why I don't accept insurance
Many people want their insurance companies to pay for their mental health care. On the surface, this desire is logical. People (including me) pay a health insurance premium that, according to the Affordable Care Act (that builds on the Mental Health Parity and Addiction Equity Act of 2008), requires insurers to cover a portion of mental health and substance abuse services. This should be simple, right?
The reality is, it is not simple at all. While the intention of this is ostensibly positive, to ensure that more people receive mental health care, the reality can be quite the opposite. So, in no particular order, below are the reasons I do not accept health insurance.
The therapeutic relationship is most effective when it is private.
First and foremost, it is my belief that therapy is a private encounter, exclusively between a therapist and a client (or clients). Trust is an essential ingredient in therapy. As soon as insurers are asked to pay for treatment, they are entitled to ask for (and be granted) access to private therapy records. This often creates the presence of a large, bureaucratic entity in the room that can have a significant impact on what is said in session. In my experience, this can be a subtle, but significant deterrent to trust, and therefore, to feeling better.
Health insurance requires you to be “mentally ill.”
I am a non-pathologizing therapist. While you may experience extreme emotions and internal disturbances, except in rare and extreme cases, my therapy frame does not include labeling you as “mentally ill.” Health insurers require mental health care providers to diagnose their clients by using a pathologizing code from the DSM-V. These codes represent psychological, behavioral, and emotional disorders that have been identified and created by committees of human beings. Despite the implication of “officialness” that coding implies, there is currently no true, independently verifiable way to measure, let alone define, mental illness or mental health. (Although some psychological disturbances do exhibit consistent symptoms.) The DSM-V is continually rewritten, with entire categories of mental illness added and subtracted with every iteration.
In addition, your "diagnosis" will become a permanent part of your health care record. Not using insurance means you do not have to create a potentially stigmatizing and enduring statement about your private health matters.
Receiving a mental health diagnosis of depression can negatively affect your ability to get life insurance.
This is from a New York Times article dated February 26, 2016!. http://www.nytimes.com/2016/02/27/your-money/an-insurance-penalty-from-postpartum-depression.html?emc=edit_tnt_20160227&nlid=55877107&tntemail0=y
Life insurers will ask for access to your medical records as part of their underwriting process. Certain formal diagnoses, including depression, will create problems for you when trying to purchase a life insurance policy. Life insurers do not want to insure people whom they believe may be at risk of suicide, and a depression diagnosis (even if you are not suicidal) can cause many insurers to hesitate and/or decline coverage.
Health insurance carriers have access to your private information
Health insurers have access to mental health care provider case notes and your “diagnosis.” If I were to seek payment from health insurance companies, your personal issues can be viewed by health insurance company employees. In addition, therapists are now receiving pressure from insurance companies to store session notes in the "cloud." Accordingly, your private information may be subpoena’d or hacked into. In fact, recently, Blue Cross Blue Shield's members private records were, in fact, hacked.
Health insurance payments can be very hard to process and receive
The bookkeeping, administration, pay rate, stress, and substantial hassle of billing through insurance companies is extremely burdensome. Sometimes payments are denied for services that have already been provided. It is very hard for therapists to participate in the insurance system and at the same time provide quality care, earn a living, continue to improve their skills, care for families, and keep their own mental health in order. In addition, it generally takes a minimum of two months for a health care provider to receive payment for services from an insurance company.
“For Profit” is, regrettably, against your best health care interests.
Commercially available health insurance in America is a for-profit enterprise. Health care is as necessary as fire protection and police departments. The for-profit motive will *always* work against your long-term best interests. Health insurers actively look for ways to deny claims, limit care, dictate care, and intrude on your personal health-care records.
A recent example of an unacceptable health insurer intrusion into the private life of a mental health care client:
Here is a link to a discouraging New York Times story of gross over-reaching by an insurance company into the private matters of a mental health client: Insurance and Its Discontents http://opinionator.blogs.nytimes.com/2015/02/10/insurance-and-its-discontents/?emc=edit_tnt_20150210&nlid=55877107&tntemail0=y&_r=0
A great explanation of marriage counseling costs, and why they cannot be billed to insurance:
Are Marriage Counseling Costs Covered by Health Insurance?
http://www.allaboutcounseling.com/library/marriage-counseling-costs/
Two well-articulated explanations from psychotherapists writing about this topic:
- What Your Therapist Hasn't Told You About Using Insurance
http://www.confessionsofatherapist.com/2010/12/what-your-therapist-hasnt-told-you.html
- Why you should think twice about using health insurance to cover counseling
http://www.apeacefullifecounseling.com/common-counseling-questions/using-health-insurance-to-cover-counseling/
And another one from a psychiatrist:
Why Don’t You Take Insurance?
http://insight-psychiatry.com/index_files/WhyNoInsurance1.htm
More links to the issues with health insurance and mental health care:
- Mental Health Now Covered Under ACA, but Not for Everyone
http://www.usnews.com/news/articles/2014/04/29/mental-health-now-covered-under-aca-but-not-for-everyone
- Does My Health Insurance Cover Mental Health Treatment?
http://www.nerdwallet.com/blog/health/2014/08/18/health-insurance-cover-mental-health-treatment/
- Study: Half of Psychiatrists Don't Accept Health Insurance
http://www.healthline.com/health-news/mental-half-of-psychiatrists-dont-take-health-insurance-121113#1
The reality is, it is not simple at all. While the intention of this is ostensibly positive, to ensure that more people receive mental health care, the reality can be quite the opposite. So, in no particular order, below are the reasons I do not accept health insurance.
