Many people find individual psychotherapy and marriage counseling an extremely worthwhile investment that is life changing. But before starting, you need to understand your costs and coverage so you can plan appropriately. If you have health insurance, the first place to start is to understand the specific mental health coverage you have under your health plan. For many insurers, you can find this information on the insurer's website or by calling the customer service number on the back of your health insurance card.
Some of the specific things to ask about include:
My office accepts most major insurance plans. Some of the more popular ones we accept include:
- Blue Cross/Blue Shield, Aetna, HAP, Value Options/Beacon Health and Magellan. I am also a provider through the Multi-Plan network
If you have coverage under a different insurer, some policies will pay for a portion of fees for out-of-network providers. In addition, I can sometimes make additional financial arrangements with you that can reduce your out-of-pocket costs if I am not in your insurer's network.
Please feel free to contact me via email if you would like my office to check your insurance benefits related to therapy to see if we are in your plan's network of providers or what your out-of-pocket expenses may be.
Some clients choose to pay for psychotherapy treatment or marriage counseling themselves because of several advantages in terms of choice and control or because of limited mental health benefits. If that is your situation, please let me know. In these financially challenging times, I am committed to providing affordable treatment to my clients by offering a sliding scale of fees.
It's helpful to understand the difference between using insurance versus paying for therapy or counseling on your own. Whether it makes sense to elect to pay out-of-pocket (called "Self-Pay" or "Private Pay" in insurance jargon) rather than use insurance depends on your particular situation and needs. Some of the issues and trade-offs include:
- You choose and contract with your own therapist and are free to choose a therapist based on your own preferences and needs.
- If you are not satisfied with one therapist, you may choose another therapist or seek a second opinion at any time.
If You Use Insurance:
- Most insurance companies limit the choice of therapist. You are usually required to go to a therapist that is part of your insurer's network of providers, and your insurance company will have a contract with that therapist. With HMOs, out-of-network providers are usually not covered.
- If you are not satisfied with one therapist, you must often get authorization to seek a second opinion from another therapist on the insurance company's list.
- You and therapist together determine the length and type of treatment. You discuss the appropriate treatment with your therapist and are an active participant in the decision-making process.
- You are free to go to therapy as long as you and the therapist deem it necessary and are able to avoid any outside interference.
If You Use Insurance:
Insurance companies often limit the length and type of treatment they will pay for, regardless of what you and your therapist find is needed. Insurers impose these limits in a variety of ways that include:
- Some will only cover you for very short-term therapy of somewhere between 3 and 8 sessions.
- Others limit you to a maximum number of visits or a maximum dollar amount for the year.
- Sometimes, even if your policy allows you additional sessions because you have not yet reached your maximum for the year, an insurer may not authorize you to use that maximum.
Sometimes brief therapy is appropriate and sometimes it is not. Brief therapy works well for many people who are dealing with a temporary crisis or a specific, well-defined problem. In many instances, a therapist can help individuals or families adapt to a challenge very quickly. However, brief therapy is not appropriate for all people or for all types of problems. If you do not feel satisfied with the results from a few sessions, longer-term therapy may prove more helpful.
A Consumer Reports (November 1995) survey found that, while most people experienced some relief in both brief and longer therapies, those who stayed in therapy for more than six months reported the most improvement. Other research has found that people who stay in treatment for longer periods report greater gains than those who receive treatment for shorter periods. It shouldn't be surprising that it takes time to develop a trusting relationship with a therapist and resolve deeper, more complex, long-standing issues.
Another option available for clients with some mental health coverage is to use their available coverage until the benefit is used up and then make an arrangement for private pay fees for further sessions if needed. For some, this option provides the best balance between minimizing out-of-pocket costs and allowing them the control they need of their health care.
I hope that the above information is helpful to you in making an informed decision on whether to use your insurance benefits (if you're fortunate enough to have them) or pay for therapy on your own. Again, the key is to make the arrangement that works best for you and your health among the options you have.
If you have insurance coverage, again the best starting point is quick phone call to your insurer to get answers to the questions listed at the top of this page. If you're a resident of Southeastern Michigan, are considering me as your therapist and have remaining insurance or fee questions, please call me at 313-675-9886 to discuss your individual situation and potential options. Alternatively, you can contact me via email if you would like my office to check your insurance benefits related to your therapy sessions.