Insurance & Confidentiality

Using insurance for therapy can make mental health care more affordable, but many clients have questions about what information is shared and how coverage works. Here's what you can expect.

How Insurance Coverage Works

Insurance can help make therapy more affordable, but coverage varies depending on your specific plan and the services you receive. You may be responsible for copays, coinsurance, deductibles, or services that are not covered by your insurance provider.

Most insurance companies require a mental health diagnosis and evidence that treatment is medically necessary before they will cover therapy services. This means that a therapist must determine whether a client's symptoms meet the criteria for a diagnosable mental health condition. While many people benefit from therapy for personal growth, relationship concerns, parenting support, life transitions, or self-discovery, these concerns do not always qualify for insurance reimbursement.

A diagnosis does not define who you are. It is simply a requirement used by insurance companies to determine eligibility for coverage. My focus is always on understanding your unique experiences, strengths, and goals, not reducing your story to a diagnosis.

Before beginning therapy, it can be helpful to understand:

• Your deductible

• Copay or coinsurance amounts

• Whether preauthorization is required

• Coverage for telehealth services

• Any limits on the number of sessions covered

Ultimately, clients are responsible for understanding their insurance benefits and any costs not covered by their plan.

What Information Is Shared With Insurance?

When insurance is used, therapists are required to provide certain information to the insurance company in order to receive payment. This may include:

• Your name and identifying information

• A mental health diagnosis

• Dates of service

• Type of service provided

• Treatment goals or clinical information if requested by the insurance company

Insurance companies typically do not receive detailed notes about everything discussed in your sessions. However, they may request additional clinical information to determine medical necessity or authorize continued treatment.

What Remains Confidential?

Your privacy is important. The personal details, experiences, thoughts, and conversations shared during therapy are generally kept confidential and protected by law.

There are limited exceptions to confidentiality, including situations involving:

• Risk of serious harm to yourself or others

• Suspected abuse or neglect of a child, elder, or vulnerable adult

• Court orders or other legal requirements

• Certain insurance audits or reviews when insurance benefits are being used

These exceptions will be reviewed in greater detail during the informed consent process.

Choosing Insurance or Private Pay

Some clients choose to use insurance, while others prefer to pay privately. Paying privately may provide additional privacy because a diagnosis and treatment information are not submitted to an insurance company. Together, we can discuss which option best fits your needs and circumstances.

Questions?

If you have questions about your coverage, benefits, or confidentiality, I encourage you to reach out. I am happy to help you understand the process so you can focus on what matters most: your well-being and growth.

• Your deductible

• Copay or coinsurance amounts

• Session limits, if applicable

• Whether preauthorization is required

• Coverage for telehealth services

Ultimately, clients are responsible for understanding their insurance benefits and any costs not covered by their plan.