Insurance & Payment
Does my insurance cover a psychologist’s fees?
What are the benefits of “Direct Pay”?
Does Dr. Markus accept insurance?
The insurance industry has consistently and persistently created policies that undermine mental health clinicians' ability to provide timely and appropriate treatment. In 2024, investigative journalists at ProPublica conducted a comprehensive examination into these all too common practices, demonstrating how insurance companies restrict, delay, or deny coverage as well as create obstacles to fair and expedient reimbursement. I have included links to two ProPublica articles, a related PBS story, and a Clear Health Costs article that go into details about the challenges with which clinicians contend. ​
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https://projects.propublica.org/why-i-left-the-network/
https://www.propublica.org/article/cigna-health-insurance-denials-pxdx-congress-investigation
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For many of the above reasons, I have limited the number of insurance carriers with which I agree to participate. Accordingly, it is best to speak with me prior to scheduling your first appointment to discuss details. We certainly can still work together even if I am not on your particular insurance panel. Many policies offer “Out of Network Coverage” which would, after any applicable deductible, reimburse you a significant percentage of my fee. If you are utilizing out of network coverage, I can submit the necessary insurance claims on your behalf in order to facilitate your reimbursement by the insurance company.
Many people prefer to pay for therapy directly and not involve their insurance company at all. Doing so permits a higher level of confidentiality in addition to providing greater flexibility and autonomy in designing a treatment plan. For many people, this provides the opportunity to see whomever they wish and reduces the more intrusive aspects of insurance companies’ policies. Direct pay offers enhanced privacy, a greater choice in who you select as your psychologist, and the freedom for you and your psychologist to choose therapy goals that are best for you and your specific needs.
When and how do I make payments?
Your payment or co-payment is due at the time of your appointment. I accept cash, checks, credit and debit cards, as well as FSA or HSA cards. If you are enrolled in a managed care program in which I participate, the insurance company will pay me directly (less your co-pay or deductible).
Insurance policies differ in the extent to which they cover mental health treatment and the amount of your co-payment. Co-payments vary and may consist of a set dollar amount or a percentage of the fee. If you wish to use your insurance, check with your insurance company to clarify what your policy covers. Be aware that some policies set limits on the number of sessions a person may attend. Some policies will only cover “paneled” providers while others may also cover "out of network" providers. It is important to know that some insurance carriers may restrict the types of treatment covered. This may, unfortunately, limit access to the services you may need or want. Furthermore, most insurance carriers mandate that you be diagnosed with a psychiatric disorder and some require detailed personal information about you, your treatment, and your progress in therapy in order for you to secure coverage.