The therapeutic relationship is most effective when it is private.
First and foremost, it is my belief that therapy is a private encounter, exclusively between a therapist and a client (or clients). Trust is an essential ingredient in therapy. As soon as insurers are asked to pay for treatment, they are entitled to ask for (and be granted) access to private therapy records. This often creates the presence of a large, bureaucratic entity in the room that can have a significant impact on what is said in session. In my experience, this can be a subtle, but significant deterrent to trust, and therefore, to feeling better.
Health insurance requires you to be “mentally ill.”
I am a non-pathologizing therapist. While you may experience extreme emotions and internal disturbances, except in rare and extreme cases, my therapy frame does not include labeling you as “mentally ill.” Health insurers require mental health care providers to diagnose their clients by using a pathologizing code from the DSM-V. These codes represent psychological, behavioral, and emotional disorders that have been identified and created by committees of human beings. Despite the implication of “officialness” that coding implies, there is currently no true, independently verifiable way to measure, let alone define, mental illness or mental health. (Although some psychological disturbances do exhibit consistent symptoms.) The DSM-V is continually rewritten, with entire categories of mental illness added and subtracted with every iteration.
In addition, your "diagnosis" will become a permanent part of your health care record. Not using insurance means you do not have to create a potentially stigmatizing and enduring statement about your private health matters.
Receiving a mental health diagnosis of depression can negatively affect your ability to get life insurance.
This is from a New York Times article dated February 26, 2016!. http://www.nytimes.com/2016/02/27/your-money/an-insurance-penalty-from-postpartum-depression.html?emc=edit_tnt_20160227&nlid=55877107&tntemail0=y
Life insurers will ask for access to your medical records as part of their underwriting process. Certain formal diagnoses, including depression, will create problems for you when trying to purchase a life insurance policy. Life insurers do not want to insure people whom they believe may be at risk of suicide, and a depression diagnosis (even if you are not suicidal) can cause many insurers to hesitate and/or decline coverage.
Health insurance carriers have access to your private information
Health insurers have access to mental health care provider case notes and your “diagnosis.” If I were to seek payment from health insurance companies, your personal issues can be viewed by health insurance company employees. In addition, therapists are now receiving pressure from insurance companies to store session notes in the "cloud." Accordingly, your private information may be subpoena’d or hacked into. In fact, recently, Blue Cross Blue Shield's members private records were, in fact, hacked.
Health insurance payments can be very hard to process and receive
The bookkeeping, administration, pay rate, stress, and substantial hassle of billing through insurance companies is extremely burdensome. Sometimes payments are denied for services that have already been provided. It is very hard for therapists to participate in the insurance system and at the same time provide quality care, earn a living, continue to improve their skills, care for families, and keep their own mental health in order. In addition, it generally takes a minimum of two months for a health care provider to receive payment for services from an insurance company.
“For Profit” is, regrettably, against your best health care interests.
Commercially available health insurance in America is a for-profit enterprise. Health care is as necessary as fire protection and police departments. The for-profit motive will *always* work against your long-term best interests. Health insurers actively look for ways to deny claims, limit care, dictate care, and intrude on your personal health-care records.
A recent example of an unacceptable health insurer intrusion into the private life of a mental health care client:
Here is a link to a discouraging New York Times story of gross over-reaching by an insurance company into the private matters of a mental health client: Insurance and Its Discontents http://opinionator.blogs.nytimes.com/2015/02/10/insurance-and-its-discontents/?emc=edit_tnt_20150210&nlid=55877107&tntemail0=y&_r=0
A great explanation of marriage counseling costs, and why they cannot be billed to insurance:
Are Marriage Counseling Costs Covered by Health Insurance?
http://www.allaboutcounseling.com/library/marriage-counseling-costs/
Two well-articulated explanations from psychotherapists writing about this topic:
- What Your Therapist Hasn't Told You About Using Insurance
http://www.confessionsofatherapist.com/2010/12/what-your-therapist-hasnt-told-you.html
- Why you should think twice about using health insurance to cover counseling
http://www.apeacefullifecounseling.com/common-counseling-questions/using-health-insurance-to-cover-counseling/
And another one from a psychiatrist:
Why Don’t You Take Insurance?
http://insight-psychiatry.com/index_files/WhyNoInsurance1.htm
More links to the issues with health insurance and mental health care:
- Mental Health Now Covered Under ACA, but Not for Everyone
http://www.usnews.com/news/articles/2014/04/29/mental-health-now-covered-under-aca-but-not-for-everyone
- Does My Health Insurance Cover Mental Health Treatment?
http://www.nerdwallet.com/blog/health/2014/08/18/health-insurance-cover-mental-health-treatment/
- Study: Half of Psychiatrists Don't Accept Health Insurance
http://www.healthline.com/health-news/mental-half-of-psychiatrists-dont-take-health-insurance-121113#1
505-377-0005
Conveniently located in Los Ranchos de Albuquerque in the North Valley, near 4th and Osuna
87107
87107
