Pros & Cons to Using Health Insurance

Hope And Healing Counseling



There are a lot of questions and debate regarding health insurance for mental health issues. I want to share with you the reasons behind this and the pros and cons to using health insurance.


  • Health insurance can often pay for the majority (or all) of mental health services.


  • Health insurance companies can be a great way to find a therapist. If you call your health insurance company, they can give you a list of ‘in network’ providers in your area.


  • Health insurance companies also often offer care management services. What this means is that the health insurance company will follow your services and be able to offer other services if necessary. (For example: if you are seeing a mental health therapist, but are struggling with substance abuse, health insurance companies can help you get hooked up with the most appropriate and helpful services).


  • In order to use health insurance, you must have a mental health diagnosis. Typically, this is not a huge deal, especially if the mental health diagnosis you’re struggling with is “more common” such as anxiety or depression. However, mental health diagnoses can often hurt us.
    • Mental Health diagnoses can hurt us when applying for life insurance. For example, someone who carries a bipolar disorder diagnosis will not be approved to get life insurance.
    • Mental Health diagnoses can hurt us if we are ever planning to go into a law enforcement or military career. I wish this wasn’t the case, but unfortunately it is.


  • Health insurance companies often dictate the type/amount of treatment you can receive. For example, if you go see a therapist, and the therapist diagnoses you with generalized anxiety disorder, and you’re interested in seeing the therapist weekly, the health insurance can come back and say “We think you only need to be seen monthly for this diagnosis so we are only going to see you monthly”


  • Health insurance companies often dictate which providers you can see so you do not have as much of a choice.


  • This does not impact you as the client, but it’s important to understand that health insurance companies often pay a very low rate for therapists. Sometimes the rate is great. Sometimes it is not so great. So if there is a therapist that does not take insurance, I promise they are not trying to “get rich off of you” or anything like that, it may just have to do with the varying rates insurance companies pay.

Things to Consider

  • Call your health insurance. Ask them about the mental health benefits and what they look like. Each insurance company and plan are different. Sometimes there will be little to no coverage. Sometimes they will cover everything. It’s important to understand before doing anything else.
  • Ask your insurance company about out of network benefits. Typically, insurance companies reimburse 60-80% of out of network expenses. What this means is that you will go see a therapist, pay their fee (let’s say it’s $100). That therapist will send a receipt to your insurance company. Your insurance company will then pay you back $80 (or whatever the reimbursement rate is). (NOTE: If you do this, you must have a diagnosis, so please make sure you are speaking with your therapist about this).
  • Speak with your therapist about your diagnosis. Let them know your concerns. Ask them what they are diagnosing you with and what it means.
  • Consider high deductible plans. High deductible plans mean that insurance will not cover anything, until you have paid a certain amount out of pocket. For example, if you have a $5,000 deductible, you will need to pay $5,000 towards medical treatment before insurance covers anything. Typically, people with high deductible plans have Health Savings Accounts (HSA’s) or Flex Spending Accounts (FSA’s). Often, employers will contribute to HSA’s or FSA’s for high deductible plans. All of the money from these accounts are a tax write off. If you have a high deductible, it does not really matter if you go to a therapist who takes your insurance or not because you will be paying out of pocket (or from your HSA or FSA) either way.

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