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"I'm thinking of using my insurance benefits.
Are there advantages and disadvantages?"
Absolutely. Here are some pro's and con's that
I've encountered:
Pros C
-
Money: you only pay your copay, if you have
one
-
It can provide structure in that sessions will
be limited
-
Referrals will be to in-network providers whose
credentials have been verified
-
Increased coordination of with prescribing provider
(which is expected)
-
When care is not approved, there is usually
an appeal process (depending on policy).
Cons D
-
Limited sessions
-
Benefit limits depend on the policy your employer
has purchased
-
You may not have out-of-network benefits so
have to see only in-network providers
-
Care usually has to be pre-approved
-
You have to be given a diagnosis in order for
the provider to get reimbursed; The diagnosis can follow you and some people have had trouble getting self-employed coverage
later;
-
There may be no in-network providers in the
network with your needed specialty; if you want to used a specialist, you may have to fight for it (appeal)
-
In-network providers may not be conveniently
located
-
Available appointment times might not fit your
schedule (but this can happen with any provider)
-
Confidentiality is limited: details about your
problem and treatment course have to be given to the managed care representative (but not therapy notes)
-
Your provider may feel “inconvenienced”
by needing to authorize more care, and may be reluctant to do so
- Non-approved and non-authorized care will not
be covered.
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