What you should know

Today we’re going to talk about what I wish everybody knew about using insurance for therapy. My message to you is different based on where your household is financially. In my own personal, professional, and political belief systems, I believe that every citizen should have access to therapy whether they can afford out of pocket services or not. Unfortunately, America has a big problem with our citizens not always having the access that they need. The good news is that the affordable care act required insurance companies to do a better job covering mental health services. That’s important because historically, insurance companies have really devalued those services and tend to only cover them when they’re mandated to do so. However, if the affordable care act gets repealed, all of that will be called into question.

Going the in-network route

If your household is really struggling to make ends meet and paying for out of pocket services is going to be a greater stressor than support, then seeing an in-network provider may absolutely be your most affordable option. Not all of those plans cover couples therapy even if they cover individual therapy so be sure to ask a lot of questions upfront. In order to find those providers, you can go to your insurance provider’s website and look for a list of in-network providers. None of our therapists here at Flourish are in network with any insurance companies. If your household is covered under Medicaid, a lot of people don’t recognize that they can access therapy without paying anything out of pocket. Not only can they go to a community mental health clinic, but they can also seek therapy at a private practice, so long as their therapist is covered by Medicaid. Flourish is not covered by Medicaid, but if you do a search at Psychologytoday.com you can find some fantastic therapists in private practice settings who are Medicaid providers.

The pitfall

To those of you who know that you have financial resources and were really just hoping that you could get coverage on anything you could, I get it. We pay a small fortune for our health insurance these days and we all love to get as much coverage as possible. What you should know about seeing an in-network provider is that your insurance company pays crap. They won’t tell you that, so I’m going to go ahead and tell you. They reimburse therapists a mere 40-50% of the going market rate for any therapy session.

Over the past decade, as the cost of real estate has gone through the roof here in the Denver market, the cost of running a brick and mortar space has also gone through the roof and the insurance company reimbursement rates are not keeping pace at all. So, this gap between the overhead of providing a session to a client and the reimbursement rate of an insurance company is getting wider, not smaller. Anybody who knows anything about business recognizes that it’s just not financially sustainable to accept business that is at such a significant loss. Additionally, as a female business owner, I have the incredible opportunity to mentor a lot of therapists who are here in our female dominated profession. I would be doing those women a disservice if I did not role model for them how they can advocate for what their 7 years of college and their years of expertise are worth.

For any of you who would like to know more about the 4 different ways that Flourish helps our clients lower their out of pocket expenses, CLICK HERE.