Posted on April 4, 2011 by Deah Curry PhD, CPC
Being both a psychotherapist and a coach, new clients often ask if they can pay for coaching with their health insurance.  In the US, this is almost never possible.
The rare exceptions might be for cases of smoking cessation and weight loss programs, if and when such coaching is prescribed and supervised by a medical doctor. But in the extremely few cases I’ve heard about where health insurance is paid, payments were made to clinics employing coaches, and not to coaches in private practice.
Health insurance pays for the treatment of a defined set of disorders.  Even though a rocky relationship or the stresses of low life achievement may contribute to some mental health problems, such conditions are not covered by insurance.  In fact, to be able to use health insurance you have to be given a diagnosis, and the only diagnosis’ that would remotely apply would be those that fall in the category of mental illness.
In effect, your health insurance company is telling you that to get coaching paid for by them, you’d have to be mentally ill.
Although I’ve had some potential clients claim to not be concerned about whether they are diagnosed with depression, anxiety, phobia, etc, there are good reasons why you don’t want to have a mental illness diagnosis on record.  Despite the Health Insurance Portability and Accountability Act ( HIPAA), which is supposed to protect privacy of medical records, there are a number of situations in which your records can be accessed or compromised — to your detriment.
Many health insurance claims are electronically outsourced to workers in other countries to process, making your records susceptible to being hacked on the internet.  A CNN reporter accessed her records in a live news hour to demonstrate how very easily this can be done.
Should you have an auto accident that involves injuries, your medical records — including your mental illness status — will be available to attorneys and legal staff, and word will come out in court if a dispute goes that far.  I’ve known cases when passengers have been denied legal representation in the aftermath of a car accident because they had a pre-existing diagnosis of bipolar disorder (manic depression), making their claim of emotional distress due to the accident, suspect.
Even though it’s not supposed to happen, employers have been known to find out about mental illness claims, and have denied promotions or even fired employees in “at will” states, on the pretext of being unstable and therefore unsuitable for employment.
For these reasons, it’s best to not even wade into the quagmire that is health insurance when seeking ways to pay for coaching.
As a practicing psychotherapist for the past eighteen years, I couldn’t agree with your advice here discouraging reimbursement from insurance companies for a mental health diagnosis . My experience has been there is severe disclosure and discrimination, HIPPA is a joke!
-couldn’t agree more
This is very helpful, and being a grief/loss coach as well as a life coach, the fact that people are denied care because their “distress” is suspect really angers me. The coach approach requires us to treat the client as the expert. If they are describing the flashbacks, inability to sleep, etc. from the trauma of the experience, there is no way that that could possibly be linked 100% to a pre-existing condition, and not to the car accident. They wouldn’t be wanting my services if it wasn’t for the car accident. But, I’m rambling and I don’t need to soapbox anything to anyone who reads this article.
Coaching, any type of coaching (life, relationship), is not regulated by New York State. That is the main reason why coaching is not covered by insurance. If New York State ever begins regulating, they may want to make it a degree…and not a certification program. Perhaps have coaches become licensed. I was told that many psychologists and social workers are claiming to be coaches, and bill their sessions accordingly to have insurance cover the costs for their clients. Is this true?
Deah,‎
Jonathan Mase here. While I agree with the premise of your article, and think your content on this blog is excellent, I think it’s extremely important that the public should never hesitate to seek mental health care‎, in spite of the valid points you make about potential ramifications. Mental health treatment is becoming increasingly common, and with that, the stigma is becoming less of an issue. As a healthcare professional who’s worked in various roles in the field, I’ve seen many patients’ (including incredibly “normal” people) lives drastically improved by mental health professionals, and the undiagnosed should never hesitate, despite the potential risks articulated in your article, to seek help.
Jonathan A. Mase, MS, MBA, RN
Airmont, New York