Why Most Therapists are Out of Network in SF

Access Issues to Mental Health: Part 1

With the uncertain future of affordable healthcare, I will begin four part informational conversation on accessing managed mental healthcare. To keep things relevant, this series will focus primarily on the outpatient (aka office setting) private practice model of care. This series is not intended to sway clients or providers to be pro-insurance or anti-insurance. My intention is to provide factual information about this issue, a few of my personal thoughts, and to help clients make informed decisions.

Using insurance to cover mental health services has gotten easier since the Mental Health Parity and Addiction Equality Act of 2008. This law had made mental health treatment be treated in the same manner as physical health services. Without this act, mental health benefits are much harder to access both logistically for providers and financially for clients.

Due to the current political climate, this act is now in limbo as the Senate decide how healthcare will be manage and how insurance companies will play a role in the decision making process. 

Being a mental health provider who accepts insurance remains increasingly rare, especially in one of the most expensive cities in the nation. It is easy to understand why most therapists do not accept insurance, it is simply not viable to have a purely insurance based practice that is going to cover the cost of living and doing business in San Francisco. Being in-network is a lot more work for much less pay. I’ve tried to run my business with the insurance model, and for me, it wasn’t sustainable. I was able to offer in network services from late 2016 to mid 2019. I’m proud I was able to offer this for almost 3 years, but I’m sad to report that I will no longer be able to work directly with the insurance industry.