Why go out-of-network for mental health care?

Why go out-of-network for mental health care? 2018-04-24T10:37:14+00:00

 

Many clients choose not to involve insurance companies in their mental health care. When they don’t involve insurance companies, their counseling is not limited by the diagnosis, treatment plans, or session limits that health insurance companies often dictate.

Here are five reasons to pay privately or go “out-of-network”:

  1. Insurance companies often limit the number of sessions you can have and the type of therapy.
  2. Many insurance companies do not cover couples or family therapy.
  3. Paying for therapy out-of-pocket offers greater privacy. In order for your insurance to pay for therapy sessions, therapists are required to provide the company information regarding your sessions, including a diagnostic code. If you don’t want your insurance company to have access to any information about your mental health, consider out-of-network options. Having a mental health diagnosis on your health record may lead to limitations such as denial for life insurance or health insurance later on, though, in theory, the 2010 Patient Protection and Affordable Care Act should prohibit this.
  4. If you have a high deductible plan, you may be paying out of pocket anyway. A deductible is the amount you have to pay upfront before your insurance coverage kicks in. If you have a $6,000 deductible and you haven’t had any other medical expenses yet in the year, you are responsible for paying up to $6,000 in therapy session fees out-of-pocket before your standard copay applies.
  5. Conversely, if you have good out-of-network benefits, your insurance company may reimburse you as much as 80% of each session fee, depending on your plan and the therapist’s rate. This means that in some situations, using your out-of-network benefits can actually be more affordable or comparable to your standard copay to see an in-network therapist.

Aspire will work with you collaboratively to decide how often to attend therapy—and you decide what you want to focus on. You have the control, not the insurance company.