Using Health Insurance for Therapy Services

Deciding whether to use your insurance for therapy services is not always as simple as it may seem. While insurance coverage does expand access to care for some, it creates considerable barriers for others. While we will always try to provide insurance coverage when possible, there are some aspects to consider before choosing whether or not to utilize insurance for your therapy:

• Insurance Claims Require a Diagnosis - There are benefits to diagnoses beyond insurance coverage, often times they are required for access to certain types of care and they can give someone a sense of what a specific mental health challenge can look or feel like. However, they can also limit care in terms of the amount of coverage that insurance companies will allow, they are often difficult to remove from your medical records, and oversimplify the challenges you may face. At Mockingbird Counseling, the treatment we provide is client-focused rather than determined by a given diagnosis.

• Deductibles/Copays - Depending on your specific plan, you may have to meet a certain deductible amount before insurance covers anything. This means that you are responsible for the full amount of the session until that amount is satisfied. For many people with high deductibles, insurance may never actually reduce out-of-pocket costs. Further, high copays can make any savings from using insurance considerably less. Insurance benefits also vary considerably from plan to plan and are subject to change with little notice.

• Fee Structure and Payments - When working with an insurance company, they are completely in charge of how much we charge you, when we have to collect payment (e.g., copays/coinsurance), and whether or not they actually cover services provided. We have no flexibility with payment when we are working with an insurance company, which can create a significant barrier to your care. Insurance companies also, often arbitrarily, change their rates frequently which makes continuing to work with them difficult for any practice.

• Maintaining your Confidentiality and the Confidentiality of your Records - Insurance companies often require more detailed and invasive records than are clinically necessary. Protecting the confidentiality of our communities is an immense responsibility that we take very seriously. After we have provided the records to the insurance company, we simply can’t guarantee that your privacy and confidentiality will be maintained.

• Coverage for Gender-Affirming Care - Presently, those with insurance provided by the federal government are experiencing increasing difficulty accessing gender-affirming care of all kinds. While coverage is largely still available through private insurance companies, this is far from guaranteed to continue and is not without its own hurdles. As the trans community is increasingly discriminated against throughout healthcare, we will always do whatever we can to provide the medically-necessary and proven care that the transgender community deserves.

• Clinical Decision-Making - One of the ways that insurance companies minimize the cost to them is by dictating a significant amount of the clinical decision-making process. If an insurance company feels that our services are not worthwhile, they can unilaterally withdraw past payments, ignoring our clinical judgment and perspective. This not only does nothing to limit your costs, but it creates a barrier to future care for you and others. Clinical judgments (session frequency, treatment approach, etc) are made using our collective experience and training as therapists, the same cannot always be said for insurance companies.

Whether or not you use your insurance is entirely up to you, our priority remains to deliver the most-effective and protective care to all of our clients. Should you elect not to use your insurance coverage, we will work together to make therapy as accessible as possible for you.