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Tattoos and Insurance: Making Long-term Choices You Can Live With

Posted by on Feb 22, 2013 in Positive Steps | 1 comment

Tattoos and Insurance: Making Long-term Choices You Can Live With

People seeking counseling are sometimes surprised to learn that their health insurance does not cover mental health. We hear it all the time. People we encounter scratch their heads and ask, “What good is all this insurance I’m paying for, when it doesn’t even cover my care when I need it? After all we pay for this, shouldn’t we receive benefits?” There’s no doubt, the realities of insurance in our day and age can be frustrating.

We’re Covered, Yes?

Health insurance—when it covers counseling at all—generally only provides benefits for individuals seeking individual treatment. They don’t cover couples. They don’t cover families. They don’t cover relationships. Of course, this is extremely disappointing, because the research is clear that the quality of our relationships is an enormous factor in our overall health and quality of life. Moreover, it’s proven that relationships tend to respond very well to professional counseling.

But this is not to say that couples and family counseling is never paid for with insurance benefits. Sometimes it is, but getting your insurance to pay is a bit tricky. The first hurdle you have to overcome is finding a therapist who is willing to commit fraud and say that the counseling will be for individual care, when in fact, it is not. The dilemma is this: In order to submit a claim, your counselor must submit the claim under the name of one—and only one—of the people seeking counseling. A technicality, perhaps, but it is not a technicality without implications.

Like a Tattoo

The first implication to consider when using insurance to pay for counseling is the permanent nature of the diagnosis that gets attached to the claim. When a claim is filed for services, insurance companies request a great deal of information about you in order to determine if the procedure (in this case counseling) is medically necessary and, therefore, qualifies for coverage. At the time of the claim’s submission, the insurance company will require your counselor to provide a diagnosis for you. This diagnosis is a label describing the mental health condition for which you are seeking treatment.

While your counselor will be very concerned about providing an accurate diagnosis that will justify therapeutic treatment, the label that goes into your permanent file with the insurance company will come from the manual that professional therapists use to diagnose mental illnesses (The DSM-V). That label is selected from hundreds of possible diagnoses that range in kind and severity, but they include labels such as “Personality Disorder,” “Chemical Dependency,” and “Schizophrenia.” Whatever label your counselor is forced to submit, it is important for you to know exactly what that label is and what it means. According to Therapist Consultants (September 2012), “On average, 12-14 individuals will view a client’s diagnosis during insurance processing.” Like a tattoo, this label is going to follow you for the rest of your life. At Positive Steps, we get especially nervous when these diagnoses are being submitted for children.

What we want all of our clients to realize is that your personal and private information (including a diagnosis), often not just about you but about your entire family (parents, siblings, your children, etc.), is collected by your insurance company and is entered into a permanent database that is available to the entire insurance industry—not just for this instance of care, not just for a year, not even for the duration of your time with your current insurance company—but…forever.

One Comment

  1. Very interesting!