The world would be a much better place if finding the right mental health treatment was a straightforward process. Unfortunately, searching for the right therapist while coping with untreated mental health issues is difficult even without the added complication of insurance. Even though we see firsthand how mental health treatment plans can improve one’s quality of life, the insurance system has proven to be an unfortunate barrier when seeking and starting treatment.
A major issue that many people deal with when starting therapy or any mental health treatment is deciding whether they should involve their insurance provider. If you have insurance, you might think the decision is simple. After all, you use insurance to cover physical health conditions and treatments without a second thought. If insurance can pay for your mental health treatment, why wouldn’t you use it? The unfortunate reality is that there are plenty of reasons why you shouldn’t use insurance for mental health treatment. It’s important to be fully informed about mental health treatment and the consequences of insurance coverage before you start therapy. In this guide, we’ll cover some of the most significant issues with using insurance so you can better understand insurance coverage for mental health and make an educated decision about your treatment plan.
You Lose Your Confidentiality
Deciding that you need professional help with your mental health is a choice no one makes lightly. It’s a personal decision that shouldn’t involve anyone besides you and the people you’re comfortable confiding in. If you don’t want to share your decision to see a mental health professional, you have every right to keep it to yourself.
However, that individual decision suddenly becomes much less confidential when you involve an insurance company. Insurance companies need to approve your therapy to help you pay for it. Obtaining this approval is a complicated process that requires proving the necessity of your treatment to your insurance provider. Furthermore, insurance providers require proof that your mental health condition has a significant impact on you and your ability to function from day to day. Insurance companies need this proof to cover therapy and other forms of mental health treatments.
This creates multiple complications that we’ll discuss below, but it also means insurers have access to personal information that would otherwise stay between you, your loved ones, and your trusted mental health professional.
Insurance Companies Require Medical Diagnoses
If you were to seek surgery that was necessary for your physical health and well-being, insurance companies would require proof that the operation is necessary before covering it. Insurance for mental health treatment works the same way. Your insurance provider won’t cover treatment without a definitive medical diagnosis. Insurance companies will only consider covering mental health issues that they deem “medically necessary,” such as bipolar disorder or schizophrenia. For insurers to consider treatment medically necessary, they need a professional diagnosis as well as proof that the condition significantly impairs an individual’s ability to function in regular life.
This presents a major problem for individuals whose treatments don’t qualify as medically necessary. Stress management, life coaching, and treatment for relationship issues are all examples of significant treatments that individuals can greatly benefit from. However, insurance companies don’t deem these treatments medically necessary and therefore rarely cover them.
Insurance Can Decide Your Treatment Duration
One of the biggest reasons why you shouldn’t use insurance for mental health treatment is that insurance companies can have a significant amount of power and influence over your treatment plan. Obtaining coverage for your mental health treatment is only the first step. Just as insurance providers only want to cover “medically necessary” treatments, they will also only cover treatment for as long as they believe it’s necessary. This usually means that insurers only approve a specific duration for treatment from the start. The only people who should be involved in the decision to stop treatment should be you and your therapist.
Protecting Your Medical Record
Your medical record can have a serious impact on future insurance coverage, job applications, and other crucial aspects of adult life. When you pursue mental health treatment through your insurance provider, details of your diagnosis and treatment become a permanent part of your medical record.
Even if you end your treatment, the information stays on your record and can affect several different parts of your life. Certain jobs will be able to access your medical records and see that you received treatment for something you would prefer to keep private. Moreover, some careers—especially fields that require security clearances or businesses that don’t wish to provide accommodations for patients with mental health needs—will reject applicants or even fire current employees over these records.
Additionally, your treatment can become a preexisting condition on your record, which can complicate your ability to find future health or life insurance policies. Providers who are willing to cover individuals with preexisting mental health conditions will likely charge higher premiums, deductibles, and copays as a result.
If You Need More Sporadic Treatment
If you only need therapy sessions once in a while or after very specific events in your life, involving your insurance company will make getting these sessions more difficult and time-consuming. A personalized treatment plan that fits your schedule, needs, and the unexpected complications of everyday life is the most effective way to confront and work through mental health challenges.
Insurance companies require a treatment plan before you begin seeing a therapist. This plan defines each session you attend, taking control away from you and your mental health professional. When insurance mandates the number of sessions you receive as well as what you do during those sessions, you can’t experience the full benefit of specialized, flexible care that meets your unique needs.
Long Wait Times for Treatment That Insurance Will Cover
Given all the issues that mental health professionals have when dealing with insurance providers, many have already moved to a model in which they don’t accept insurance. This makes finding quality treatment for your issues even more difficult because you’ll need to find someone that takes your specific insurance.
Moreover, professionals who take insurance tend to provide more generalized care as part of their contract with the insurance company. This means that many individuals with many different conditions are seeking care from a single provider. As such, new patients might have to wait weeks or even months before attending their first session. Not using insurance grants you more flexibility with your treatment options and allows you to find the care you need faster than you would with insurance coverage.
Insurance Companies Can Surprise You With Costs
Insurance coverage varies, and companies can deny claims without your knowledge. You might attend multiple sessions believing that your insurance is covering them, then receive an unexpected bill due to denied claims or high deductibles or co-pays. When you pay for your mental health treatment out of pocket, you are fully aware of and prepared for every cost.
Foregoing insurance coverage gives you full control over your mental health treatment, allowing you to worry less about diagnoses and medical records and more about receiving effective care to improve your quality of life.
If you’ve been searching for a psychologist in Beverly Hills that can handle a wide variety of common and uncommon mental health issues, Blair Wellness Group can help. Our experienced team of licensed clinical psychologists can help you find the best way to treat your mental health and move forward with your life.