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Veteran Member
Member Since Jan 2018
Location: Somewhere in a cloud
Posts: 719
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#1
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. |
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Magnate
Member Since Oct 2018
Location: USA
Posts: 2,788
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#2
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. |
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Veteran Member
Member Since Jan 2018
Location: Somewhere in a cloud
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#3
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Always in This Twilight
Member Since Feb 2015
Location: US
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#4
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).
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Merope
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Veteran Member
Member Since Jan 2018
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#5
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! |
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Grand Poohbah
Member Since Feb 2019
Location: Toodlepip
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#6
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. |
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Merope
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#7
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Thanks so much for this! |
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Always in This Twilight
Member Since Feb 2015
Location: US
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#8
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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. |
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Veteran Member
Member Since Jan 2018
Location: Somewhere in a cloud
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#9
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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. |
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Writing my way through...
Member Since Feb 2020
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#10
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.
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LonesomeTonight, SlumberKitty
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