Currently, I am a “participating provider” with most of the plans offered by Excellus Blue Cross/Blue Shield, Empire Plan/Beacon Health Options (formerly Value Options), Aetna, MultiPlan (Ithaca College insurance), and Medicare. Many other insurance companies provide some payments to out-of-network providers, but how much out-of-network coverage they provide varies widely. I may apply to other insurance companies to join their networks; call my office to check on my current status with your insurance company. I do not plan to become a participating provider with Medicaid.

If you wish to use your health insurance for your counseling, George will check with your insurance plan to find out whether the plan will pay for therapy with me, what its coverage rates will be, and what portions of the rate you would be responsible for. In order for me to be “in network” with any insurance company, I have to agree to accept their reimbursement rate as full payment, even though it is generally less than my published fee, and I must “write off” the difference. In order to cover my expenses, I cannot accept less than $70/session, so if your insurance plan reimburses at less than that amount, you will not be able to work with me using your insurance. In that case, you can decide whether to pay for my services out of pocket, or to seek services elsewhere.

Most clients prefer to use their health insurance for their sessions with me. However, there are risks as well as benefits associated with using health insurance. Insurance companies only reimburse for psychotherapy when you have been assigned at least one reimbursable mental health diagnosis. You may prefer to avoid being labeled with a diagnosed “mental illness.” In addition, insurance companies decide which “illnesses” they will cover, and they do not reimburse all conditions that may be the focus of psychotherapy (such as relationship conflict and bereavement). Some insurance plans may limit how many sessions per year you are allowed. Also, you may prefer to avoid the risk of “having a paper trail.” Submitting a mental health invoice for reimbursement carries some risk to confidentiality, privacy, or future eligibility to obtain health or life insurance or to obtain certain types of employment. When I submit a claim to your insurance company in order to get paid by them, I must communicate your diagnosis, the date and length of our appointments, and what services were provided. Some insurance plans may also require me to send regular reports regarding your progress. While insurance companies claim to keep this information confidential, I have no control over the information once it leaves my office. I will not charge you for my time spent making routine reports to your insurance company. However, I will have to bill you for any extra-long or complex reports the company might require. The insurance company will not cover this fee.

Two “silver linings of the cloud” of using health insurance are that your cost for each therapy session is generally less than if you were paying out of pocket, and if you itemize deductions on your tax return, fees you pay for therapy services that are not reimbursed by insurance may be deductible as medical expenses.