"Do you take insurance?"

One of the first questions I get asked by most people interested in therapy is whether or not I take insurance.

I love this question. Only within the past decade or so has mental health coverage been mandated for all insurance plans, so I love this because it means people have coverage and want to use what they’re already paying for.

The challenge is that parity in coverage for consumers has not equaled parity for provider compensation. Most providers do not take insurance if they can, based on the demand of their local area,  because it means getting compensated below the going rate. Taking insurance means getting paid less than what their time+training+education+office space is worth as well as having a delay in payment and having time-consuming paperwork to do to submit claims.

Mental health advocacy groups worked hard to achieve parity in consumer coverage, and it represents a cultural shift toward increasing access to services and ending the stigma of mental health treatment. I was trained in programs that believed the role of the psychologist involves also being an advocate for our clients and potential clients, and as a private practice psychologist, I want to be able to further this mission. (I get fired up about this, can you tell?)

I firmly believe that everyone who needs mental health care should be able to get it, no barriers, no stigma, just the same as any other health care.

Providers in private practice have no negotiating power in terms of compensation, and must simply accept the company’s rate as is. That’s fine, however, the rate and the additional paperwork burden often is not sustainable for many in private practice, leading many to not try to bother with insurance. That is fine for many, and there is nothing wrong with that, but it narrows the options for those who need to use their insurance.

I think back to my life in grad school, before that when I worked two jobs as a time sometimes, and before that in college, times when I was making almost no money. (News flash: being poor usually comes with more stress and problems than having a healthy income.) Thankfully there were providers I was able to find who took insurance in the part of the country where I was. Those people were were life-changers. But there’s no way I would have been able to see them if I had to pay their full fee instead of a copay.

There are many ways to find low-cost counseling for those who need it: community clinics and graduate school training clinics, for example. I have been a provider at multiple and loved it. Yes there can be more turn-over and difficulty scheduling with such clinics because the need for low cost services is so high, but I believe the larger point is that clients should be able to have their choice of providers and not be limited.

For me, this means jumping through all the hoops (so many hoops…) to hopefully be able to take insurance, even if it means more work and less pay. Bowing out of the system doesn’t help clients and doesn’t help change the system.   

So the answer to “Do you take insurance?” right now the answer is no, I am an out-of-network provider, and I can give you a bill to submit claims to your insurance company. I can do a sliding scale for people in specific situations, and/or we can have sessions every other week to make it more affordable. This is not the answer I want to give and hopefully it won’t be for much longer.