Why Mental Health Practitioners Don’t Always Take Insurance (And What That Says About Our Society)
Why Don’t More Mental Health Practitioners Take Insurance?
It’s a question I hear often, especially when people are looking for mental health support and wondering how they’re going to afford it. The short answer? The system isn’t set up to make it easy for therapists to accept insurance and still provide sustainable, quality care.
So, let’s break it down.
Insurance Reimbursement: The Pay Problem
When therapists accept insurance, they agree to the reimbursement rates set by the insurance company. These rates can be so low that many therapists, especially small independent practitioners, struggle to cover their bills and sustain their practices without burning out.
Even when reimbursement comes through, it’s rarely at the full session rate. For example, if a therapist charges $140, the insurance might reimburse only $70—and that’s after hours of paperwork, phone calls, and follow-ups just to get paid.
Small, solo practitioners often don’t have the admin support to handle this. They’re juggling client care and the time-consuming tasks of submitting claims, chasing down payments, and dealing with insurance red tape—often without any help. This means spending hours on tasks that take away from what they do best: supporting their clients.
The Impact of Insurance Rules on the Therapy Process
One of the biggest challenges in working with insurance is the requirement to provide a formal diagnosis in order to be reimbursed. As a therapist, my priority is always to meet my clients where they are—especially in grief work, where every person’s experience is unique. Grief isn’t diagnosable. Unfortunately, to get reimbursed, therapists have to play by the insurance company’s rules—rules that often require a diagnosis, even when one isn’t necessary or helpful for the work at hand.
What Does This Say About Our Society?
As a society, we say mental health is important. We see the hashtags, the mental health awareness campaigns, and hear slogans. But when it comes to actually compensating mental health providers for their time, expertise, and care, the message often feels more like: “We value mental health—just not enough to pay for it.”
This disconnect between what we say and what we do sends a pretty clear message to mental health professionals: If you want to make a living in this field, you’ll have to figure it out on your own. So, many therapists choose to opt out of insurance entirely—not because they don’t care about accessibility, but because they have to care about their own survival too.
The Advocacy Piece
This is where advocacy comes in. If we truly believe mental health matters, we need to advocate for systemic changes that reflect that belief. Here are some ways we can make that happen:
Increase Reimbursement Rates: Insurance companies need to reimburse therapists at rates that reflect the value of their work. Period.
Streamline the Process: Let’s make it easier for therapists to file claims and get reimbursed without jumping through endless hoops.
Shift the Narrative: Mental health is healthcare. Full stop. And the people providing that care deserve to be compensated accordingly.
This isn’t just about therapists being able to make a living (though that’s important!). It’s about creating a system where more practitioners can accept insurance without sacrificing their well-being—and, in turn, offer accessible care to more people.
What You Can Do
If you’re reading this and feeling frustrated (because, yeah, this is a frustrating topic), there are ways to help. Advocate for mental health parity laws that hold insurance companies accountable. Support organizations working to improve access to care.
We need a cultural shift—a move from talking about how much we value mental health to actually showing it in the way we treat practitioners. Because when mental health professionals are supported, we all benefit.
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