Payment and Insurance Information

There are a number of things to consider regarding the cost of therapy. Paying for therapy is part of making a commitment to it, and the willingness to invest in oneself is a subtle but important part of taking better care of oneself and cultivating new, positive patterns. It may also be useful to put costs of therapy in a context of what one spends on other optional expenditures, including cable TV, eating out, etc., and considering what is most important in one’s life. Clarifying one’s values can be an important and valuable part of paying for therapy.

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If you are hoping to use insurance, you will need to ascertain whether you have “out of network” benefits as part of your plan. I am no longer a participating provider in the insurance panels (read below for more). I will help you submit a claim to your insurer to be reimbursed for the expenses they cover if you have out of network benefits. Be aware that deductibles and other limitations to reimbursement may apply. Contact your insurance company to be clear about how reimbursement works for your policy.

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In our current system, essentially there are two choices regarding the cost of therapy: To pay privately or use health insurance. There are pros and cons to both. Self-pay comes out of your pocket, at least initially, and if you seek reimbursement from insurance it takes some time and paperwork. On the other hand, you can often deduct it as a medical expense on your taxes. Self-pay gives you more freedom and privacy than going through your insurance. Some clients choose to self-pay because they prefer to avoid using insurance to cover mental health care in order to maintain their privacy. Other clients find they are not able to find someone on their provider panel that feels like a good “fit”, or who provides the services they’re looking for, such as more alternative or mind/body therapies.

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A few things to consider about using insurance for mental health issues:

• In order to use insurance, a diagnosed psychiatric disorder must be assigned, even if your primary concern is being stressed by life situations, getting anxious in social situations, or finding yourself in need of guidance or support during life transitions. The psychiatric diagnosis becomes part of your permanent medical record, which can have ramifications for certain employment opportunities and for your ability to purchase reasonably-priced life and other types of insurance policies in the future.

• Your insurance company will assign an employee to “manage” or monitor your activities in therapy, which can include making note of your personal matters being discussed, the number of sessions you attend, and other information, which becomes part of your medical record. Some question the security of this information once it is part of the company’s records.

• The insurance company may dictate the terms of your treatment, including the number of sessions, type of work considered acceptable, and other factors. It may require the therapist to discuss your treatment with insurance company employees and/or fax in forms about your treatment. It is common for insurance to refuse to pay for therapy at a certain point, even when the client feels they haven’t completed the process.​

 

Finally, many mental health providers, myself included, have resigned from participating directly with insurance companies because of a variety of problems with the system of reimbursement and limitations on the types of treatment we provide.

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Most providers find the fees paid by insurance companies are less than half of the going rate in their geographic area and marketplace. Many providers find they either can’t make a livable wage or they must see 40 to 50 clients per week, turning their practice into a conveyor belt of services. Neither the provider nor their clients thrive in such conditions.

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It is notable that some large insurance companies make hundreds of millions in profit in Massachusetts alone each year, while paying providers far below the market rate. Many of us have concluded after much debate that we essentially have no choice but to resign from participating. Such is the nature of our healthcare system as it currently exists; unfortunately, in many ways it’s a poor deal for both provider and subscriber. My goal is to help clients create meaningful, valuable, sustainable changes that in the long run pay for themselves by promoting radiant health and well-being, reducing stress, and supporting more efficient and effective living.