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How does Insurance impact Couples Therapy?

We all pay a great deal for health insurance, and we all want our insurance providers to cover the maximum amount of services that we are entitled to. However, it is important for those seeking couples therapy to understand what their insurance actually covers, and what it does not. First of all, what if there is zero client/therapist connection between you, and the therapist your insurance company determines you get to select from?

How does true healing, truth and sustained change occur in session if you don't connect and feel safe with a therapist that genuinely gets it. How did you wind-up allowing strangers to limit your options on such a personal decision with potentially life-long consequences?

Insurance companies only pay for things that are “medically necessary.” This means that we have to actually diagnose you with a mental health disorder according to the DSM-V, then document how it is impacting your health on a day-to-day basis.

So? What’s the big deal with requiring a diagnosis? Despite what many people think. HIPAA doesn’t keep your information 100% confidential. Your diagnosis is something that is seen by multiple people at the insurance company, and can be shared with other insurance companies such as life, disability, future health insurance companies, and even the government. A University of Illinois study revealed that half of the Fortune 500 corporations acknowledged using employee medical records in making employment decisions,” so it’s up to you to decide whether to risk being rejected for a job in the future based on your insurance claim.

If you claim your marriage counseling fees as a deduction, even if the insurer has accepted your claim, the Internal Revenue Service could reject the expense; so proceed with caution. Its important to consult your tax and insurance administrators. We believe that private-pay clients enjoy the greatest amount of privacy over insurance clients related to informational disclosure and preauthorization. No Disclosures. No Co-Pays. In many cases, health insurance companies will not pay for couples counseling nor will they pay for missed sessions, telephone calls, reports, letters, or interactions with attorneys and others; you will be solely responsible for payment for these services. If you wish to still attempt to get reimbursed from your out-of-network insurance coverage, we are happy to provide you a monthly billing statement free of charge.

However, payments are still expected to be made to us at the start of each session, unless you have a prepaid account. The responsibility to submit the appropriate documentation to the health insurance company remains with the client(s).

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