[Merope]

Apologies in advance, I know this is a bit of a dumb question, but I know next to nothing about how health insurance works.

At the moment, I am paying for therapy out of my own pocket. My T charges quite a bit and because of Covid-19 and other factors, I am starting to worry about the future and being able to afford him.

If I were to get health insurance, how would it work in terms of sessions? Would I pay a monthly sum and then they would cover some (or all?) of my session cost? I'm in the UK if this makes any difference. Of course, I know it depends on which insurance you'd go for, but how does it generally work?

I guess what I'm really asking is....is it worth it in terms of saving/affording therapy long term?

Again, apologies for my ignorance. I tried reading about it online but find it quite confusing.

[ArtleyWilkins]

In the U.S., if I intend to use my insurance, I have to choose a therapist from the insurance provider list. Then I pay the copay for mental health which is the same as for any doctor visit.

Some insurance you might have to pay the full deductible before insurance kicks in - policies vary. You have to read the fine print to know for sure.

In the UK, that is a whole different system, so maybe you will get replies from other UK individuals here. I am certain they'll have more accurate information.

[Merope]

Originally Posted by ArtleyWilkins

In the U.S., if I intend to use my insurance, I have to choose a therapist from the insurance provider list. Then I pay the copay for mental health which is the same as for any doctor visit.

Some insurance you might have to pay the full deductible before insurance kicks in - policies vary. You have to read the fine print to know for sure.

In the UK, that is a whole different system, so maybe you will get replies from other UK individuals here. I am certain they'll have more accurate information.

Thank you!

[LonesomeTonight]

Also in the US, many therapists don't take insurance (including mine), so they're "out of network." In my case, my insurance does have out-of-network benefits, so I submit claims and get 60% of what I pay T back from them (after meeting the deductible, but our deductible is pretty low--insurance through my H's work).

[Merope]

Is it true that if you pay for therapy with insurance, your T HAS to give you a diagnosis? Again, I assume it depends on who insures you. And is it open ended or, do they only cover a certain number of sessions based on the “diagnosis”?

Thank you for your replies!

I am in the UK. My limited understanding is that a therapist has to be registered with the private healthcare provider. You approach the insurance group (BUPA for example) and they direct you to a choice of their recognised therapists. This is more info from BUPA: 7 billion versions of normal | Mental health hub | Bupa UK

Your therapist would not diagnose you. Your GP or psychiatrist would provide the diagnosis, or a medical professional from the insurance group. Therapists in the UK are not qualified to diagnose people as they are not medical practitioners.

[Merope]

Originally Posted by comrademoomoo

I am in the UK. My limited understanding is that a therapist has to be registered with the private healthcare provider. You approach the insurance group (BUPA for example) and they direct you to a choice of their recognised therapists. This is more info from BUPA: 7 billion versions of normal | Mental health hub | Bupa UK

Your therapist would not diagnose you. Your GP or psychiatrist would provide the diagnosis, or a medical professional from the insurance group. Therapists in the UK are not qualified to diagnose people as they are not medical practitioners.

Thanks so much for this!

[LonesomeTonight]

Originally Posted by Merope

Is it true that if you pay for therapy with insurance, your T HAS to give you a diagnosis? Again, I assume it depends on who insures you. And is it open ended or, do they only cover a certain number of sessions based on the “diagnosis”?

Thank you for your replies!

Again, this is for the US, but here, there needs to be some sort of diagnostic code for insurance to cover it. Like my T just puts the code for Major Depressive Disorder. I think ex-T used the one for Generalized Anxiety Disorder (I have both). But it's not really a formal diagnosis per se, just what they bill the insurance for. I think the idea is, because it's health insurance, they want to be covering a medical condition (which depression and anxiety are, along with many other diagnoses).


Note that here (unlike UK), clinical psychologists (they have PhDs) and psychiatrists are able to formally diagnose, but I don't know if clinical social workers or licensed professional counselors can.

[Merope]

Originally Posted by LonesomeTonight

Again, this is for the US, but here, there needs to be some sort of diagnostic code for insurance to cover it. Like my T just puts the code for Major Depressive Disorder. I think ex-T used the one for Generalized Anxiety Disorder (I have both). But it's not really a formal diagnosis per se, just what they bill the insurance for. I think the idea is, because it's health insurance, they want to be covering a medical condition (which depression and anxiety are, along with many other diagnoses).


Note that here (unlike UK), clinical psychologists (they have PhDs) and psychiatrists are able to formally diagnose, but I don't know if clinical social workers or licensed professional counselors can.

Thank you for this. I didn’t know psychologists in the UK couldn’t diagnose. My T has a PhD in counselling psychology and several years of specialist training, so I always assumed he was qualified to diagnose.

[ArtieTheSequal]

I'm in the US. Ex-t (who is probably about to become t again, thanks 2020) doesn't take insurance either so I paid her out of pocket. I didn't bother with receipts and filing with insurance because my out of network deductible is so stupidly high I'd never meet it.