Possible Complications of Using Health Insurance Benefits

There are 3 things you could lose when you use health insurance... 

1. You could lose privacy

2. You could lose control

3. You could lose peace of mind 

You could lose privacy

 In the past, therapists only needed to provide a diagnostic code to insurance companies.  They require a thorough description of your problems, history, family life, work life, and so on. Insurance companies almost always require a psychiatric diagnosis, which then becomes a permanent part of your medical history, accessible along with your non-psychological records, to any physician or hospital you authorize. This information can also be viewed by employees of both the insurance company, managed care company and sometimes by your employers. This all puts your privacy at risk.  

You could lose control over your healthcare

Insurance and managed care companies can decide if they think your treatment is "medically necessary." Even if you or I feel like you need help, they can deny paying for it. 

Company representatives who do not know either you or me, and who may be working in another state, often with the benefit of little psychological training, are empowered to make decisions about the type and amount of testing and therapy that is appropriate for you; insurance companies rarely cover an unlimited number of sessions, so that you may have to quit therapy or suddenly begin paying a much higher fee, if you wish to continue beyond their willingness to reimburse your costs. 

You could lose peace of mind.

Using your insurance company to pay for therapy can cause your premiums to go up after making a claim(s).  Life and disability insurance may be affected as well.  In addition, future employers may receive background checks that include your history in therapy if you use insurance.  

It is usually best to use cash if you can afford it. 

What costs should I expect if I use my insurance?

We have developed this list of specific questions to ask you insurance company so you can get an accurate answer to this question.  Insurance companies often directly increase you out of pocket expense by: 

1. Imposing an annual deductible you must pay before they begin to reimburse

2. Increasing the size of your co-payment for each visit.

3. Reducing the number of visits allowed per year, or hiding your costs by labeling them "co-insurance" (which means you pay, not them). 

The indirect means of reducing benefits paid to you include:  requiring "pre-authorization" for every 5 visits, requiring clinical information be supplied to them before they "authorize" continued therapy, making "customer service" difficult to find and time-consuming to use, and refusing to pay for service until you appeal. 

What costs can I expect without health insurance?

If you are contemplating long-term, ongoing therapy, your costs might be as high as your monthly car payment for a while. If your therapy turns out to be brief, your out of pocket costs actually may be very small. If your in-network benefits are not much different from your out of network benefits, the actual difference between the two may be minimal. The insurance questions listed above should help you figure this out. 

I will be glad to help you find the best solutions for your personal situation. 

The Doctor-Patient Relationship

The information on www.livemoresimply.com is for general information or educational purposes only and can in no way substitute for clinical and/or healthcare services. Visiting this website or contacting me by email, text or telephone does not constitute or establish a professional or therapeutic relationship. This can only be completed in my office and after you have completed all the necessary documents and met with me in person. Neither are Meet & Greets clinical sessions. I can not provide any clinical advise or consul during a Meet & Greet. 

If You Are Experiencing An Emergency

I am not medically trained and the limitations of my licensing require me to inform you that in an emergency -- medical, psychiatric, psychological, safety, health, welfare and/or others -- you must contact your medical doctors and/or 911 and/or the proper government authority. You should also always consider going directly to a hospital emergency room or psychiatric hospital, or calling a suicide help line like Contact Dallas at 972-233-2233. There is a list of alternatives emergency contact numbers and locations on this website at http://www.livemoresimply.com/Who_to_call_for_emergency.htm

 If You Need Medication, You Must Contact A Medical Doctor

I am not licensed or qualified to prescribe medication. I feel comfortable making suggestions to a patient’s psychiatrist or family doctor with the patient’s permission, and I will always take an active interest is what medications you take and at what dose. My treatment will not be complete without doing this. You need to clear any changes in your meds, however, with your medical doctors in advance.

 This is especially true in considering whether to stop medication abruptly, or whether to decrease or increase a dosage, as opposed to phasing out a medication, or to changing a dosage slowly over time. Abrupt changes to meds can be very dangerous and I strongly advise patients to never stop taking their medication as directed until discussing the implications with their physician in person, and until then, it is very important that patients remain on whatever medications currently prescribed.

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