Insurance & Psychotherapy: Understanding Coverage (for Clients And Practitioners) - Repost From 2018

By Author: Yourstorycounselling
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Therapy can be expensive, and often times those expenses can really add up. As a clinician in private practice I fully recognize that for many people, financial access to services is often the biggest hurdle in accessing therapy. At the same time, therapy often is an important first step for many wanting to take control of their mental health and create positive change in their lives.

Fortunately, times have changed and are continuing to change. Many Insurance policies now offer some form of therapy coverage in their plans and benefits.

For those that have insurance coverage, coverage for therapy is confusing, even for someone in the business. My hope is to help you gain some clarity in this post.

This post serves as an introduction of insurance coverage for psychotherapy purposes, I hope it can offer both Clients and Practitioners some more clarity in regards to how Psychotherapy is covered by private insurance

Unlike Medical Doctors, Psychotherapy is NOT covered by OHIP. Like many other services adjacent to Medical Health (Chiropractor, Massage, etc.) Psychotherapy ...
... is most likely covered by private insurance companies or policies.

If you’ve been doing a bit of research and digging into finding the right therapist already, you might already know about this coverage. Many therapists (including myself) ask clients to check with insurance providers themselves to find out if services are covered. Most therapists will accept payment first and provide a receipt afterwards. Client can utilize these receipts afterward with their insurance company to receive reimbursements for their sessions.

Similar to Dentists, Chiropractors, Massage Therapists, and other Health Professionals, our services are covered by private insurance companies (think Manulife, SunLife, Blue Cross, etc.).

Billing of psychotherapy services are often times fully or partially reimbursed by such companies. However unlike Dentists, Chiropractors and other Health care professionals, not many insurance companies have infrastructure for therapists to directly bill such insurance companies. Hence, why we ask clients to work with their insurance coverage without our involvement. We have found in recent years that Blue Cross has implemented bill direct. If you have insurance under Blue Cross you will most likely be able to ask your therapist to bill the insurance company directly for that appointment instead.

There are several ways psychotherapy is covered by your insurance, and the words they use here matter.

The top categories that insurance providers cover are:

Psychotherapy

Counselling

Psychological Services

Social Work

Sometimes insurance companies will specify what coverage entails, they will often state service provider credentials, this can include (but not limited to):

Registered Psychotherapists

Registered Psychologists/ Registered Psychological Associate

Registered Social Worker

Certified Canadian Counsellor

Registered Marriage and Family Therapist

Seems simple enough right? In many cases, insurance providers are clear and concrete in their policies and I have found that as therapy and counselling become more mainstream and socially accepted, insurance companies have also become more expansive in their coverage.

Now here is the tricky part, many insurance companies also simply state ‘Psychological Services’ in their policies. Always check with your service provide to confirm exactly what is covered in your policy, Insurance companies are slow to update the eligibility of policies so it is always best to call and check to ensure you know the most up to date coverage.

It seems simple right? If your coverage only allows psychologists to be covered, then you end up seeing a psychologist. Simply put that is true, but as a client it limits your search for the right therapist and the style of therapy that might best fit your needs.

Psychologists, Social Workers, and Psychotherapists are all trained with rigorous standards but have varying philosophies and approaches towards therapy. With insurance policies limited the public to only access services by psychologists, it limits the opportunity for clients to have a free choice in who they would like to choose as well as limits accessibility.

It can be pretty disappointing to finally find a therapist in the right area, with the right availability, and the right modality, only to find that your insurance won’t cover the fees. For many Registered Psychotherapists like myself, I have found a way to eliminate this barrier to access for my clients. The solution? I am supervised by a Social Worker and therefore when issuing receipts I can issue receipts showing my credentials as a Registered Psychotherapist or indicate that I am working under the supervised practice of a Social Worker.

How am I able to do so? I meet with my supervisor who is a social worker once a month to discuss cases and continue my own development and training as a therapist. Supervised practice allows me to give my clients better access to their insurance benefits without having to sacrifice their freedom to choose their own clinician. While I am no longer a student and no longer require supervision, I truly believe that my work and development as a therapist never ends and supervision allows me to stay aware and sharp in my practice.

At our clinic, most of our counsellors practice in this manner. We are either Registered Social Workers or Registered psychotherapists that work under supervision of another professional with the opposite designation. Therefore our services are then covered for insurance claims under the titles of:

Registered Psychotherapist

Certified Canadian Counsellor

Registered Social Worker

Many professionals work under supervisors of other expertise to provide a more breadth of coverage for their clients like myself. It is always best to inquire about financial and insurance coverage options prior to booking a session to avoid unwanted surprises.

Insurance is a tricky and sticky world for both clients and therapists. For many therapists our focus tends to lie in our quality of service and ability to match our skills to support client needs.

I believe that clinicians we must be more mindful of the financial barriers to access that our clients face. I whole heartedly believe that being transparent with our work and having conversations about insurance coverage and financial aid are very important aspects in fully supporting and empowering our clients.

I wrote this article in the hopes of helping both clients and therapists understand the process of insurance coverage and aid as a way to better understand and navigate the reimbursement of services. I hope that it has offered you some knowledge in better understanding how to fully utilize the psychotherapy insurance policies. Thank you for taking the time to read and process, I really do appreciate it.

I welcome members of the public and practitioners to contact me regarding any questions you may have about this article. Please feel free to share/pass this article around.

Profile photo of psychotherapist, founder and clinical director Judy LuiProfile photo of psychotherapist, founder and clinical director Judy Lui
Judy is the founder and clinical director of Your Story Counselling Services, A private practice clinic in Vaughan Ontario servicing individuals, couples, and families across the Greater Toronto Area.

As a Psychotherapist and Clinical Supervisor, Judy is passionate about creating change and making mental health services more safe and accessible to the public. Judy believes in working collaboratively with others so that they can get back to themselves and their preferred way of life and living.

To learn more about Judy and the services she offers click here.

If you have additional questions regarding the contents of this article please feel free to contact me and we will be happy to answer you.

As always, should you ever have questions or inquiries regarding counselling and the process of counselling, We offer complimentary 15 minute phone consultations. Judy can be reached by completing the contact form on our website here, by phone at 1-416-473-3333 ext. 1 or via email judy@yourstorycounselling.com

Terms and Conditions of Use:

The information provided in this article is intended to be general knowledge and does not constitute as professional advice or treatment. This information is not intended for the use of diagnosis or treatment. Please do not share or distribute this article without the proper referencing or written/verbal consent of Judy Lui. Additional information can be found at www.yourstorycounselling.com or requested via info@yourstorycounselling.com

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