Can I use my health insurance to pay my bill?

The best answer is “it depends.”

There are a few things that factor into whether you can use your health insurance to offset the cost of your services. One factor is whether you are interested in “therapy” services or “coaching” services.   DC and MD state regulations define therapy as the diagnosis and treatment of a mental and/or emotional disorder.  Therapy  therefore, requires the diagnosis and treatment of a mental illness.  Because medical insurance covers the treatment of medical disorders, all insurance companies require that the clinician provide a diagnosis for each therapy session in order to provide payment for services rendered.  In fact, the insurance company will not reimburse the clinician for therapy services without a mental health diagnosis reported on the insurance claim form.  (Many mental health practitioners do not inform patients of this requirement.)  This requirement may not pose a problem for many clients; however, some professions do require the mandatory reporting of participation in mental health treatment.  Although, HIPPA laws may protect the content of therapy sessions, some professions require that clients report their participation in mental health treatment.   If you see a mental health professional (ie. a therapist, psychologist, social worker, psychiatrist, counselor, etc.) for services and use your health insurance benefits to offset the costs, there is a permanent transactional record that you have been diagnosed with a mental illness and have received mental health services.  For this reason, many clients prefer to cover the cost of their sessions, personally maintaining as much privacy and autonomy  as possible.

Life and/or relationship coaching is the best fit for clients who do not have a mental health diagnosis.  Conflict and misalignment are occur periodically in all of our lives. Used properly, challenges offer opportunities for greater self-awareness, intimacy and growth.  Coaching allows clients to glean from expert skill and training in conflict resolution, problem solving, communication skills, goal setting, solution-focused strategies and more; however, coaching does not involve the diagnosis and treatment of mental illness.  Coaching situations that individuals and couples experience when no medical disorder is involved.  If you (and/or your partner) are dealing with life challenges, and you do not suspect the presence of a mental illness, then “coaching” services are likely best suited for you.  However, because medical  health insurance is intended to address medical health issues, health insurance can only be used to offset the cost of “therapy” services.  Using health insurance is not an available option to cover the cost of coaching services.   

We are hopeful that antiquated stigmas associated with seeing a mental health professional have generally dissipated within our culture allowing clients the freedom to pursue mental health services whenever needed.  However, some clients who  question whether a mental health diagnosis could be unhelpful.  for instance, in some cases, clients’ whose professions require a security clearance, have questioned whether a mental health diagnosis would have a negative impact on employment options and assignments.  In other cases, some clients who are actively considering divorce, have questioned whether a mental health diagnosis could influence issues related to child custody, etc.  Answers to these questions may be best answered by employment and legal attorneys.  At Sonja Williams and Associates, we believe that if mental health services are needed (and cost is a factor), then reporting requirements and/or concerns about stigma should not be a hindrance to improved health and/or creating a better quality of life.  if you need mental health (therapy) services, then the use of health insurance can be helpful.  We offer private, professional and personal therapy services aimed at facilitating livable solutions and the best quality of life possible.


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