Treatment Whos Really In Charge
Insurance companies often try to dictate the course and method of your therapy.
I believe in a strength-based, collaborative approach that focuses on the client, rather than the problem. Furthermore, I believe that change happens when the primary focus of therapy is on the clients goals for the future, not the pain and discomfort of today.
However, when utilizing insurance to pay for treatment, the insurance company dictates the course of treatment. They set parameters by determining the length of treatment allowed and type of therapy used. They can even discontinue paying for treatment at any time!
Remember what I said in the beginning about the ethical code? Well, included in the Code of Ethics is something called client abandonment. If the insurance company suddenly decides they are no longer willing to pay for services , what then is the client do?
Ask For A Consultation Without Commitment
Why not try before you buy? Consider asking for a consultation, which will let you connect with a professional before committing to any ongoing seshes. That way, you can see who truly connect with.
You can also look for teletherapy services that offer free trials. When it comes to therapy, you definitely want to go to someone you feel comfortable around, and this can take a little trial and error.
Frequently Asked Questions About Counseling
Can insurance be used for therapy?
This depends on a few factors and varies among insurance plans, whether Blue Cross, Blue Shield, Aetna, Kaiser Permanente, Medicare, or any other plan. BetterHelp does not officially accept insurance or partner with any health insurance providers and partners. However, the Mental Health Parity Act currently requires that employers and others who provide access to group health plans must offer equal benefits for medical and mental health-related services. As a result, some major health insurance providers now cover online behavioral health and mental health services all of which are covered by insurance.
How do I know if my insurance covers a therapist?
The best way to find out if you can have therapy covered by your health insurance is to ask your provider by either calling a human resources department or human resources representative or by reviewing your health insurance coverage plan online.
How much does therapy cost?
In-person therapy prices will vary by therapist, location, and insurance plans. The cost of therapy through BetterHelp app subscription options ranges from $60 to $90 per week and it is based on your location, preferences, budget, and therapist availability. You can cancel your membership at any time, for any reason.
Is getting a therapist worth it?
How do I find the right therapist?
How often should you go to therapy?
How long does the average person stay in therapy?
How long is a therapy session?
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Is There Anything I Should Know When Using Insurance Coverage
It is important to know how much coverage you have. Your insurance provider can give you this information. Questions to ask are:
What types of clinicians do I have coverage for?
Is there a maximum coverage amount ? If so, what is it?
When does my insurance coverage ‘roll-over’ or ‘renew’?
If I use up all my sessions/coverage but need more therapy what happens?
If I am on disability – What information will be provided in the reports? Can I get a copy? How do I get a copy?
If I am on disability – Do I have to go to the psychologist/therapist my case manager sends me too, or can you ask to work with someone of my choice?
What To Do When You Need Help Covering Therapy Bills
Insurance isnt the only way to lower your out-of-pocket expenses for therapy. If you need help paying for therapy, here are some strategies you can try:
- Look for therapists who offer a sliding-scale discount.
- Try telehealth, which is often less expensive and can be done from the comfort of your home.
- Visit a federally funded health center for treatment instead of a private practice.
- Check to see if a local college offers inexpensive therapy services by their psychology students.
- See if group therapy would meet your needs. It often costs less.
There are plenty of ways to support your mental health needs on a budget. Dont give up until you find the services you need.
Find the closest federally funded health center is through the Heath Resources and Services Administration .
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It All Boils Down To Choice
Many insurance companies do not give you a choice of what therapist you can see. They have preferred providers and you must choose one of them. Even if you are happy with your provider, as I said, you dont have a choice about what information is put into your file and shared with everyone. You dont get to take that information out of your file once it is there. This can be devastating for some, and a minor irritation to others. You are the only person who can decide what is right for you.
You have a choice in who you see, whether you see them for a long or short amount of time, and whether youd rather use your insurance. We just want you to have all of the info you need to make the right decisions for your health and your family.
Does Insurance Cover Therapy
If you have a health insurance plan, your insurer might help pay for therapy sessions. Most plans offered through health insurance exchanges through the Affordable Care Act are required to provide mental health coverage. Private insurance providers not under the umbrella of the ACA may offerbut arent necessarily required tomental health benefits.
