You may choose to have health insurance pay part of the cost of your mental health services; evaluation, counseling or psychotherapy. Insurance benefits usually are not paid until the insurance company or a “carve out” managed care organization (MCO) authorizes payment.
When you use your health insurance to help pay for psychotherapy, you must allow your therapist to give your problem a psychiatric diagnosis. You must also permit reports to the MCO about your treatment, about your progress during treatment, and about how you are functioning in many areas of your life; at work, in your family, and in your activities of daily living. All the reported information becomes part of the MCO’s records and will be included in your permanent medical record at the Medical Information Bureau, a national data bank. The information will be examined when you apply for life, disability or health insurance, and may be considered when you apply for employment, credit, loans, or a security clearance. You may be required to indicate that you were treated for a psychological condition and to allow access to this information. You may be denied insurance, employment, loan, or clearance or find your premiums for life or disability coverage are increased because of these records.
All insurance carriers claim to keep the information they receive confidential, and there are federal laws about health information release. The laws and ethics codes that apply to therapists are much more protective of your privacy than the rules that apply at present to insurance companies and MCOs. If you are concerned about who might see your records now or in the future, you should discuss this issue fully before you begin treatment and before any information is submitted to an insurance company or MCO. You should evaluate your situation carefully in regard to confidentiality. For some people and some problems, the privacy of communications to a therapist is absolutely essential. For others, their problems do not raise much concern about confidentiality. You should discuss insurance disclosure requirements with your therapist and perhaps review the disclosure forms before they are sent to your insurance company or MCO.
If you are concerned with these issues, you may have the choice of paying your therapist directly and not using your health insurance. This will create no record outside the therapist’s files. However, direct payment may not be possible if the therapist you choose is contracted with your insurance company or Managed Care Organization – such contracts usually deny therapists the right to negotiate payment privately with covered clients.
The National Petition on Privacy is co-sponsored by