Affirmative Heart Counseling | Therapy that's a work of heart

Why Michelle Doesn’t Take Insurance – Affirmative Heart Counseling | Michelle Martinez, LMHC

When seeking therapy, one of the first questions you may have is about the cost and how insurance can offset this. As a mental health professional, I have made the conscious decision not to accept insurance. I realize this decision may bring up questions and concerns, so I want to provide a clear explanation as to why this is the case and how it ultimately benefits the therapeutic process.

Control Over Therapy

Insurance companies often require a mental health diagnosis to cover therapy costs. This necessity can inadvertently pathologize clients who are simply seeking support or growth. Not accepting insurance allows me to work with you based on your individual needs and goals, rather than trying to fit our sessions into a predefined category of a diagnosis. This autonomy means that our therapeutic journey will be paced and oriented by your unique process and not dictated by an insurance company’s policy.

Confidentiality and Privacy

By not involving insurance companies, I can offer a higher level of confidentiality. Insurance companies require access to your records to verify the services provided, which means sharing detailed notes about our sessions. Choosing to pay out-of-pocket ensures your information remains confidential between us, offering peace of mind and trust in the therapy process.

Consistency and Flexibility

Insurance plans often limit the number of sessions they cover. This restriction can lead to an abrupt end to therapy, even if you’re still benefiting from our work together. Out-of-pocket payment allows us to determine the length of therapy based on your needs, and not on an arbitrary limit set by an insurance company.

Potential for Reimbursement

While I am an out-of-network provider, you may still be eligible for reimbursement from your insurance company. Many insurance plans offer out-of-network benefits. I can provide a detailed receipt known as a “superbill” that you can submit to your insurance for potential reimbursement. *Please note, however, that I will not directly interface with your insurance company if you choose to pursue this. You will be responsible for negotiating with them about your reimbursement. I also will not spend time in excess of 20 minutes putting together additional documentation and justifications, should they request that.

Commitment to Your Care

Choosing to forgo insurance involvement is part of my commitment to providing personalized, quality mental health care. This approach allows me to focus on you as a unique individual and create a treatment plan that resonates with your specific needs and aspirations. My commitment is to make our therapeutic relationship a place where you can experience growth, self-understanding, and emotional healing at your own pace and in your own way.

I understand this decision may impact the affordability of therapy. I have dedicated 50% of my caseload to sliding scale spots for this reason. However, current utilization is actually over 50% and I cannot accept any new clients at sliding scale rates for the foreseeable future.