If your plan does cover mental health benefits, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act requires that mental health and addiction coverage is comparable to their physical health coverage, according to theAmerican Psychological Association. For example, if you pay a $20 copay for most physical health visits, your copay cant be higher for mental health services. The law also prevents insurance companies from placing a firm limit on the number of visits per year. However, they can request a review after a certain number of visits to determine if the care is still needed, or they may require prior authorization.
Its important to note that the reimbursement rates insurance companies pay therapists is quite low, which is held over from the time before mental health parity laws. Unlike so many other branches of medicine, a disproportionate number of mental health professionals simply do not accept insurance.
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My Copay Is $20 When I See My Psychologist But Only $10 When I Visit My Primary Care Physician Isnt That Against The Law
Not necessarily. The parity law requires copays for mental health services to be equal to or less than the copay for mostnot allmedical/surgical services. In this case, for example, its acceptable to pay a $20 copay for a mental health visit and a $10 copay for a primary care visit, as long as your copay is $20 or more for most of the medical/surgical services covered by your plan.
Psychologist Psychiatrist Or Therapist: Whats The Difference
Psychiatrists are medical doctors and have medical training specializing in mental illness. Psychiatrists can write prescriptions and may offer psychotherapy, or talk therapy, to their patients.
Psychologists usually have a doctoral degree, or a Ph.D., in Clinical or Counseling Psychology. They can also treat patients using psychotherapy and are trained in making psychiatric diagnoses.
Psychologists can work in clinical, research or educational fields. Unlike psychiatrists, psychologists do not prescribe medication. However, psychologists work closely with psychiatrists if medication is needed when treating a patient.
“Therapist” is a broader term used for those who are trained and licensed in a variety of fields to help people.
Therapists can be:
- School counselors
Though there are many professionals who claim to be therapists, its a good idea to find someone who is accredited and licensed to work in their field. If you are looking for a mental health professional, talk to your doctor about what type of therapy is right for you.
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Risk #: You’ll Probably Pay More With Out
Youll almost always pay more to see out-of-network providers than you would to see in-network providers. You may simply have a higher co-pay, but in most cases youll have to pay coinsurance instead of a co-pay . You may also have a higher deductible.
You may have already figured that youd have to pay more to see an out-of-network provider. But you might not realize just how much more you could pay. Read on to learn some of the hidden catches of using out-of-network benefits than can end up costing you more than you might have ever expected to pay to use insurance.
Research Health Insurance Options
There are several options for people and those without insurance coverage. When looking for a plan, make sure they include mental health treatment.
- Medicaid is health care coverage offered by the federal government and your state government. You can apply for Medicaid through yourstate or fill out an application through theHealth Insurance Marketplace.
- Medicare is a health insurance plan run by the federal government for people who are over the age of 65 or disabled. To apply for Medicare, visitSocial Securitys website.
- Check to see if you qualify for health insurance through the Affordable Care Act, which bases premiums on income. You can find plans and apply for coverage at the Health Insurance Marketplace.
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Why Therapists Dont Take Insurance
Therapists who dont take insurance have to be really good in order to create and maintain a thriving practice. With therapy, you usually get what you pay for and if someone is charging a high fee, its usually because they are worth it.
Speaking of that price tag, I know it can feel scary to drop a couple of hundred dollars on a therapy session every week, especially if you dont have a ton of disposable income.
Do You Need To Use An In
Not every physical therapist will be the right fit for every patient. Some specialize in certain injuries or treatments. You may find that you can only get the treatment you need with someone who is out of your network. Ask about costs or limits on coverage if you go out of network. Compare this to the cost for in-network care.
If you are having trouble finding a therapist who is in your network, ask your doctor for recommendations. They may be able to help you find someone.
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See If Youre Eligible For Medicaid For Free Therapy
If you dont have insurance coverage, check to see if you qualify for Medicaid .
If a person does not have commercial insurance but has medical assistance , then they need to look for someone who is in their network, says Dr. Jesse Matthews, a licensed psychologist.
Most providers who take Medicaid work at clinics or community mental health centers. Sometimes these are affiliated with universities and are used as training sites for graduate students. If a person has Medicaid, they should be able to access mental health care free of charge.
How Do I Assess My Insurance Coverage For Counseling And Mental Health Support
You will find a member phone number most often located on the back of your insurance card. When you call this number, ask about your behavioral health coverage. Counseling and psychiatry are covered under behavioral health which is separate from medical health benefits. Each has its own coverage, reimbursement, and procedures.
