Therapists who don't take insurance

growlycat · Feb 03, 2016 at 12:06 AM

My long term T in the past year has decided not to accept insurance.
Thankfully, I have a local CBT T who does accept my insurance.

It seems like this is a nasty trend ---what if medical doctors decided that they would only take cash?

In some cities like NY and Boston this seems increasingly true. I may have the opportunity to move to San Francisco but it such an expensive place to live I could imagine a whole commi=unity of T's who don't accept insurance.

Feel free to share your stories here.

If you know anything about SF specifically please give me your thoughts!

LonesomeTonight · Feb 03, 2016 at 12:11 AM

Quote:

Originally Posted by growlycat

My long term T in the past year has decided not to accept insurance.
Thankfully, I have a local CBT T who does accept my insurance.

It seems like this is a nasty trend ---what if medical doctors decided that they would only take cash?

In some cities like NY and Boston this seems increasingly true. I may have the opportunity to move to San Francisco but it such an expensive place to live I could imagine a whole commi=unity of T's who don't accept insurance.

Feel free to share your stories here.

If you know anything about SF specifically please give me your thoughts!

Not sure about your insurance plan, but do they offer out-of-network benefits? My T, MC, and p-doc aren't in any network, but we get reimbursed 60% by our insurance (have good plan from H's employer). I'm lucky in that they file the paperwork for it--I get the sense many places will give you what you need to submit, but you have to send it to the insurance company yourself. I think with Obamacare, plans have to provide the same level of coverage for mental health as, uh, regular health. So you should still get reimbursement for out of network on some level.

Pennster · Feb 03, 2016 at 12:23 AM

Quote:

Originally Posted by LonesomeTonight

Not sure about your insurance plan, but do they offer out-of-network benefits? My T, MC, and p-doc aren't in any network, but we get reimbursed 60% by our insurance (have good plan from H's employer). I'm lucky in that they file the paperwork for it--I get the sense many places will give you what you need to submit, but you have to send it to the insurance company yourself. I think with Obamacare, plans have to provide the same level of coverage for mental health as, uh, regular health. So you should still get reimbursement for out of network on some level.

Sadly, it depends on your location and your insurance plan as to whether you'll get any out-of-network coverage. There are some areas where none of the plans on the individual marketplace offer any out of network coverage- for either physical or mental health.

My therapist doesn't take insurance and I have no out-of-network coverage. It's expensive!

stopdog · Feb 03, 2016 at 12:27 AM

The first one I see takes insurance from one or two companies. The other does not take insurance at all.
I would probably like dealing with an md who does not take insurance better than ones that do. It pisses me off that it is hard (not impossible) to find an md who wants to check out insurance coverage rather than just taking the cash I have in hand to give them (should I go see one which I rarely do).

doogie · Feb 03, 2016 at 09:28 AM

My T doesn't accept insurance either. My insurance will let me turn in receipts and be reimbursed 70% (after meeting a $2000 deductible). My T's reasons for not taking insurance are because the insurance companies are so difficult to deal with and because she doesn't want the insurance company dictating how she develops treatment plans for her clients. I'm in a Southern state, so I don't know anything about San Fran - sorry. Good luch!

bolair811 · Feb 03, 2016 at 12:11 PM

My T recently talked to me about my insurance company doing a review on my case and wanting to know how many more sessions I would need. He was able to get 30 authorized before another review. It makes me nervous and we talked about it. He let me know his frustration too that insurance companies try to dictate treatment and only pay half of what he actually charges an hour ($60 per session including my copay). He's decided to no longer take insurance for new clients. He let me know that he told the review person very clearly that I had a life threatening eating disorder and a history of multiple psych hospitalizations and that as a clinician, he did not believe I would be a short-term client. Made me feel better that he's fighting for me, but I can understand why he's frustrated and decided to no longer deal with insurance (other than current clients).

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Feb 03, 2016 at 12:21 PM

Finding a therapist who takes insurance isn't really a problem in my area. Pdoc's are a different story; a bit more of a challenge. Neither would happen for me without insurance; just not even remotely financially possible, so I am highly grateful for decent medical insurance. Up until a few years ago (when some of the laws about parity in mental health coverage changed), my insurance company would do a review with my therapist about twice a year to verify that therapy was still needed. It was never a problem and never interrupted services. A few years ago they stopped requiring any kind of verification and I've always had unlimited sessions available (and mine is an HMO which you would think would be uncooperative -- I've actually found them more than cooperative with both my therapy and pdoc coverage ironically enough).

Feb 03, 2016 at 12:28 PM

Every city is so different...

How about calling the local NAMI and asking them about the insurance situation? With a bit of legwork, you could scope out the mental health provider situation before making the decision to move. San Francisco sounds wonderful.

How convenient for insurance companies to reimburse so low and require extra paperwork so that less and less providers want to deal with them. I think it borders on criminal activity. Insurance companies do those things as it is known to reduce their costs as providers drop them and people with mental health conditions give up.

It also saddens me that many of the providers who don't take insurance don't offer sliding scales.

Feb 03, 2016 at 12:35 PM

The way I see it is the insurance companies are the problem, not the doctors.

With or without it, though, it sure does a disservice to the person that's in need of medical care!

Lauliza · Feb 03, 2016 at 12:48 PM

I am in Boston and I find that most, or at least many, therapists do take private insurance. It's more common to see Ts not accept public insurance (or the public plans don't cover them). In terms of private insurance, I tend to see more psychiatrists who don't take insurance, but in those cases they are usually older, Ivy League professors with very few patients.

Ts who practice in affluent suburbs can probably afford to be cash only, although the ones I see are in those areas but still take insurance. Actually, my plan is an HMO and I have unlimited coverage for psychiatry and therapy. I think Ts who refuse insurance by choice probably don't see therapy as health care but rather a luxury, almost like massage therapy.

Feb 03, 2016 at 03:28 PM

Sometimes, you can appeal to your insurance carrier when a provider is not on the list, particularly stressing continuity of care. It's up to the provider to ultimately make the decision if they are willing to work with the plan. Some companies are doing this
because their own providers are limiting the number of clients on certain plans. I suspect it has to do with paperwork/computer hassles and lousy reimbursement terms.

growlycat · Feb 03, 2016 at 10:42 PM

Thanks everyone for sharing! My problem has been moving from state to state. My boston T does not have a CA license so technically is not supposed to practice on me (he does but cash only.) He's affiliated w/Harvard for gods sake.

I think I will look into NAMI AND I will try to learn how to get reimbursed by submitting claims on my own.

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Anonymous37842 Guest Posts: n/a	Feb 03, 2016 at 12:35 PM #9 The way I see it is the insurance companies are the problem, not the doctors. With or without it, though, it sure does a disservice to the person that's in need of medical care!
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growlycat Therapy Ninja Member Since Jan 2007 Location: How did I get here? Posts: 10,308 17 16.1k hugs given	Feb 03, 2016 at 10:42 PM #12 Thanks everyone for sharing! My problem has been moving from state to state. My boston T does not have a CA license so technically is not supposed to practice on me (he does but cash only.) He's affiliated w/Harvard for gods sake. I think I will look into NAMI AND I will try to learn how to get reimbursed by submitting claims on my own.
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