Why You Might Choose to Not Use Your Health Insurance for Mental Health Services
- Of course the obvious reasons people want to use their health insurance for mental health counseling is because it is a benefit you have that you may have spent money on. However, there are considerations to think about when seeking out mental health counseling and using your health insurance.
- Providers are required to “diagnose” you in order to bill your health insurance. As with any health provider, some may misdiagnose, or over diagnose, and these diagnoses will be on your permanent health record with the insurer.
- Confidentiality cannot be guaranteed because in order to bill your insurance, your PII or Personally Identifiable Information, and your diagnoses, are sent from your mental health provider to a third party. This is mostly done over electronic means.
- Having certain diagnoses can be problematic for later reasons, such as obtaining certain jobs and passing security clearances.
- Insurance does not provide coverage for several types of counseling, such as couples counseling, grief counseling, career counseling, etc.
- People often come to counseling for help with stressors in their life that don’t lend themselves to a diagnosis. Again, some providers may assign a diagnosis to you that is not quite correct in order to bill your insurance. And, again, this will go on your permanent health record.
- Insurance companies usually have a limit on the number of sessions you are allowed.
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- You have the right to receive a “Good Faith Estimate” explaining how much your mental health services will cost.
- Under the No Surprises Act (January 2022), mental health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for psychotherapy services.
- You can ask your mental health care provider for a "Good Faith Estimate" before you schedule a service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Be sure to save a copy or picture of your Good Faith Estimate.
- For questions or more information about your right to a Good Faith Estimate, please visit www.cms.gov/nosurprises.