Thinking of using insurance to pay for therapy? Read this first!

Many clients enter therapy wanting to use insurance. This is completely understandable, as using insurance can greatly offset the cost of obtaining much-needed mental health services. What a lot of clients don’t realize, however, is that a lot of personal information may need to be shared with the insurance company to use in-network benefits, and there may be limits to the benefits they are allowed to use. When using in-network benefits it’s helpful to know the following:

  1. A diagnosis is required by insurance companies, and this label will become part of your medical record. While this is not concerning to some clients, others feel this to be too much of a violation of their privacy, and it can pull therapists to assign a label to clients that they many not be totally comfortable with. 
  2. Clients' records are not protected, which means that all information about the client, including very personal information, may be obtained by the insurance company. Different companies require different types of information, so it is in your best interest to contact your insurance carrier and ask what types of information they obtain from mental health professionals. 
  3. Clients' care is dictated by the insurance company, and the therapist essentially works for the insurance company, not the client. This can compromise the quality of mental health services provided and can limit services provided. It is not uncommon for insurance companies to dictate the length, duration, and frequency of therapy sessions.

While using insurance is not always a negative experience for clients, it’s useful to understand the power insurance companies wield, and to have a plan in place if they try to limit your services.

One alternative that works for many clients is to use their out-of-network insurance (OON) benefits. Many insurance plans have good OON benefits, which is a well-kept secret that many clients don’t realize. If you’re curious about your OON benefits, definitely give your insurance a call and ask them what your OON behavioral health (outpatient) benefits include. You may be pleasantly surprised! The upside to using OON benefits is that the insurance company is not entitled to as much personal information about you (it’s usually pretty minimal), and your therapist will work for YOU, not the insurance company.

If you’re wanting to start therapy at KCMHA, we will work with you as best as possible to use your in-network benefits if needed, but will also help you use your OON benefits when when that is preferred!