Insurance for psychoanalysis or psychotherapy

My practice is strictly fee-for-service, meaning I am not on any insurance panels. I ask that patients pay my fee at the beginning of each session. Then, if your insurance allows, you may collect out-of-network reimbursement.  On request, I will be happy to provide a statement at the end of each month so that you can file claims.  Since policies vary widely, I cannot guarantee that your insurance will pay for my services.

I certainly understand the wish to use one’s insurance, especially given today’s premiums and the potential reduction of the out-of-pocket cost of therapy. Having said that, therapy is an investment in oneself and one’s future and there are other factors to keep in mind:

Advantages of paying privately

• Find a therapist quickly: Many people have trouble finding a therapist through their insurance. This happens for several reasons: Clinicians want to limit how many patients they take at the greatly reduced fees insurance companies pay. They also commonly restrict those reduced fee patients to hours of the day that are routinely harder to fill.

• Find an experienced counselor: Many young therapists use insurance panels to build a core practice until their income reliably covers their overhead. Then they wean themselves off insurance panels.

• Avoid a diagnostic history: Insurance claims (in or out of network) require a psychiatric diagnosis, which will permanently remain in your medical history. In addition, the Medical Information Bureau maintains a central database of confidential information used mainly by underwriters when one applies for life, health, disability, long-term care or critical illness insurance. Your file may include your psychiatric diagnosis. MIB is required to purge files every 7 years.

• Protect your privacy: Once you file a claim, that information is available to all involved in processing your claim. If the claim is in network and your coverage allows a specific number of visits, your therapist will have to repeatedly discuss your case with insurance employees in order to negotiate additional sessions. This means revealing detailed treatment plans and progress updates. This privacy violation is a major reason I do not work with insurance companies.

• You stay in control: A clerk at the insurance company cannot tell you how long you can stay in therapy or what your treatment should entail. Those decisions remain to be made mutually between you and your therapist.

• Focus is on you: Your therapist can concentrate on your needs and not be sidetracked by submitting claims, often more than once, and sitting through lengthy phone calls to argue the need for more therapy or correct frequent payment delays and errors.