The issue of insurance plagues the health care world and is something I find clients really struggling with. It seems more and more difficult for clients to find therapists who take insurance, as therapists are moving away from working with insurance companies. Because this is a growing phenomenon that is frustrating for clients and their wallets, let me explain it and how to deal with it!

There are several reasons that therapists have moved away from accepting insurance and none of it is glamorous. Unfortunately, our government and healthcare system do not prioritize mental health and recognize the necessity of fully covering therapy. The first issue that comes up is financial. While I won’t get into the battle between therapists and insurance companies, it is safe to say that in many cases, insurance companies simply do not pay at rates that independent practitioners can afford to accept. This is the business side of things. The second reason is that insurance companies tend to cover a limited amount of sessions. Therapy can be short-term treatment; however, long-term issues take time to work out and it is not lucrative for insurance companies to pay for ongoing treatment. Diagnosis is the third big reason that using insurance can be highly problematic. In order for insurance companies to cover treatment, they need a client diagnosis. Without a diagnosis, therapy is seen as unnecessary to insurance companies and not worthy of coverage. However, many clients come to treatment to work on ongoing issues in their lives that do not fit a diagnosis. When a client comes in to make changes in his or her life, it is not necessarily appropriate to label with a diagnosis.

But therapy isn’t cheap! Correct. It is something that clinicians struggle with as we are in a helping profession. There is an option that I always suggest clients take advantage of if payment is a problem for them. Many insurance plans include out-of-network benefits. If you are considering treatment but either cannot find a therapist that takes your insurance or found a specific therapist you want to work with who is not on your insurance panel- check out your plan’s out-of-network benefits. Your insurance company may reimburse your treatment fees in part or in whole. This option opens up the list of clinicians available to you and may allow you to find someone you are truly comfortable with and who can really help you with your needs. Alternatively, many therapists (myself included) work with a sliding scale for clients who cannot maintain long-term therapy at the therapist’s regular rate. If it makes the difference in your ability to seek treatment, inquire about a sliding scale.

When it comes down to it, the system leaves clients in an indisputable conundrum. Mental health is not well enough understood or appreciated. This unfairly leaves much of the financial burden on clients to determine how important their mental health is to them. With that said, I cannot stress enough that positive mental health is the basis for success and an absolutely worthwhile investment in one’s self. Certainly I am biased in this belief, but taking care of one’s mind and strengthening one’s self is extraordinarily important and a valuable use of funds.

I hope this has provided a bit of clarity on a frustrating topic and opened up some options!