Using Health Insurance for Mental Health Services
Navigating Mental Health Services can be overwhelming. If you would like support and/or direct referrals from the CCA counseling team please call to book a consultation at 415.551.9267.
When students are referred outside the college for psychotherapy, they often have questions about how to find a therapist, how to navigate health insurance, and how to schedule the first appointment. The following are guidelines to help you.
Call a customer service insurance representative
- To determine your health insurance benefits, call the customer service number listed on the reverse side of your medical insurance card. (The number may be listed as customer service, behavioral health, or mental-health services.)
- Health insurance may cover mental health treatment, depending on your particular plan.
- Be certain to ask your insurance representative to explain your mental-health benefits to you.
Get the names of three mental-health clinicians
- Also ask the representative to guide you on how to look up mental health professionals covered by your insurance plan on your insurance carrier's website.
- Request the names of at least three mental-health clinicians in your area.
- A referral from your primary care physician may be required, or an outside referral may be acceptable.
- If a managed-care company or HMO or PPO manages your health insurance, you will likely pay a reduced copayment for seeing an approved clinician who is listed by a preferred provider.
How do I make an appointment with a therapist?
- Once you have three referral names, start by calling each mental health clinician.
- Most likely you will get an answering machine -- this is expected.
- In a couple of sentences, explain why you’re seeking treatment.
- Be concise by summarizing your situation: “I’m having some trouble in school” “I can’t concentrate and I think I’m drinking too much” or “I have an eating disorder and it’s taken over my life.”
- Clearly state your phone number twice.
- When the mental health clinician returns your call, find out if the person has experience with your particular area of concern.
- If so, then ask about insurance coverage and fees. You should expect to speak with the therapist no more than five to 10 minutes reviewing these issues.
- If you’re comfortable with the therapist’s responses, make an appointment. (It's just an appointment.)
- Feel free to interview a number of therapists until you find someone with whom you feel the most comfortable.
Other things to consider:
- Where did the therapist train? How many years has the therapist been in practice? Is the therapist certified or credentialed by any professional programs or associations? Is the therapist licensed in California?
- What kind of approach does the person use? If a specific school, such as psychodynamic, cognitive behavioral, etc., is mentioned, ask what the approach looks like in a typical session as well as expectations over the course of the work you'll do together.
- Is there an assessment / initial interview fee, and if so, is it the same as the regular fee.
- What are the clinician’s availability and scheduling options?
- Is there a fee for canceling or rescheduling an appointment?
- What’s the emergency protocol? (For example, when you’re unable to make an appointment or in case you urgently need to speak with someone.)
- Do vacation arrangements need to be made?
- Does the potential counselor run a group? (Note: Groups are typically less expensive than individual counseling and can be a great complement to one-on-one work, whether now or in the future.)
- Whether in person or on the phone, listen to your intuition as you speak with potential therapists.
- Remember psychotherapy is difficult work for most people, yet it is important you feel understood and comfortable:
- Do you feel supported?
- Do you feel heard?
- Are the office environment and surroundings comfortable?
- Do you feel a good sense of privacy exists in the office space(s)?
- Remember, in the initial stages you are collecting information to assess if the clinician is going to facilitate your process.
- You are paying for a service, so if you feel intimidated or awkward asking questions, do so anyway; recognizing a poor fit will ultimately lead to a good fit if you trust your instincts.
Who Can Prescribe Medication?
- Unless you are experiencing a fairly straightforward clinical depression or anxiety, it’s best for a psychiatrist to provide a thorough medication evaluation if you are seeking prescription medication.
- If you have an existing medical condition, always consult your health-care physician first to inquire if it might be complicating your emotional difficulties. At that point you should discuss whether seeing a psychiatrist is in order.
- Many medications and physical illnesses affect our mood. For example, diabetes is known to cause depression, and a psychiatrist can work with you successfully.
- While some psychiatrists are trained as therapists, most are not, so it is generally recommended you see a licensed practitioner (listed below) for counseling or therapy.
How do the varying titles of mental health practitioners differ?
- Psychiatrists are medical doctors who have completed a residency in psychiatry. As physicians they are able to prescribe medication and are experts in the use of medication to treat emotional distress.
- Psychiatrists also specialize in treating the medical and psychological interface between illnesses such as chronic headaches, gastrointestinal disorders, asthma, and pain -- particularly because these illnesses often have an emotional component.
- Licensed psychologists (PhDs) have a doctorate in clinical or counseling psychology. Psychologists in California have completed a minimum of six years of clinical training before licensure.
- Psychologists are trained are trained to work with individuals, couples, families, and groups and can also administer and interpret psychological tests, but they cannot prescribe medication.
- Licensed clinical social workers (LCSWs) and licensed marriage and family therapists (MFTs) hold a master’s degree and are trained to work with individuals, couples, families, and groups.
- As a requirement for licensure, they also must complete a two-year supervised clinical internship and are trained primarily in the theory and practice of therapy.
- In general, when seeking talk therapy, the specific degree may not be as important as the therapist’s years in practice and area(s) of specialty, such as training in substance abuse, expertise working with the LGBT community, eating disorders, sexual abuse, or marital counseling.
- While a new therapist may be quite competent, no substitute exists for the years of life experience and practicing therapy -- that’s why it’s called a practice.
What About Licensure?
- It is important to choose a therapist who is licensed in California. State governing boards regulate educational, licensing, and continuing education requirements, and investigate any ethical violations. These regulating agencies are there to protect you, the consumer.
- Feel free to ask about a therapist’s training, licensure, and expertise so you feel comfortable the person has the knowledge and experience to be helpful for you.
Portions of the above text are derived, with permission, from Earlham College, Columbia University, and UC Berkeley.
For more information, visit:
- Student Insurance Plan
- Bay Area Mental health and substance use resources
- 988 Suicide & Crisis Lifeline
- JED Foundation
- Seize the Awkward - created in partnership with JED, the American Foundation for Suicide Prevention, and the Ad Council. It provides warning signs that a friend is struggling, conversation starters, tips for support, and resources to get help.