For those who reside in New Mexico where I am a licensed professional clinical counselor, I am a participating provider with Presbyterian and Molina Health Plans. I am out of network with all other insurance providers. Please contact your insurance company directly to find out about any out-of-network coverage provided by your policy.
Sessions with clients who reside in other states fall outside of the scope of my licensure, which precludes submitting to insurance.
Many people want their insurance companies to pay for mental health services and on the surface this seems logical. People pay a health insurance premium that requires insurers to cover a portion of this cost. But if you are thinking about using insurance to cover the cost of counseling, here are some things to consider:
- Health insurance requires that you be given a mental health diagnosis so that your therapist can be reimbursed.
- You may wish to opt out of using your insurance for counseling if you do not wish to have a mental health diagnosis in your permanent healthcare record.
- Not using insurance means you do not have a potentially stigmatizing and enduring statement about your health.
- Health insurance carriers have access to your private information, including provider case notes and your diagnosis. Your personal issues can be viewed by health insurance company employees.
- Electronic Medical Records require stringent HIPAA compliance and are stored in the cloud. If you choose to pay privately there is no requirement for an electronic record. Though highly unlikely, your private information could be hacked.
- Sometimes payments are denied for services that have already been provided, meaning you will have to pay out-of-pocket for services after the fact.
- Though not all health insurers are like this, some insurers do periodically deny claims, limit care, dictate care, and intrude on your personal health care records.
- Insurers may decide that certain diagnoses are not eligible for reimbursement, though they have paid for the same service with the same patient in the recent past.