You may want to use your insurance to cover the costs of counseling, or you may decide to pay out of pocket. Since the best decision is an informed decision, below is important information about the risks and benefits of using insurance to cover costs of your mental health care.

Benefits of Using Insurance:

You pay premiums for your insurance so it’s nice to be able to use it help defray the costs of counseling. In addition, some insurances or HMO’s will cover a significant portion of counseling costs, saving you money.

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Risks of Using Insurance:

You will be diagnosed with a mental illness, which becomes part of your permanent medical record.

Before your insurance company will cover your counseling expenses, you must be diagnosed with a mental illness as listed in the Diagnostic and Statistical Manual. This means that even if you come to counseling with “life issues”, you will leave diagnosed with a mental illness. At Full Circle we will be happy to discuss this with you and work with you to ensure you are aware of and comfortable with the process and impact of a mental health diagnosis. In these uncertain political times, in which pre-existing conditions could become an issue once again in obtaining and paying for health insurance, a diagnosis could carry additional weight for you down the road. 

Your personal information can not be guaranteed confidential.

When using your insurance, biographical information and your diagnosis will be entered into the computer network of a clearing house or billing company. It will then be forwarded to your insurance company’s computer network in order to pay for treatment. In this internet age, no computerized information can be considered completely confidential.

Insurance companies can also audit counselors or their practices who are in network/contracted with them; this gives insurance companies the right to view the contents of your entire counseling file, including detailed progress notes.  The only files that can be exempt from such an audit are those that are private pay.

As you can see, your personal information can not be guaranteed 100% confidential when using your insurance benefits to pay for counseling.

Your insurance company, not you, will be in charge of your counseling process.

In addition, insurance companies can, at any time, call your counselor to conduct a “clinical review” in order to confirm medical necessity of your counseling sessions. During that review details about your personal issues, your diagnoses, your medications, your treatment process and progress and any other information requested are all shared with the insurance company.  At times, insurance companies decide after such a review that your counseling services are not medically necessary and may discontinue or limit coverage.

Full Circle is an in-network provider for the following insurances and can accept all other insurances on an out-of-network basis.

  • Blue Cross Blue Shield
  • United Health
  • WPS
  • Humana
  • Galaxy Health Network
  • Health EOS
  • Health Payors Organization
  • Plan Care America
  • Prime Health Services
  • Star Healthcare Network
  • ThedaCare EE Benefit Plan
  • Arise
  • Three Rivers Provider Network