I hit “send” on several emails to potential therapists around 11:50 p.m. on Dec. 31. After bailing on New Year’s Eve plans with friends in favor of spending the evening with two uninvited guests — anxiety and depression — I figured that there was no better time to peruse my health insurance website and try to set up an appointment for the beginning of the year.
Initially, I was hopeful. There seemed like a lot of decent options. But I quickly found out that just because a therapist is listed as being in-network, it doesn’t mean that they are currently accepting new clients. Thankfully, I found one who was able to squeeze me in and was in-network, but given my pop-culture knowledge that New York City is the therapy capital of the world (some people even have multiple therapists!) this process was much harder than I expected.
Turns out, it’s not just me. An article in Vice’s new health vertical Tonic discusses this obstacle to affordable mental health care, including the fact that doctors and therapists don’t always know which plans they belong to because of complex and ever-changing contracts with insurance companies.
So if insurance companies keeping provider databases up to date is the problem, shouldn’t we be able to fix it? Apparently, this is easier said than done, as insurance plans rely on providers for updates, and providers aren’t always clear on their network plans.
There’s also the fact that the current system doesn’t make it easy for therapists to become in-network providers. For Anna Eckhardt, an licensed and certified social worker trained in eye movement desensitization and reprocessing trauma therapy in private practice, the low insurance reimbursement per patient coupled with time-consuming paperwork to submit to insurance companies followed by a wait for payments does not make being part of insurance panels as an in-network provider very appealing.
This becomes even more complicated for therapists like Eckhardt who have a specific niche, and therefore need constant training to develop the specific skills necessary for working with people with trauma. Between the continuous training, rent, malpractice and liability insurance and yearly dues for maintaining licenses and certifications, many therapists find that they need to charge more than what the insurance companies reimburse just to stay financially afloat.
Having said that, many providers like Eckhardt will help people submit to their insurance companies if they have out-of-network coverage.
I’m fortunate that my late-night New Year’s Eve message turned into a great working relationship with an in-network therapist, but realize that other people aren’t as lucky. In the meantime, here’s hoping for more streamlined easy-to-navigate plans for both clients and providers.