Why You May NOT Want to Use Your Health Insurance for Counseling

Why not use your health insurance for counseling? Isn’t that what it is for?

Perhaps.

But using health insurance for mental health services is a little different than other medical issues. Sometimes mental health issues are not covered by your health insurance. Once you use your health insurance for mental health, you will have a mental health diagnosis on file – a mental health disorder/mental health illness must be on the insurance claim in order for insurance to pay for treatment. This will be in your permanent medical record.

Of course you want to consider using your health insurance for counseling, but there are some good reasons for you to consider why you may not want to use your insurance for counseling services.

Why doesn’t my counselor accept my health insurance?

Many counselors choose not to accept health insurance for very good reasons. They want to focus 100% of their time in treating you. If they accept health insurance, there is a lot of extra work involved in accepting insurance, in addition to agreeing to work for a discounted fee. The counselor may spend hours on the phone getting benefit information, authorizations, or following up on claims payments. The counselor has to wait a month for payment from the insurance company. The counselor has to file progress reports with the insurance company. The counselor is required to submit treatment reports and other details about your medical history with the insurance company.

It’s not that counselors don’t like insurance companies, or don’t want you to use your insurance (we have health insurance too!), but many counselors prefer to focus 100% of their time and energy in helping clients, rather than doing paperwork for insurance companies.

But this isn’t the only reason counselors may not be in network with your health insurance company.

The other reasons are more compelling, and you need to consider them BEFORE you decide to use your health insurance.

Many counselors prefer not to work in network with health insurance companies so that they can better protect your confidentiality. Any information (claims, reports, or treatment plans) filed with health insurance leaves the protection of their office and their locked files and your personal, private, emotional information is outside of your counselor’s office. In order for any insurance company to reimburse or pay for counseling (both in network and out of network), you must be considered “ill”. You must be diagnosed with a mental health illness or disorder. If you are not ill enough to warrant a diagnosis, then insurance will not pay for counseling services. If you do qualify for a mental health diagnosis, your illness will be listed in your permanent medical record. Many counselors don’t like this “medical model” of declaring someone ill, so they choose not to accept insurance because they want to focus on their client’s strengths, and not label them as mentally ill.

Do you want to be considered mentally ill? If you have a mental health diagnosis already, because you have been to counseling or psychiatric appointments in the past, find out what your diagnosis on file is. If you already have a mental health diagnosis, this may not be a concern to you, but if not, you may not want this in your medical record.

Counselors also do not like releasing information to others to protect your confidentiality. Once a claim is submitted to the insurance company, who knows how many people take a look at it and rubber stamp it while it travels through the system? If insurance pays for any counseling sessions (in network or out of network), then the insurance company has the right to audit your complete file. They can request copies of counseling notes, assessments, and other personal emotional information to determine if you really are “sick enough” to warrant their payment. They can deny services to you if they think you aren’t sick enough or if they think your counseling is not “medically necessary”.

Additionally, there are many counseling issues that are not even covered by insurance at all. Stress management and anger management are usually not covered. Marriage counseling is usually not covered. Certain medical conditions/mental health conditions may be excluded (such as attention deficit disorder or adjustment disorder). Even if your illness or disorder is covered by your insurance plan, they may limit the number of visits they will cover (sometimes only 20 per year), and they will set a maximum amount they will pay per calendar year or in your lifetime.

Additionally, counselors prefer not to have someone in the insurance company telling them how to treat their clients. Insurance companies can decide what type of counseling is covered, what diagnoses are allowed, and how many times the client needs to come before they are cured. Many counselors prefer to work directly with clients to serve their needs, without interference from an insurance company.

Using your health insurance for counseling services can also affect your security clearance, life insurance rate, employment, or future health insurance coverage.

For the above reasons, I recommend that you be informed about using health insurance for counseling. You may choose to file anyway, but be an informed consumer.

Be an informed consumer.
Know your mental health diagnosis.
Talk to your counselor about the diagnosis.
Ask your counselor about your treatment reports.
Decide if you have, or want to have, a psychiatric illness.
If you have clinical, severe depression, anxiety, or other issues, then you probably already have a diagnosis.

But if you are stressed, having relationship problems, or trying to figure out your purpose in life, your symptoms may be minor, and you may not want to have a mental health diagnosis in your records.

