Insurance Limitations

Reduced Ability to Choose

Many health care plans provide limited coverage or reimbursement for mental health services.
Patients must obtain “pre-authorization” by justifying their need for therapy to the insurance company.
An insurance representative, not necessarily a mental health professional, decides if services are approved.
Patients are often restricted to in-network providers, with reduced reimbursement for out-of-network choices.
Some psychiatric diagnoses are not eligible for reimbursement.

Insurance often authorizes therapy in limited sessions, requiring justification from the therapist for continued treatment.
Additional sessions may be denied, even if therapeutic goals are unmet.
Confidential clinical information may be required for continued service approval, with no guarantee of confidentiality.
Insurance companies decide whether to continue or stop coverage and personal treatment data may be added to national databases.

Insurance requires a mental health diagnosis for reimbursement.
Psychiatric diagnoses may negatively impact you in the following ways:
- A diagnosis may lead to denial of disability or life insurance,
- Increased claims handling may result in loss of confidentiality,
- A diagnosis can affect employment, job applications, financial aid, or permits,
- And can be used in legal cases (e.g., divorce, family law, criminal).

You are more in control of your care, including choosing your therapist, length of treatment, etc.
Increased privacy and confidentiality; however, limits to confidentiality still exist.
Not having a mental health disorder on your medical record.
Room for consultation with your therapist on non-psychiatric issues that are not necessarily billable to insurance, such as:
- Learning how to cope with life changes,
- Gaining more effective communication techniques for your relationships, increasing personal insight,
- And developing healthy new skills.

For more information, click here for an article discussing why therapists may choose not to accept insurance.