Many clients find us after searching for care for a long, long time. If you’re reading this, chances are you’ve either struggled to find a therapist who takes your insurance, or you recently learned that your therapist no longer works with your plan.

Many people in need of care are getting caught in the middle of an ongoing, mostly invisible conflict between therapists and insurance companies. We believe having more information about this conflict can empower clients and improve the chances of you getting the care you need and deserve.

The bottom line: Insurance companies are for-profit businesses. If you use the insurance you’re paying for, you are reducing the insurance company’s profit. Therefore, it is in the best interest of the shareholders for the plans to make it difficult and expensive for you to obtain care. There are several ways this occurs.

  1. Many people have very high deductibles that must be met before insurance will pay for services. If you are using insurance, providers are contractually not allowed to reduce the contracted fee. The same goes for copays, which are increasingly unaffordable. Some clients reduce the care they need due to financial constraints and a desire to avoid debt.

  2. Insurance companies often delay payments for inscrutable reasons, create administrative burdens in the way of “treatment reviews” or audits, and/or unilaterally change contracts to reduce reimbursement rates. One insurance company reduced treatment for couples and family therapy by 20% last year, with no recourse by providers. Practices like this are a frequent cause of providers deciding to end their contracts, resulting in fewer and fewer clinicians who take your insurance.

ProPublica articles such as this one help further explain the dynamics at play that make it hard for you to find care. It dives into the widespread and often unethical tactics insurers use—tactics that are quietly damaging small, independent practices and making mental health care harder to access across the country.

We’d like to offer you some support in engaging in this “battle for care.”

  1. When choosing your insurance plan, check the actual availability of in-network providers. Don't rely on an online list—call and ask if therapists are actually taking new clients. Insurance companies are legally required to provide accurate lists of providers to their subscribers. Many plans however, rely on “ghost networks,” seemingly robust lists of therapists, many of whom are chronically full, not in practice, moved to other locations/states, or in some cases, even passed away. Before re-enrolling in a plan, ask yourself: Is this plan actually giving me access to the care I need? A cheaper premium means nothing if you can’t get help when you need it.

  2. Ask about appointment wait times. If it takes weeks or months to see someone, and you need help now, this is something your employer needs to know about. Call your plan representative or HR and let them know that the plan is not serving you.

  3. Explore out-of-network options. If your copay is low but no one's available, see if your insurer offers reimbursement for out-of-network therapy. Always get confirmation in writing—what percentage they’ll cover, what the process is, and how long it takes to be approved and reimbursed.

  4. Talk to your therapist about sliding scale options. At Beehive, we offer a self-selecting sliding scale based on equity and accessibility. Many local therapists reserve a few lower-fee spots for clients paying out of pocket. If you’re stuck, reach out and ask.

  5. Request a Single Case Agreement (SCA). If you can’t find an in-network provider, your insurer is legally responsible for helping you access care. An SCA allows out-of-network therapists to be paid at an in-network rate—sometimes temporarily, sometimes for up to a year.

If your therapist has left your insurance plan, please know this: it wasn’t about you. Most of us got into this field because we care deeply about helping people. But some of us are being pushed out by insurers who profit when therapists give up—and when claims don’t get paid. Meanwhile, you’re still paying your premiums, even if you can’t access care.

Please know we’re very much in this with you, and are genuinely here to help, even if we don’t have availability at our practice. Our Care Coordinator is an outstanding resource for your care, and can be reached at hello@beehivecw.com.