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10 Reasons Why You Shouldn’t (or can’t) Use Health Insurance for Therapy or Counseling

by Don Laird, NCC, LPC, DCC

Did you know that your current health insurance plan may not cover therapy or counseling? You would assume that using insurance to pay for therapy is just another part of your existing coverage, right? You pay enough in premiums, so why wouldn’t it be covered? The long and short answers are typically “no” or “not always.” Most insurance providers continue to relegate mental health to the bottom of the coverage barrel. So it is possible that your health plan may not even contain mental health coverage. If therapy is included it may be minimal at best. If in doubt, ask your carrier. In the meantime, here are just 10 reasons why we do not accept insurance and why you should think about using alternative payment methods regardless of your current health plan.

  1. Cost. Your insurance company’s hidden fees, deductibles, co-pays, and co-insurances are expensive and they add up quickly. Furthermore, due to frequent delays and confusion with billing, you may not receive an invoice until months after a service is provided.
  2. Your treatment is NOT confidential when you use insurance. Since we will not bill insurance companies for our services, the information about your treatment remains confidential between us, unless you wish to release that information to another party.
  3. We would be required to give you a diagnosis. which your health insurance will keep on file permanently. Health insurance companies require us to submit a clinical diagnosis in order to provide you with treatment. However, not everyone has a “mental illness” that requires a diagnosis, but rather they are struggling with life issues and related stressors.
  4. Insurance companies want LOTS of your most intimate information. We would be required to discuss your private information with a total stranger, who then determines (usually after reviewing your case with several other people) whether or not the therapy or counseling is helping you. In other words, the insurance company controls treatment instead of you and your therapist.
  5. Pre-existing condition. This alone should steer you away from using insurance for therapy. With the changing dynamics of healthcare a diagnosis could mean that once again your insurance company will use it against you as a way to raise your premiums or deny you coverage.
  6. Out-of-pocket costs. Deductibles and co-pays for insured clients continues to increase, and in 2019 tax payers won’t be penalized for being uninsured. Therefore, more under-insured and uninsured clients will find themselves seeking alternative avenues to pay for mental health services.
  7. Your insurance company’s Mental Health or Wellness Coach/Concierge is NOT a substitute for a Licensed Professional Counselor or Therapist. They can dress it up however they want, but don’t be fooled. Many of these faux counselors have a minimum amount of therapy experience are not licensed with the state or national boards, and they are in that position to provide simple advice and a referral to an in-network counselor provided by the insurance company. They are there to support the insurance company, not you.
  8. Insurance increases healthcare costs for everyone. Therapists and medical professionals spend more time on administrative paperwork, billing and follow-up than seeing clients. Working with insurance companies costs therapists more in overhead, and that means less time with clients and higher costs for all.
  9. The Bottom Line. In our years of professional experience, there is no “cookie cutter” or “one-size-fits-all” solution when it comes to good mental health. People experience life differently. People navigate their problems and issues differently. There is no substitute for a strong and honest therapeutic relationship. Having an insurance company demand that we get all of your issues resolved in a few sessions is not only unrealistic and unhealthy, but it is unfair to you as a person. We don’t want you to discontinue your sessions because an insurance company representative or medical director doesn’t value your treatment or well-being.
  10. Some additional perspective. Below is the recent annual profit for just one of our region’s largest health insurance providers. The number speaks for itself. Moving forward, and simply said, we can’t in good conscious agree to accept insurance when the price is too high for clients to afford and quality of care is potentially jeopardized by administrative and other related costs.


I hope this helps you understand why we do not accept health insurance and why you should check with your provider before assuming therapy and counseling is included under your plan. It may be, but it could also be very costly to use in the end. Of course these are just a few reasons, and I’m certain I could fill several volumes worth before covering all the grounds for why using insurance is just not always in your best interest.

At eTalkTherapy we provide professional, HIPPA compliant online therapy that is both affordable and convenient.  We are serious about your mental health needs and we have highly trained, experienced therapists and licensed counselors who are also certified in telehealth. eTalkTherapy is reasonably priced, and fits easily into most budgets. If you want to change your life for the better, contact us today. We hope to work with you soon.

In good health,