Five Reasons I Do Not Take Health Insurance for Payment for Counseling Services

  1. I do not want to have my clients branded as mentally ill for the rest of their lives. To justify payment of services for mental health counseling the insurance company must have a diagnosis of a mental illness. Although such information is supposed to remain confidential it is used to determine eligibility for life and health insurance, employment, promotions, pink slips and lawsuits. This information is especially harmful to children and adolescents later in life when trying to get in certain schools, colleges and jobs.

2. I believe that the most important part of counseling is that whatever my client(s) say to me in private remains confidential. This allows my client(s) to say whatever they need for mental and sometimes physical health. Using health insurance for payment causes the forfeiture of Privileged Communication (confidentiality) because counselors must submit progress notes to the insurance company upon request.

3. For the most part, the best therapists do not accept insurance for payment. They do not need referrals from insurance company lists and will not allow the companies to determine their value. They are in great demand for the excellent therapy they provide. An exception to this is the counselor who accepts health insurance to get his or her name around when building a new practice in a different area. .

4. Accepting health insurance for payment sends a false and damaging message to the public that professional counseling is practically worthless. Insurance companies encourage the use of Employee Assistance Programs wherein the employee pays nothing and the insurance company incurs a smaller payout. Co-pays are usually $15 to $50 dollars, sending the message that counseling is worth only that amount. People believe that insurance companies pay counselors according to their worth by the amounts allowed for a session. The insurance company is merely setting that amount so it does not have to pay what the counseling is actually worth. Then, when a specialist is required to resolve a difficult issue, people are unwilling to pay normal rates of $100 to $225 a session because they have come to believe that therapy is not worth that much. We find this to be true especially for couples with marital or divorce problems and individuals with serious mental issues..

5. Because co-pays are so small for all counselors who take health insurance, people tend not to pay attention to the amount of education, training and years of experience that distinguish the best therapists from the rest. People just assume that all counselors have the same abilities and make their choices for the wrong reasons. I know that most who find therapists simply call every counselor on a list and the first to answer or return the call is chosen. That is pathetic.Many times in Psychology Today the person chooses a pretty woman or cute man or is drawn to those who write a good profile. Clients need to ask counselors a lot of questions before turning his or her life over to that person’s influence. As a rule, the longer the therapist has been practicing, the better the therapist. Education and training are helpful, but we don’t learn to do counseling in school. We learn by doing and by honing our expertise over time. Wisdom and better techniques come with age and experience, not because of titles after one’s name. We therapists expect to be asked about our education, training, years of experience, specialties, passions and tend not to take clients seriously who just call up and say, “Do you have any openings?” I ask the client, “What do you want to accomplish in counseling?” I want to work with clients who are serious about getting what they want and for marriage clients I don’t give them an appointment until they send me information I require.

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