Affordable Care aka Obama Care recently included a law that will increase access to mental health services and mandating that insurance cover care in the same way medical services are covered. I’m hugely happy about this because, it will make seeing a therapist much easier for many. It will mean that many people will be able to get services and lessen their suffering. It will also serve, indirectly, as a way to decrease stigma that this society has about getting help for emotional or mental disorders. This is great, right? Well, yes but……
There will be many new health plans on the free market. Many of these plans will have a high deductible and most certainly, a Co pay for services. So while, theoretically, a person will have mental health coverage, the insurance will not pay until the deductible is satisfied. For example, a plan might cover mental health services at 80/20 percent once an 1800.00 deductible has been met. This means the person has to pay 1800.00 out of pocket first, until then, the insurance company isn’t paying anything. . The medical professional will submit bills to the insurance company, but you will pay for all services up front. After your deductible has been paid, the insurance company will pay 80% of the fees and you will pay 20%. Either way, unless you have medical assistance, you will be paying for services.
Is paying out-of-pocket for your mental health care a bad thing? Actually, it’s a good thing and I’m recommending it more often. In fact, I advocate people paying for their mental health services completely and not using insurance. Allow me to explain this ‘radical’ thinking. From the perspective of a mental health professional, I can tell you that insurance, largely dictates how we work with you, how long, and even determine if it is medically necessary. Also, increasingly, insurance companies are demanding that providers send them your records for ‘audits’. That means at any time, I have to turn over ‘randomly’ selected records, send them through the mail to an ‘auditor’. I don’t know what this person’s qualifications are and what they do with the records once received. I assume they’re looking for, billing inconsistencies, validation that services were necessary and fraud. Those are important things but, at what cost to the person seeking care? Insurance companies are covered by HIPPA so the provider really has no choice but to comply and send the records. I am becoming increasingly concerned about privacy and who has access to your private, confidential information.
Also, when using insurance a therapist is bound by the number of times you can be seen, the type of therapy you receive and what you can be seen for. There are lots of restrictions that the average consumer is not aware of. Often times, I have to inform clients of the restrictions, which can be frustrating for everyone.
What if you can’t afford to pay for your mental health services? I’d like to argue that you probably can afford to pay out-of-pocket. I think we must consider what is important. Untreated mental health problems don’t go away by themselves, in most instances, they get worse. Depression and anxiety alone will end up costing you, time away from family, work and enjoying life. Both of these conditions can lead to other medical problems.
Lastly, do a calculation of where you spend your money. How much do you spend on recreational activities? How much on clothing/shoes/vacations? You’ll soon see that you can absolutely afford to pay for mental health services without going broke. Yes, you might have to sacrifice some things but when you need a change, the sacrifice is worth it. Most mental health professional are willing to negotiate their rates. You have to ask. People often have unrealistic ideas of what it cost to see a therapist. They come expecting to pay hundreds per session. If you don’t ask, you’ll never know if it is affordable. Your mental health is worth it. You deserve it and so does your family. You will only be frustrated trying to get insurance companies to pay for a service that has the potential to positively impact your life.