Reasons I Do Not Accept Insurance

Higher Insurance Premiums

• Insurance-Driven Treatment Plan

  Less Confidentiality

Usually, what we talk about in therapy stays in therapy, except for a few situations meant to protect you and others. However, this is not the case if I were to use your insurance company to pay for therapy, and I’ll explain why.

When you use insurance to pay for therapy, I am required to provide your insurance company with a diagnosis, even if that diagnosis doesn’t truly reflect your situation. It’s fair to say that not everyone needs a diagnosis when they come to therapy, but your insurance doesn’t seem to think this way.

Many people seek therapy when contemplating important decisions or looking for clarity in personal exploration and growth. Unfortunately, insurance companies don’t consider personal growth or self-exploration valid reasons for therapy, and without a diagnosis, they will not pay for your sessions.

Not only do insurance companies require therapists to provide a diagnosis, but they can also request treatment notes—essentially, your personal information related to what you share in our sessions. This undermines the fundamental premise of therapy and can expose unnecessary private health information about you.

Some people don’t mind this since they already share confidential information with their medical providers, but you don’t discuss the most intimate details of your life with them every week, making the content much more vulnerable.

If you’re thinking, “You know what, Maria? At this point, it really doesn’t matter what I share with those insurance companies, so go ahead and do it,” I’d advise you to err on the side of caution. Sharing this confidential information can have unintended consequences in the future. Providing insurance companies with a diagnosis and therapy notes can put you at risk for higher premiums if you choose to renew or switch insurance companies. If you do not meet the criteria for a mental health diagnosis, then I’m left with three options.

1.    Assign a diagnosis you don’t meet criteria for so that your insurance company will continue authorizing sessions.

Let’s say I decide to go along with it and choose option 1. Maybe you meet the criteria for a diagnosis, or maybe you don’t. Either way, you now have a diagnosis on record with your insurance company, which means that when it comes time to renew or switch insurance companies, you will have a “preexisting condition.”

2.     Ending therapy

Personally, I would not feel comfortable making up a diagnosis that you don’t even meet the criteria for, and discontinuing therapy wouldn’t be advisable either—assuming we have already established a good treatment plan that is working well.

3.     Continue therapy without assigning a diagnosis but risk having claims denied and not getting paid for the work.

"I certainly don’t want to risk having my claims denied and not getting paid."

"So there it is, folks. Please feel free to ask me any questions."