Should I use Insurance to Pay for Therapy?

The question of whether to use your health insurance to help you pay your counseling fees is important.  The answer is complex and unique for each individual who seeks counseling.  I do not believe there is a correct answer to this question; it is more a matter of what level of privacy makes you feel comfortable.  The laws concerning privacy and confidentiality of medical records are in flux and as health insurance companies (HMO, PPO, etc.) gain more power it is possible that mental-health records will become less protected.  It is also possible that they will become more protected.  This proposes a quandary for psychologists, counselors, social workers, therapists, and psychiatrists around Silverlake and Los Feliz.  Therapists in Los Angeles disagree as to whether health insurance should be mixed up with mental health.  Los Angeles is a battle ground for the discussion of how health insurance should be involved in marriage and family counseling.


If I use insurance:

Insurance companies will cover a portion of your fee while you pay a co-pay directly to your therapist.  He is after you leave the office that it gets complicated.  Your counselor then must fill out a document concerning you and your treatment, and send it to the insurance company.  This document usually contains all of your relevant contact information as well as your clinical diagnosis and at times the answers to questions about your treatment and prognosis.  Should health insurance companies have access to this otherwise confidential information? I think not.  Shouldn't this information be kept between you and your therapist?  I think so. 


It is my belief that until health insurance companies allow for complete therapist/client confidentiality, the transfer of personal information for billing purposes compromises your privacy. 

In addition, at times your therapist does not directly bill your insurance company.  Just as with mortgages and stocks, there are middlemen companies buying and selling your insurance claims.  This means that sometimes your personal therapy information is being transmitted two, three, and even four times back and forth before the process is completed. 

As of the writing of this article, progress is being made as to how much input an insurance company has toward the type and duration of your treatment from a counselor or therapists.  In previous years, insurance companies like Blue Shield, Kaiser, and CIGNA would limit the amount of sessions you were allowed based on your diagnosis.  This led to therapists diagnosing clients in such a way that they could continue to use their health insurance to cover treatment. 

Now, you may be asking why your privacy is important.  Well, many career paths require a full disclosure of medical information including mental-health records.  I'm not sure what your career path is, or whether it will change someday, but applying to become a police officer, government official or even airline pilot could require this review of records.  You do not have any control over what you're therapist gives you as a diagnosis.


If I do not use insurance:

Therapy will cost more money but be more private and confidential.  Furthermore, clinical decisions about the duration and type of your treatment will be left up to the people who know the most about your issues: you and your counselor.  Your confidential therapy records will be maintained by your therapist for seven years and then destroyed. 


The only reasons why your private medical records will be disclosed are as follows:

1. You sign a release and ask your therapist to disclose your records to somebody.

2. You ask for a copy of your records.

3. A judge creates a court order to subpoena your records. (Unlikely)

4. It is determined that you are a serious threat to harm yourself or somebody else. (This is a last resort action used only for your own safety.)

5. In the case of elder or child abuse.


Overall, if you believe that the disclosure of your mental-health records will never affect your ability to get a job, retain custody of your children, apply for health insurance, or bother you personally, use insurance.  If the idea of anybody else knowing about your mental-health status and prognosis bothers you in the slightest, please consider bypassing your insurance and paying out of pocket.  What is the price of peace of mind?  What is the price of a sense of satisfaction in life?  Therapy does not provide instant results, but affordable therapy does provide lasting results that are certainly worth the expense.