Why don’t you take insurance?
I am an out-of-network provider only. This means that I do not work directly with any insurance companies. If you have out-of-network benefits, I can provide you with an invoice or super bill to get reimbursement from your insurance company, however you must pay for therapy services up front. If you are unsure if you have out-of-network benefits, I recommend calling your insurance company directly. Important questions to ask are, "What are my mental health benefits?", “What out-of-network mental health coverage do I have?”, "What is my out-of-network deductible or what is my out-of-pocket max?" and "Do you cover session code 90837?"
Please contact directly if you need any additional guidance.
Health insurance is tricky.
There are a few main reasons why I opt to not take health insurance:
1. Less Confidentiality
While typically we think of therapy as a confidential space, when you use insurance to pay for therapy, your therapist is required to provide a diagnosis and potentially treatment notes to your insurance company in order to get paid. This is rooted in a capitalist medical model that requires using a pathologizing approach to justify your access to therapy. This undermines the basic premise of therapy, many therapists’ non-pathologizing approach to therapy, and also gives access to private health information about you.
2. Higher Insurance Premiums
Sharing protected health information such as diagnoses and treatment can have unintended consequences in the future.
Therapists who process payment through insurance are required to provide your insurance company with your diagnosis in order to get paid for the services provided to you. But what if you don’t have a mental illness? Many people seek therapy for personal growth and exploration, not necessarily because they have a diagnosable mental health condition. Within the operating standards of our current managed health care model, these are not valid and allowable reasons for seeking therapy. If you don’t have an actual diagnosis, insurance companies currently will not pay for your sessions and will not continue to authorize future sessions.
This puts therapists in an awkward and ethically challenging position if you don’t meet criteria for a mental illness. Therapists are left with choosing between 3 options.
Assign a diagnosis you don’t meet criteria for so that your insurance company will authorize sessions.
Discontinue therapy.
Continue to work with you without assigning a diagnosis but risk having claims denied and not getting paid for the work.
To loop this back to you how this relates to increased premiums for you—
Let’s say a therapist opts for option 1 and assigns you a diagnosis so that your insurance company will authorize future sessions. Maybe you meet criteria for a diagnosis, maybe you don’t. Either way, you now have a diagnosis on record with your insurance company.
When it comes time to renew your insurance or switch plans, your premiums could rise as a result of your “pre-existing condition.” In addition, you may be required to share your diagnosis in future job interviews, which for many could be invasive and awkward. Although it’s rare to have to disclose something like that for a job, it can happen in security, government, and some other professions.
3. Insurance-Driven Treatment Plan
When therapists take insurance, they are required to use treatment methods that are covered by your plan. This means they have less autonomy in how to treat you based on your specific and individual needs. The people who work in your insurance company and decide which methods of therapy can be used are usually not therapists, yet they maintain authority over aspects of your care.