"Why can't I find therapists who take my health insurance plan?"

The answer is a complicated one. The short answer is that managed care insurance companies do not truly value quality health care, especially mental health or psychotherapy. You must remember that insurance companies are in the business of making profits, not in helping their clients. One way that they make profits is by limiting the type and number of services that a client receives. Therefore, they may limit the number of therapy sessions you may have in a calendar year. Also, they only pay a small portion of the doctor or therapist fees. Another portion is paid by your co-pay. But all together, those fees add up to only about half to two-thirds of what a doctor or therapist is worth. The reason that doctors and therapists are willing to accept these low fees from managed care is that it gives them a certain number of guaranteed patients. However, because of these low fees, and due to the large amount of required paperwork, many therapists simply decide not to accept any insurance.

Further, managed care often limits the number of therapists to be providers in a given area. So many of the available therapists are simply ineligible to be on your insurance panel.

Another consideration is that many insurance companies will only pay for services that are deemed "medically necessary." Couples therapy, family therapy, and similar services such as grief counseling are often determined to be "optional", and are therefore, uncovered. So therapists providing these services may find that they are unable to receive compensation for them.

"What type of information will my insurance company receive about me?"

Managed care companies, in their efforts to "manage your care" expect a diagnosis in order to cover the services. This will typically be some type of mental health diagnosis specified in the Diagnostic and Statistical Manual of the American Psychiatric Association. In attempts to reduce risk and costs, many diagnoses are not covered by managed care. Further, if an insurance company does cover a diagnosis such as "Major Depression", this may go into your permanent health record. This could affect your ability to receive certain insurance coverage in the future, or even things such as job promotions and background checks.

"What about confidentialty between me and my therapist?"

Your insurance company may require your therapist to provide notes and treatments plans, in order to receive more detailed information about you. Despite HIPAA laws, once an insurance company is involved, there is no longer such a thing as complete confidentiality. For these reasons, many clients decide to forego using their insurance to help cover the cost of therapy. This puts the client at the center of his own healthcare choices and prevents others from having personal information about his mental health or therapy records. If you choose me as your therapist, and decide not to use your health insurance coverage, you will retain full confidentiality as proscribed under state law and my professional ethics.