A very frequent question I am asked by a new client inquiry is “Do you take [plan name] insurance?”

I understand that times have been tough and everyone wants to save money and benefit from their insurance plan.  I know I do, when I need professional services myself.  Insurance helps us get access to the professionals we need, from doctors, to therapists, to chiropractic, to physical therapy. 

But, like most advanced psychotherapists (18 years experience), I don’t participate in “HMO”‘-style insurance panels for a number of reasons, that affect both of us:

First, using HMO insurance involves a third party in the relationship between me and you.  I don’t like this; I feel that the information you share with me, and our working relationship in sessions, should be fully confidential and private.  A big, rich insurance company has no business in our work; it’s none of their business.  However, in an HMO situation, while you might only have a small co-payment, the insurance company will demand asking (and receiving) regular “clinical updates” on your progress in therapy, in essence to determine how fast they can stop paying, whether you and I think you’re ready to stop or not.  Not only can they demand your diagnostic code (which even PPO insurance demands), but they can demand details of your symptoms and other very personal information on regular “treatment reports” that I don’t think is appropriate, which countless insurance company employees might see.  I find that creepy. 

Second, insurance companies are out to make a profit — and they make billions in profit — and yet they actually pay very little to therapists on HMO plans.  They often pay a maximum of $45 per session, while they require their patient to pay a co-payment of $20-30.  This sounds like a great deal for the patient, except that for me to be available to see you in a private practice office setting, and with my years of advanced education, experience, specialization in gay men’s mental health, and a very costly overhead to run a private office (you’d be surprised how many costs there are), I need to make a living, just like you.  That $60-70 per session would not allow me to run my office and be available to you at the specialized level I want to give you, and allow me the standard of living that I believe appropriate for an advanced professional.   (By contrast, personal fitness trainers with nearly no advanced education, make on average about $85 per session, several times a week, and “life coaches”, with sometimes no education beyond high school and certainly no state-sponsored credentials (such as a license) can charge up to $150 per session or more — with no formal oversight to protect consumers, like licensed psychotherapists have, by a state board with very strict standards. )

So, I prefer that you and I create a private-hire professional relationship, and “cut out the Middle Man” of HMO-style insurance companies.  I can provide you a receipt at each session with the date of the session and just the diagnosis code (that’s required) for you to just mail in to your insurance company, as long as you have a “PPO”-style plan.  Then, after your  annual deductible is met, you would get a reimbursement check mailed directly to you, according to your plan’s terms. 

Your out-of-pocket costs might also be deductible from your taxes as a business expense if we are doing more “business coaching”-style work. 

You also need to consider the value of therapy to you.  If you ever feel that you are not getting value for the money you spend hiring me privately, we can talk about that, and see how I can be more attentive to your needs.  But hopefully the money you invest in therapy is helping you to earn more in your career, get more satisfaction from your relationships, support your health, improve your mood and outlook, and solve the problems that bother you the most.  I think you’ll find that’s worth the investment.