You can use all of the remaining questions on this website as a guide for what questions to go over when you call your insurance companys customer service. Ask for information about your out of pocket costs which includes deductibles and co-insurance/copays, whether there are session limits, and whether referrals from a doctor are required. You also can receive guidance in finding providers that are paneled in your insurance network and learn about your out-of-network coverage.
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Where You Can Find Help
There are several ways to find a licensed therapist. You might start by talking to your personal physician to request a referral. Some therapists even offer a free phone consultation before scheduling an appointment.
There are also online therapy directories you can use to find someone that you might like to talk to. Most of them include biographies, credentials, and pictures of local therapists you can choose from.
You can even decide to try online therapy sessions, where you stay completely anonymous and chat with a professional from your computer or smartphone.
In any case, dont be afraid to try out speaking to a therapist. If you are hesitant, then err on the side of caution. At the very least, you can find out if your issues are something that can be addressed in treatment.
Or you may find out the same thing that many other professionals have discovered. A little bit of therapy could be just what you need to become the strongest and best version of yourself.
Federally Funded Health Centers
A federally funded health center is a healthcare facility that is community based. This means that they receive funding from the Health Resources and Services Administration to provide care and treatment for people in underserved areas.
According to the HRSA, these centers must provide care on a sliding fee scale. Therefore, this may be an affordable option for people in more rural areas.
There are several therapy services that a person can use to talk with a licensed therapist online, either on the phone or via webcam or text.
Online therapy services can be an accessible and affordable alternative to traditional therapy.
In fact, a 2016 review of online services that provide psychiatric help suggests that this method is more cost effective than receiving similar treatment in person.
However, prices can vary quite a bit and not all services accept insurance. Some also offer memberships with a specific number of sessions or messages every week or month, while others may charge per individual session.
Online therapy is available through many apps and websites, some of which match people with a licensed therapist based on their needs. Many providers also offer virtual therapy for individuals who prefer online counseling over in-person therapy.
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How To Incorporate Balance Into Your Life
Reena Vokoun, CEO, and Founder of Passionfit often talks about The 3 Fs, which stands for family, friends, and fun. Vokoun shares, âIn my opinion, the 3 Fs are what life is all about. We need to work hard and pursue our goals, passions, and dreams, but if we aren’t able to spend enough time with our family and friends and to have fun in life, what’s it all for? While this philosophy might seem obvious, it’s amazing how often people lose sight of it, myself included. Oftentimes we think if we can work hard and push through a situation, then we can enjoy these things. But in the end, we always have a new goal to push for and we lose touch with what is important.â
Vokoun believes incorporating balance in your life entails:
- Build time for fun into your daily, weekly, and monthly schedule
- Do check-ins with your loved ones on a regular basis
- Plan weekend activities, vacations, and short getaways with family and friends
- Write down your priorities for each season of your life and actually look at them, often
Federally Supported Mental Health Services
Canada-wide, there are nonprofit and government-funded organizations like the Canadian Mental Health Association , or associations that oversee mental health professionals in the country, like the Canadian Psychological Association, that can help direct you to services that will work for you.
The federal government has also invested in programs including togetherall, an online community and support service for postsecondary students, young adults and teens across Canada Wellness Together Canada, a program launched due to the COVID-19 pandemic that provides free resources for mental health and substance abuse and Hope for Wellness Help Line developed specifically for Indigenous people nationwide with website resources, a chat tool and 24/7 helpline at 1-855-242-3310.
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What Can I Do If My Health Insurance Policy Doesnt Cover The Therapy Or Counseling I Need
Your most obvious option is to pay for counseling or therapy out of your own pocket if your health insurance wont cover it. A lot of people do this even if their health plan will pay for their therapy or counseling.
If you cant afford to pay for your counseling or therapy yourself, search for a public or community treatment center. Many offer low-cost and even free treatment options to people with financial needs.
If you can afford therapy but want to save money, a health savings or flexible spending account may help. Both let you pay using pre-tax dollars.
Does Medicare Cover Therapy
Yes, Medicare Part B coverage includes outpatient mental health services, including therapy or counseling. Diagnostic testing for mental health conditions is also covered.
With Medicare Part B, youll be responsible for part of the therapy costs. Youll pay 20% coinsurance plus your deductible. You may also have copays or coinsurance for services in a hospital outpatient clinic or department.
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