Paola Caraker - Using Insurance

Positives and Negatives to Using Insurance

If you plan to use health insurance please be aware of the following information:

In Network
-means that the insurance company has contracted with your therapist to prvide services at a discounted rate and that you will only be charged a co-pay for services.
-you may have a deductible that you have to pay in full before your insurance starts to pay.
-insurance companies have the right to audit charts so there is less confidentiality and privacy.

Out of Network
- the insurance company may cover % of the cost of services if the  therapist provides a statement called a "superbill" that the client can submit to the insurance company for reimbursement. It is your responsibility to confirm if your insurance company will reimburse you and what the % will be.

Positives of Using Your Insurance
- less out of pocket cost thus psychotherapy is more accessible

Negatives of Using Health Insurance
-decreased privacy and confidentiality that require a mental health diagnosis to justify that the treatment is medically necessary.
-increased paperwork, thus a paper trail is created which can be accessed during legal proceedings or by long term insurance companies.
- you may have a limited amount of sessions and/or will need further authorization to warrant that the sessions are "medically necessary."

Using insurance when seeking couples therapy

Using insurance for couples therapy is tricky. Your insurance company will require that I designate one person as the "patient"  who will receive a mental health diagnosis. This  conflicts with my clinical perspective as well as the ethical/legal standards established for marriage and family therapists indicating  that the "couple" is the client. The word "patient" implies that ones is "sick" which conflicts with my perspective as I do not believe that you are " sick." If you choose to use your insurance I will open a chart for each person and each person will be required to obtain a diagnosis that is "medically necessary" to warrant the services.