Psychotherapist dropping out of plan – what now?

I just got a letter that my psychotherapist is leaving the group practice, and going on her own.  That might have been fine, but she is also dropping out of all health insurance plans.  She says she will help clients file insurance paperwork.  My plan does not cover out-of-network providers at all; it’s a strict HMO.  Is there anything I can do?  I hate to start over again with a new therapist.

Going Off the Grid

Dear Going Off the Grid,

This is a tough situation!  Therapists, especially in solo practice, are burdened by the insurance claims process and hassle.  We may hear of more and more therapists “going off the grid” and accepting only private-pay patients.

You have a few choices.  One is to beg her to join your plan.  Your plea may fall on deaf ears, but it’s worth a try.  Another choice is to see her and pay the rate.  If you have a medical reimbursement account, you can get the money from that to pay for it.  Or you could space out your visits so that you can afford to pay it.  She might be willing to offer you a payment plan.

Yet another choice is to see whether your employer has more than one plan.  At your next annual enrollment, you could choose a plan that would cover out-of-network providers.

If none of those options work, then you can ask your therapist for a referral to another provider.  She can, with your permission, forward your records to the new therapist.  It won’t be quite like starting from scratch if the new person has your records available.

Good luck!

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.