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To Use Insurance or Not to Use Insurance for Counseling?

When Seeking Counseling Should You Use Insurance?

When I was first trained in counseling Managed Care was just starting out.  The Professors at my school were adamant against using insurance for clients.  They were afraid of confidentiality getting compromised and, as a result, urged students to tell clients to “self-pay” for counseling.  This would protect confidentiality, a hallmark of the trade.  They gave an example of someone running for public office who was denied the opportunity because they had been diagnosed with Adjustment Disorder in childhood. 

However,  I have found insurance to be very useful for clients and helps clients who need counseling gain access with a manageable co-pay for sessions.  Counseling can add up and is a significant investment in yourself.  People tend to minimize the importance of such an investment because it is often difficult to see tangible results without first giving it a try.  People are very private about counseling.  Unlike seeing a good haircut and asking “who is your hairstylist?,” people don’t usually say, “Wow, your attitude is so much better, who is your therapist?”  The word doesn’t get out about good therapy because most of us are very private about it. 

Insurances are getting better at recognizing the need for counseling and some plans have good coverage.   Other plans have poor coverage for counseling and limited choices in counselors.   A diagnosis does have to be made in order to use the insurance.  Most therapists try to go with a general diagnosis such as Depression or Anxiety.  This does go on your insurance record, and if you are worried about changing insurance and being denied because of a pre-existing condition, then consider self-pay.  However, things are changing and hopefully most will not get denied because they used their insurance for mental health.  

EAP’s are also a good way to gain access to good counseling.  Typically an Employee Assistance Program will cover 4-8 sessions completely with no co-pay.  Then after the EAP time is used, a client can change to their primary insurance with a co-pay. 

Finding a qualified therapist that you like, feel at ease with, and can trust is important.  Make sure you spend some time on the phone with your potential therapist, check out their website, or ask if they will allow a free 15 minute meeting to see if you are compatible with your therapist (see my previous blog on How to Choose a Therapist). 

So, basically, if you are not planning to run for public office and need support during a time of stress then go ahead and use your insurance.  There is confidentiality within the system and it can offset the cost of good therapy. 

If you don’t have good insurance coverage for counseling then try to find a therapist who offers a sliding scale based on income, or use an intern in training to get started.  Some interns are naturally good at what they do and others are not.  It all depends on who you get. 

I have a practicum student starting on January 20th, 2011 who will be trained by me and will offer low-fee counseling.  I have a good feeling about her and think she will be a good therapist.  I also offer reduced rates if clients qualify based on income and expenses.  The insurances I currently accept are: Aetna, Humana, United Behavioral Health, and Tri-Care. 

Blessings to you on your life journey and moving forward. 


by Gretchen Flores