Once an insurance claim is submitted to your health insurance company, your diagnosis becomes part of your permanent medical record, and can affect future life insurance, preexisting conditions, or the cost of private health insurance.

Jama Thurman is a Licensed Professional Counselor in Manassas, VA. She helps teens and adults who are stressed and anxious find peace and purpose.

You can get a FREE download of her book, How to Find a Counselor at [http://www.howtofindacounselor.com]. This book will help you figure out if you need professional help, how to find it, and whether you want to use your health insurance for payment for counseling services.

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Know More About Types of Health Insurance Plans in Florida

Individual, families, groups, and businesses need customized health insurance plans to ensure that they have to spend minimum out-of-the-pocket money for their healthcare needs. With the implementation of healthcare reforms, the options for buying health insurance are widened.

With the advent of internet technology, the concept of transparency of price is gaining momentum. Insurers in Florida health insurance are facing a compelling need of price transparency when they offer health insurance quotes to their clients. At the same time, application time and waiting time for health insurance has reduced significantly as compared to earlier times.

Types of health insurance plans offered in Florida
Apart from State and Federal governments’ sponsored program including Medicare, Medicaid, etc., there is an option of buying health insurance from private companies. Like many other states, health insurance plans in Florida are offered to the residents in traditional format. These could be classified as:

1. Individual health coverage
2. Family health coverage
3. Group insurance
4. Student health coverage
5. Dental health insurance
6. Low cost insurance
7. Low-income families insurance
8. Short-term insurance
9. Small business insurance

Companies offering health insurance Florida
Below is the list of health insurance companies offering health insurance to the residents of Florida:
• Aetna
• AMS
• Assurant
• Avalon Healthcare
• AvMed Health Plans
• Blue Cross and Blue Shield
• Celtic
• Cigna
• Coventry
• Golden Rule
• Humana One
• IAC
• Solera Dental
• Vista

Types of health plans offered in Florida

A lot of consumer end up having discount coupons, which sometimes are termed as health plans; however, it needs to be understood that these discount coupons are not insurance. To buy affordable health plans in Florida, consumers need to equip themselves with proper knowledge about the same.

Traditional categorization of health coverage in Florida offers indemnity and managed care health plans. Indemnity health plans have the insured file claims for reimbursement. While managed care health plans allow the providers to file claims for the insured person.

Managed care health plans are further categorized as HMO, PPO, and POS.

Impact of the Affordable Care Act on insurance in Florida
• 290,000 small businesses in Florida will be offered tax credits for offering health coverage to their employees.
• Medicare beneficiaries in Florida will be automatically mailed a check of $250 to defray the cost of their prescription drugs.
• Early retirees will be offered reinsurance options.
• Uninsured Floridians with pre-existing condition will have a huge boost with $351 million federal dollars made available to Florida starting July 1 to provide coverage.
• Like many other states, for the first time ever, Florida will have the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.
• 8.8 million Floridians will no longer have to worry about lifetime limits on the coverage.
• Around 1.1 million individuals will not have to worry about getting dropped from coverage when they get sick.
• Children in Florida will be able to stay with their family insurance policy till the age of 26 years.

Costs involved in a health coverage plan in Florida

It is important to understand types of costs involved in a health coverage plan to make sure that Floridians have assessed everything before they finalize a health plan. We talk about the types of costs involved in a health coverage plan:

Premium-premium is the amount of money to be paid on monthly basis. Premium is the main cost that a health plan constitutes. It could vary from person to person and in plan to plan. It mainly depends on the age, gender, and health status of a consumer applying to get health coverage.

Deductible-deductible is the second major cost involved in a health plan. It is the amount of money that a consumer pays before the insurer actually begins to pay for the coverage. With higher deductibles, premium costs are reduced.

Coinsurance – coinsurance, as the name explains itself, is the amount of money that the consumer agrees to pay in percentage of the total cost of medical service after the deductible has been paid. Generally, it is usually 80/20 of the total value where 80% of the cost is paid by the insurance companies while the 20% is by the consumer.

Copay – copay is like coinsurance but it is not represented in percentage but in real value. Moreover, there is no consideration of deductibles in copays. Supposing a consumer needs to pay $70 per visit for the doctor: with copay, consumer will be paying $40 and the remaining $30 will be paid by the insurer. However, this copay facility will have some impact on the premium costs.

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