Does Insurance Cover The Cost Of Marriage Counseling?

It’s important to note that more and more, many therapists are not taking private insurance. Unfortunately, with new health care reforms it can take months to be reimbursed by insurance companies. Despite health care reform many insurance companies have not raised their reimbursement rates for the past 20 years resulting in therapists working for just a fraction of their actual fee schedule when they accept insurance. Because recovering fees through insurance billing can cost a therapist more time which tends to not be worth the return, most professionals put the burden of seeking reimbursement back on the couple, and require full payment prior to services.

Because many couples who have insurance benefits which cover counseling assume they will be able to find a therapist who takes insurance, they may be hesitant to try a model of psycho-educational support that is not covered by insurance.

Making relationship repair expertise affordable is one of my core service values.

Looking for a provider who accepts insurance may sound like a great idea – in fact, on the surface can sounds like the best of both worlds – you get help but you don’t have to pay for it. You will have to pay and it could be more costly than you thought.

 

Insurance Coverage for Marriage Counseling has its Disadvantages

 

The truth is there are some disadvantages – the biggest impairment is having a psychiatric disorder noted on your medical record.  

Since when is marriage difficulty a mental disorder? It’s not. Marital conflict isn’t considered a condition that is “medically necessary” to treat.

In order for insurance to cover the cost of your sessions either you or your partner will need to be identified for treatment under criteria for a mental health disorder. The most common diagnosis for insurance to cover marital counseling is “Depression”, “Anxiety” or “Adjustment Disorder.” While benign as a diagnosis, any of these labels can haunt you during future applications for entrance to colleges and universities, insurance and employment. Some careers require full disclosure of your mental health and psychological conditions (law enforcement, security positions, airline pilots, doctors, lawyers, or those positions requiring bonding.) Given the state of this world, it is routine in the background check processes of most employers to check mental health records.

In her book, Don’t Shrink To Fit! A Confrontation with Dehumanization in Psychiatry and Psychology,  Eileen Walkenstein, M.D., a psychiatrist, says “A psychiatric diagnosis is like a jail sentence, a permanent mark on your record that follows you wherever you go” .

In the August 1990 issue of Consumer Reports, an article titled “The Crisis in Health Insurance ” exposed the difficulty of getting a health insurance policy after having sought psychiatric or psychological “therapy” or even marriage counselling. “Virtually no commercial carriers and only a handful of Blue Cross and Blue Shield insurance plans will sell policies to anyone who has had heart disease, internal cancer, diabetes, strokes, adrenal disorders, epilepsy, or ulcerative colitis. Treatment for alcohol and substance abuse, depression, or even visits to a marriage counselor can also mean a rejection. If you have less serious conditions, you may get coverage, but on unfavorable terms” (p. 540).

How will they know? According to LegalZoom.

“The federal Health Insurance Portability and Accountability Act (HIPAA) has set a national standard for the handling of     electronically stored medical records by health care providers, health plans, and health clearinghouses. Notably, your financial records, your child’s school records, and your employment files are not included under the HIPAA protection.

Under the HIPAA, individuals have to sign a Notice of Privacy Practices from health care providers, which outlines the provider’s privacy policies. After this notice is signed, your medical records can be disclosed for “routine” purposes without any further consent or notification on your part.”

Your medical records, complete with a psychiatric diagnosis, can be released without your consent to people with whom you would not necessarily share the intimate details of your private life.

Confidentiality can also be breached when the therapist you select is an in-network provider for your insurance company. Oftentimes, insurance companies require the content of the sessions be reported. This can be particularly bothersome for some people if they are discussing issues regarding substance abuse, sexual issues, or other issues they would rather keep private within the confines of the counseling office walls.

Many insurance policies put a cap on the number of sessions they will pay the therapist for as well as the amount of money they will reimburse. Because many couples tend to put off seeking help until unresourceful patterns of communication and interaction have been well established, it may take a therapist more than the allotted number of sessions to change the couple’s relational style. When couples are forced by their insurance to end their sessions they may falsely conclude that marriage counseling doesn’t work. This causes couples to give up and lose hope for their relationship prematurely.

There is also a stigma attached to a label applied by a therapist. The person receiving the diagnosis can, even when you understand the purpose of labeling, be seen as the “one with the problem” in the relationship. If both partners buy into the diagnoses it could greatly impair the ability of the relationship to be repaired and the couple to achieve their goal of marital bliss.

My goal in our work together is to assist you in making fast, effective and lasting change using the Strategic Intervention Model and other evidence-based-techniques. Because change can take place in an instant – repairing your broken relationship won’t break your bank.