When a client comes to see me for a free consultation, inevitably the question gets asked:

​Many people don't realize that in order to use your mental health insurance benefits you have to be diagnosed with an illness. Insurance companies call this "medical necessity" and if you and I can't prove to the insurance company that you need the treatment you are seeking, they can deny your request to use your insurance.

Even if you made it past the initial request, I would have to consistently prove to your insurance company that it was important for me to continue to see you, otherwise they may deny you further sessions.

​Beyond that, all diagnoses go on your medical record and could be considered pre-existing conditions in the years to come.

Pre-existing conditions can have a significant impact on your ability to secure any health insurance coverage in the future. And even if you are able to obtain insurance with a diagnosis on your record, your insurance premiums, deductibles, and co-pays are likely to be much higher, as protections for pre-existing conditions have been, to say the least, scaled back.

​I don't want to take that kind of risk with your well-being.

​Did you know the average insurance claim passes through fourteen people on its way to being approved?

Fourteen people...

Now remember, in order to use your insurance, I have to diagnose you with a condition relevant to the treatment you would receive from me. That means upwards of fourteen people could find out that you're suffering from a sexual dysfunction, are struggling with a sexual concern, or have a problem in your marriage or partnership.

It's embarrassing enough to have to reach out and talk to someone about your concerns, and the last thing I want is for everyone at your insurance company to know your problems and be the judge of when you should stop seeing me.

And ultimately, if I take your insurance directly, that's what they would do.

​Talk about a lack of control over your own situation.

​More often than not, couples and relationship counseling is not covered when you use your insurance.

I know a lot of insurance companies say they cover couples or relationship therapy, but there is no such thing as a couple's therapy code for insurance claims, nor is there a diagnosis I could give a couple that would qualify for mental health treatment.

What insurance companies really mean is the person who gets a diagnosis for an individual mental health concern can have their partner present in session while we work on their diagnosis.

But sometimes, even if you meet all the criteria to have your partner present while we work on your depression, low libido, or erectile dysfunction, having your partner in session may not be considered "medically necessary" and so your claim for couples therapy would be denied.

​I get that you're frustrated, and until I feel that the insurance companies I might contract with are safeguarding your mental health and allowing us to do the work we need to do, I won't be taking your insurance directly.

But let's look at the positives! Not a lot of people realize that, because I don't take insurance right now, I can do a lot of amazing things like:

• Give every one of my clients personalized attention and be 
• Offer 85-minute sessions (seriously, your insurance would never cover that)
• Go to cool trainings regularly to become a better and more experienced therapist

And it's all because I don't have to spend my off hours talking to insurance companies and seeing people who aren't committed to doing the hard work of therapy.

​Right now, I do not take insurance plans directly, but you have options if you want to see me and possibly use your insurance benefits:

I take cash, cards and checks for all services.

I am able to take Flexible Spending Account cards and Health Savings Account cards.

• I will provide you with documentation of services for your records after each session if you choose to use your FSA or HSA to cover my services. I will provide the appropriate documentaion through your client portal, which is the most secure way of receiving forms from me with your personal health information on them. Sometimes 85-minute sessions are not covered on your insurance plan, so be sure to check with your plan if that length of time for sessions is something you are interested in.

​
​While being an out-of-network provider for all insurance plans means I do not file with your insurance directly, I can provide you with what is called a superbill, which you can submit to your insurance for potential out-of-network reimbursement.
But be warned that:

• There are times where couples therapy is not eligible for reimbursement
• HMO plans do not provide out-of-network coverage
• And if you have a high deductible, your deductible will need to be met before you are eligible to receive reimbursement.

If you want to try to use some of your insurance benefits for my services, the best thing you can do is call your health insurance company and ask about reimbursement for outpatient mental health services with out-of-network therapists.

I hope that spending some time explaining why I do not take insurance right now was helpful and informative. If you have any questions about it, please feel free to email or call me with further questions. I would also recommend checking out my Fees & Insurance page for my current rates.

If you think you may be ready to take the leap into therapy with me, head on over to my Contact page.

You’re having trouble maintaining an erection or you don’t feel lubricated enough to make penetration pleasurable and it’s starting to kill your desire for sex.

Before you throw in the towel, it could be helpful to check out some contributing factors to a lack of arousal and some things you can do about it:​

I know I said that stress interferes with desire, but it also interferes with your body’s physical responses too.

If you’re afraid of getting an infection, getting pregnant, you have a looming deadline at work, you and your partner have been fighting, whatever, your body is going to be expending precious time and energy on these problems over getting you physically ready for sex.

Some would describe it as an evolutionary mechanism we developed to keep us alive.

Think about it, our ancestors had to prioritize running away from that lion over having sex (in order to keep having more sex…).

We may not have to worry about lions anymore, but chronic stress and anxiety produce the same physical reactions in people. Your adrenaline and cortisol levels go up when you start fighting with your partner or realize that your big project is due at 8am tomorrow morning.

As mentioned in the previous post, if stress is impacting your physiological ability to become aroused you should consider:

• Exercising, even once a week for 30 minutes is better than nothing!
• Getting 7-8 hours of sleep
• Eating fruits, vegetables and other nutritious foods
• Staying hydrated
• Doing things that relax you, like meditating, getting a massage or spending time with friends

These things will help balance out your hormones and make it easier to put fears aside when you want to make time for sex.