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SpicewoodGroup.com Spicewood
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John T. Stallworth, J.D., Ph.D.
David S. Litton, Ph.D.
Carol Pierce-Davis, Ph.D.
Beryl Rushefsky, Ph.D.
Rebecca Redwood, LMSW-ACP
Theodore Carlos, M.A., LPC
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John T. Stallworth, J.D., Ph.D.
David S. Litton, Ph.D.
Carol Pierce-Davis, Ph.D.
Beryl Rushefsky, Ph.D.
Rebecca Redwood, LMSW-ACP
Theodore Carlos, M.A., LPC

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Complications of Using Health Insurance Benefits

There are 3 things you lose when you use health insurance...

  1. You lose privacy
  2. You lose control
  3. You lose peace of mind

Do you want other people to know what's going on with you? 

In the past, therapists only needed to provide a diagnostic code to insurance companies.  Today, they want a thorough description of your problems, history, family life, work life, and so on.  This information can be viewed by employees of both the insurance company and the managed care company.  Recent reports of disturbing breaches of privacy have caused a stir in the industry.  Someone you know could find out what's going on in your personal sessions!

Do you want someone to tell you that you can't get help when you need it?

Managed care companies can decide for you if they think your treatment is "medically necessary." Even if you feel like you need help, they can deny you the help you need.  This is because they base their decisions on formulas, not on the care of the client.  Don't be a result of a formula, take control of your health!

Do you want to be haunted by your therapy?

Many people have found that using insurance for therapy has actually cost them more money because their premiums went up after making a claim.  Life and disability insurance may be affected as well.  Even worse, background checks may include your history in therapy if you  use insurance.  The bottom line is, Big Brother is watching you if you choose to use insurance.

What costs should I expect if I use my insurance?

We have developed this list of specific questions to ask you insurance company so you can get an accurate answer to this question.  Insurance companies often directly increase you out of pocket expense by:

1. Imposing an annual deductible you must pay before they begin to reimburse

2. Increasing the size of your co-payment for each visit.

3. Reducing the number of visits allowed per year, or hiding your costs by labeling them "co-insurance" (which means you pay, not them).

The indirect means of reducing benefits paid to you include:  requiring "pre-authorization" for every 5 visits, requiring clinical information be supplied to them before they "authorize" continued therapy, making "customer service" difficult to find and time-consuming to use, and refusing to pay for service until you appeal.

What costs can I expect without health insurance?

If you are contemplating long-term, ongoing therapy, your costs might be as high as your monthly car payment for a while.

If your therapy turns out to be brief, your out of pocket costs actually may be very small.  If your in-network benefits are not much different from your non-network benefits, the actual difference between the two may be minimal.  the insurance questions should help you figure this out.

We will be glad to help you find the best solutions for your personal situation.  To find out how we can help you,
contact us today.

512-345-6781

4131 Spicewood Springs, Suite K-6, Austin, TX 78759 512-345-6781 Map to our offices 
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