Marriage Counseling - Should Health Insurance Pay For Your Marriage Therapy (And Why Not)?

Jan. 27, 2010 - PRLog -- Couples in counseling are often shocked to find out that their health insurance does not cover marriage counseling. In fact, health insurance only provides coverage for individual counseling. If couples counseling is to be paid for by your health insurance company, the counselor must commit fraud. In order to submit a claim that will be covered, the counselor must make the claim under the name of one and only one of the spouses or not make a claim at all. Otherwise, the couple must pay for the counseling out-of-pocket.

In my opinion, marriage counseling, and all counseling should not be submitted to health insurance for payment. As a marriage counselor in Overland Park, Kansas, I have not had anything to do with submitting claims to insurance companies for nearly a decade.

There are two primary reasons for this. First, when a claim is filed for services, the insurance company requests a great deal of information about the client in order to determine if the procedure (in this case counseling) is "medically necessary" and therefore, qualifies for payment. What most people don't realize is that all of that personal, private information, often not just about the person him or herself, but their family, is collected by the insurance company, codified and submitted to databanks that are available to anyone in the insurance industry. And it stays there indefinitely. The personal information does not expire after a certain time period, as does credit bureau information.

What this means is this personal and sensitive information is available to be taken into account in the future when this client makes a request for any other kind of insurance. Not only that, but the same personal information can and is used to determine disability coverage, life insurance coverage, security clearances, and job qualifications. For me, this breach of privacy is not worth using insurance reimbursement for counseling, marriage or otherwise.

Secondly, once the insurance companies are brought into the reimbursement process for counseling, they will determine how much and what kind of counseling is necessary, or when payment should stop. Generally speaking, these decisions about how much counseling a client should receive is made by staffers in the insurance company who have no clinical experience or direct knowledge of the clients needs. Generally speaking, the therapist has little to say about this finalizing decision. So, again, in my opinion, this loss of control over the counseling process is not worth what little bit the insurance company will provide to cover counseling.

No. If at all possible, get your marriage counseling paid for without using your insurance coverage. As a here is no justifiable reason that counseling should even qualify under health insurance reimbursement procedures.

Dentistry rarely is covered by health insurance. Accounting and legal services are not covered by insurance. Many health procedures that people use to sustain quality living, such as massage, spa treatments, yoga, meditation, and nutritional consultation are not covered by health insurance. People don't even think about insurance coverage when they procure these kind of services. As a result, privacy in these areas of service is protected and control over the services is retained by the provider and consumer, as it should be.

I use several ways of enabling my clients and me to come to agreeable compromises around paying for counseling without using health insurance coverage. I use credit cards. I negotiate fees down to a given minimum. I have an advance purchase program whereby clients receive up to a 25% discount depending upon the number of sessions they purchase in advance.

Visit us online at : http://betterlifeinformation.com/