A Therapist Who Takes Insurance

Finding a therapist who accepts insurance was difficult prior to the pandemic. According to therapists and patients, an increase in the demand for mental-health care is making the search even more difficult.

Molly Pratt, a 30-year-old math teacher in Boston, says she called many neighbouring therapists when she was depressed a few years ago, but they didn’t take her insurance plan. She attempted a handful that were labelled as in-network on her insurer’s website. One did not return my call. Another stated that she no longer accepted Ms. Pratt’s insurance. And a third didn’t fit into her timetable.

“I wasn’t in a good mood. “Every day that I didn’t visit a therapist felt much more urgent,” Ms. Pratt adds.

Demand for mental-health care is so high, especially in large areas like Los Angeles, New York, and Washington, D.C., that many skilled therapists refuse to accept any insurance coverage, they say. They argue that they can easily fill their practises with people who will pay out of pocket. Therapists who accept insurance are frequently scheduled. Furthermore, there are very few mental-health professionals in many smaller towns and rural areas. Finding a provider who accepts insurance or lowering your fees in other ways is doable, but it typically necessitates homework, which can be exhausting when you are already dealing with mental-health concerns.

Paying for individual weekly counselling out of pocket can cost thousands of dollars per year. In major cities, qualified clinical psychologists can charge up to $300 for a 45-minute appointment. According to Anna Mangum, deputy director of programmes at the National Association of Social Workers, the usual charge for a session with a licenced clinical social worker is between $120 and $180. Patients with out-of-network benefits may be eligible for partial bill reimbursement. However, when consumers use in-network providers, they frequently just have to pay a minimal copay.

Psychologists, social workers, and psychiatrists who do not accept insurance claim that the payment rates set by insurers are too low. According to Ms. Mangum, insurance companies typically pay social workers one-third to one-half of the cost they can charge out of pocket. Some therapists also express dissatisfaction with the paperwork and limitations on the types of service that are covered.
“If you’re competent enough, have excellent enough promotion, and are in demand,” says Ken Goodman, a certified clinical social worker in Los Angeles and board member of the Anxiety & Depression Association of America.”

Obstacles to Obtaining a Therapist

According to the National Alliance on Mental Illness, a national mental-health advocacy group, approximately 34% of people with private insurance reported difficulty finding a therapist who would accept their coverage, according to the most recent data available from a 2016 survey of more than 3,100 participants. In comparison, only 9% indicated it was difficult to find an in-network primary-care provider.

According to a 2019 analysis from Milliman, a consulting firm that reviewed insurance-claims data, office visits to mental-health physicians are more than five times more likely to be out of network than visits to primary-care providers. According to the Milliman analysis, 17.2 percent of mental-health office visits in 2017 were out of network, compared to 3.2 percent of primary-care visits.