Because of the unfortunate stigma still attached to mental health conditions, people should think twice before using their health insurance to pay for visits to a mental health professional, such a marriage and family therapist, a psychologist or psychiatrist.
If you do have health insurance coverage, your first reaction might be to think, “Well, if I’ve got insurance, why shouldn’t I use it? That’s what it’s there for.” And, most of the time, that’s true. I know I’m certainly grateful for my health insurance when I go to the doctor or dentist.
But it gets more complicated when it comes to mental health care because of negative associations attached to psychological disorders. For example, people probably think differently about an individual who has a physical condition such as a thyroid disorder versus someone who has a psychological condition such as major depression.
The reality is, if you want to get your insurance company to pay for your mental health care, the mental health care provider has to give you a serious psychological diagnosis or the insurance company won’t pay for the treatment.
For instance, many insurance companies won’t pay for someone seeing a therapist for couples counseling or for “normal bereavement” following a loved one’s death. So your mental health care provider needs to find a serious diagnosis that legitimately describes your situation and that will be acceptable to your insurance company. But, once you have that diagnosis, the big issue becomes confidentiality.
Here’s how that works. When you’re seeing a therapist and paying for it yourself, the information you discuss in session stays in the room for the most part. The therapist doesn’t share the information with anyone else, except when they’re required to report child abuse or elder abuse or a handful of other situations covered by law or their profession’s code of ethics. So the vast majority of the time, the information you share with your therapist stays just between the two of you, and you can feel completely free to share all the deep problems that brought you to the therapist’s office in the first place.
However, your sessions won’t be so private any more if your insurance company is paying for all or part of your mental health care, because your diagnosis then becomes part of your health record and it’s no longer confidential. That could be detrimental to you in the future.
For example, let’s say your therapist diagnoses you with major depressive disorder, which is a very common diagnosis. Think about how people view other people who are seriously depressed. They generally have certain expectations of how depressed people behave.
So having that diagnosis in your health record could affect your ability to get a job in the future. It could be an issue in a child custody battle or other legal problems, especially since law enforcement agencies can access your insurance information at any time. A serious mental health diagnosis could cause problems if you tried to obtain other health insurance or life insurance in the future. Those are just a few examples of situations to think about.
The other issue with using insurance benefits for mental health care is that the insurance company might place limitations on the number of sessions you can obtain or require that you get pre-approval from your primary care physician. Some insurance companies are very generous and allow weekly sessions until your problem is resolved, and they don’t interfere very much in the therapeutic process. But some companies place a limit on the number of sessions they’ll cover in a given year, and that frankly might not be enough to resolve some serious or longstanding problems.
But, to me at least, those pragmatic challenges of trying to get your insurance company to provide adequate mental health coverage pale in comparison to the confidentiality issue I was talking about earlier. Confidentiality really is the Number One thing you should consider when you’re deciding whether you want to use your health insurance to cover mental health care.