Q: What are the benefits of paying for therapy services on my own?

Quite simply, paying for therapy services out of pocket provides you the greatest level of confidentiality and control over your own treatment.

Health insurance companies do contract with some mental health providers, but the contract process and agreement have several distinct disadvantages to the consumer.  By way of illustration but not exhaustion, these disadvantages include:

-In most states insurance companies have “provider panels” these panels determine which therapists are allowed into the specific insurance company network.  Through this process the insurance companies restrict patient choice of which provider a patient can be treated by.  In most states this is common place and acceptable practice, but states like the state of Vermont have led the way in consumer protection and patient choice by passing bills that protect consumers and eliminate the insurance companies ability to restrict patient choice of licensed providers though provider care panels. 

-Providers that contract with insurance panels are required to agree to participate in the terms set by the insurance company.  These terms very often include:

            -acceptance of fee set by the insurance company

            -agreement to disclose patient diagnoses to the insurance company

            -agreement to share all treatment records with the insurance company

-agreement to restrict sessions to the number and frequency prescribed by the insurance company.  Additionally, the number of sessions a patient is allowed by their insurance company per year is most often based on the insurance plan purchased and not based on treatment needs or diagnosis. 

-agreement to allow an insurance company case reviewer to dictate the type of treatment provided, course of treatment, and length of treatment. This is often done without patient participation in the process.  In addition, notes, records, and treatment plans must be submitted throughout treatment to ensure the patient and therapist are following the course of treatment prescribed by the insurance company reviewer.

-loss of control over where information is sent and what it is used for.  Few states provide strict laws on what insurance companies do with treatment records, how the information is used, and protection of the release information such as mental diagnosis to other parties such as life insurance companies.  Places such as the state of Vermont, the state of Rhode Island, the commonwealth of Massachusetts, and the state of Connecticut are often cited as leading the way in consumer protections in mental health. (more info. >>>)

- Some mental disorders can restrict your ability to get life insurance coverage.

-Insurance companies can store your medical and mental health information in banks of data which is shared with other companies.  This is usually not illegal since consumers are required to sign a release for their records to maintain benefits

-Many insurance companies “carve out” mental health benefits to another company for cost containment purposes. 

Sources for additional information: