whatever that means or looks like to you.

Reaching out for help is not a weakness, but in fact a strength. It's the strength of knowing your limitations and recognizing getting help will allow you to heal faster, rather than trying to work through the problem on your own, only to realize that you're sinking fast.

So, if you are doubting as to whether or not your issue is important enough for therapy, ask yourself this:

Am I succeeding at overcoming the problem myself?
What will it take for me to recognize I need help to get my life back in order?

Remember: Only strength allows you to take one step at a time.

Why am I Requested to Fill Out Paperwork at the First Session?

You took the first step. You picked up the phone and called a counselor. The first appointment is set. The therapist may request you come in early to complete paperwork or some are now email the paperwork to you, so you can fill it out in the comfort of your own home. You see the packet...you cannot believe how much paperwork there is to complete! It begins to feel overwhelming. Why do some therapists have you complete paperwork while others don't?

In the world of insurance and lawsuits, now more than ever many therapists are outlining their policies and procedures to protect you, the client, and themselves. If all the policies are spelled out, then you know exactly what to expect from the therapist and the therapeutic process. From a therapist's point-of-view, clients can feel anxious and overwhelmed coming into the first session and may not remember the policies discussed. For this reason, many therapists will require you complete the paperwork.

Another possible reason for the paperwork is the HIPAA (Health Information Portability and Accountability Act) laws, which went into effect in April 2003. As clients choose to use their insurance for counseling, therapists are turning to the internet to expedite billing procedures. Therapists who are utilizing the internet to bill for services must become HIPAA-compliant, which requires the therapist provide you with a copy of the Notice of Privacy Practices (NPP), which discusses how your health information can and cannot be used. The therapist is mandated to obtain a signature from you demonstrating you received such a copy. This doesn't mean you agree with the policy, only that you've received one.

But what if I'm not using my insurance? I'm just paying for therapy out-of-pocket. According to HIPAA law, regardless of the means of pay, if the clinician must be HIPAA-compliant, then they have to provide all clients with an NPP and treat their information according to HIPAA laws.

All in all, the paperwork, while it may seem unnecessary, protects you, the therapist and may be required by law.