The conversation around mental health and insurance coverage cannot be allowed to fade into the background. Our community is suffering like never before, yet despite advancements in medicine and therapy, too many people are being left without access to the care they desperately need. For many, paying cash for essential mental health services is simply not an option—and yet, that is exactly what they are being asked to do.
Imagine if general practitioners and pediatricians suddenly refused insurance, demanding cash payments for every visit. The public outcry would be deafening. Politicians, rabbanim, and askanim would rush to intervene. So why is it that when it comes to mental health, this same level of urgency is missing? Why do we turn a blind eye when people are drowning in silent agony? Mental health patients often lack the strength, resources, and advocacy that others have, leaving them to suffer in silence while society continues to fail them.
Yes, insurance companies are notorious for minimizing payouts—this is nothing new. But we also know doctors and specialists who have fought to negotiate fair contracts, not only for themselves but for the sake of their communities. There is an ethical obligation to make mental health services accessible, not to turn it into an exclusive privilege for the wealthy.
The reality is, insurance billing for mental health care is not the nightmare some claim it to be. Unlike other medical specialties, mental health coding is relatively simple—there aren’t endless diagnoses or complex procedures to navigate. Yes, paperwork is tedious, but is that really an excuse to deny care to those in need? Many insurance providers do pay fairly—perhaps not the exorbitant $300-$500 per session that some practitioners chase, but reasonable, contracted rates that make therapy accessible to more people.
If you chose this profession, if you took an oath to heal, then where is the compassion? Where is the responsibility? Every industry has an obligation to serve its clients with care and integrity—shouldn’t the medical and mental health fields be held to an even higher standard? Or have we allowed healing to become just another profit-driven industry, where only those who can afford it deserve treatment?
This is not just a conversation—it’s a crisis. It’s time for medical and mental health professionals to step up and fight for better insurance contracts that serve their communities. It’s time to prioritize patient care over financial gain. The people suffering cannot wait any longer—and neither should we.
Signed,
Anonymous
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18 Responses
Something can’t be a “right” if it requires someone else’s labor. You can’t have the “right” to knock on a doctor’s door and demand that he give you free healthcare because that would infringe on his individual rights.
When the integrity of a Mental health practice is questioned, it’s not surprising to see defensive responses. However, the reality is that when individuals seek mental health services—often referred by trusted organizations—they frequently face the challenge of affording care. This issue extends to psychiatrists as well, many of whom refuse to accept insurance. It’s frustrating to see that, beyond struggling with mental health issues, people also have to navigate financial barriers. Insurance often provides reasonable reimbursement, such as $200 for a 45-minute session, which is standard for other medical services. The way billing codes are structured is based on session length, whether it’s a clinician or a doctor, so it’s hard to justify the reluctance to accept insurance. Providers don’t have to take all insurances, but they can choose the ones that offer fair payment. However, refusing to accept any insurance at all is simply unacceptable.
We should start off by demanding the shaitel machers, clothing stores, and restaurants, etc. accept insurance. Why are we trying to drive mental health professionals, who provide an essential service to the community, out of business?
Here in Israel, the HMOs – Kupot Cholim – offer mental health services, but frum people want practitioners who understand their culture and will offer appropriate, sensitive treatment.
That’s why there are frum organizations in Israel such as Bayit Cham that have good practitioners and their clients get their therapy covered by HMOs.
Abe_S mentions similar agencies in the US, who I assume (or hope!) that also offer quality care.
The problem on both sides of the ocean is that HMOs underpay, so these organizations/agencies have to raise funds to pay enough to attract good mental health professionals to serve people who can’t afford private care.
It may seem unfair, but that’s capitalism. Insurance companies are out for themselves to make as much profit as they can get away with. If someone wants to have a private practice and not work for a chessed agency, that’s his (or her) prerogative. He can’t fundraise for himself to make up the difference…
Wow!
What dos I just read?!
There are plenty of mental health clinics both within our community and out of our community that accept insurance.
Obviously you are talking about the “highest end” therapists in private practice.
You are selling them out because they have a reputation of being able to help in the stickiest of situations.
You feel entitled to their service and skills developed through years college, internships, clinical service, etc that enabled them to become the top in their field. But you don’t think they are entitled to set a market rate fee to justify providing you that service?!
Really?!
And what’s this nonsense about an oath?
When you go to the doctor, you sit in waiting room with lots of other patients and then sit in an exam room to wait some more before a medical assistant comes in to ask you your symptoms. After all that waiting, the doctor finally comes in for about three minutes.
The doctor gets about the reimbursement rate for those three minutes as the therapist does for a 45 minute session. Does that make sense to you?
In short, like many of these letters, it is a cry for help that throws in a whole bunch of accusations that are unfounded, suggestions that are impractical, and proclaims a false understanding of an issue.
Do you suggest we chase mental health professionals into anxiety and depression by forcing them into a situation where they can’t afford the basics and need to reconfigure their whole lives? There is a real problem here, but your solution will just make more people have mental health issues and no one around to help.
There is a concept of charging what you are worth
I am a plumber and I charge 300 to come down and include 30 minutes, after that it is usually diagnosed and I can give the customer an accurate estimate to fix the issue.
Before everyone loses there mind here is a basic breakdown of what it cost me show up
Truck payment
Truck insurance
Liability Insurance
Workmans comp insurance
Worker wage
Gas
Wear and tear on the vehicle ( having to put in $3500 right now)
Stock material
Tools ( some of which cost thousands of dollars)
Billing and scheduling software
Then my time,
Now complain about the price,
I know many mental health professional’s,it is beyond taxing work it is emotionally draining and you are holding someone’s sainity in your hands.
In many cases especially in our community the client has been abused beaten or has other severe disorders.
If you had sewer pumping out of every fixture in your house would you not pay any price to get it out.
We as klal yisroal , in this time before moshiach have a lot of sewer in our brains we need to heal it.
Insurance is not able to pay a livable wage they are in business to pay as little as possible.
Pay the right mental health professional once get your mind right and don’t pass along your trauma.
May we see moishach soon
I second what Abe_S said.
If someone beleives he/she, or someone else needs mental health services, there are organizations and private therapists who accept insurances.
I also second those saying nobody has a right to anyone’s services without
paying.
I would also add that it’s probably true that people initially get into the field cause they want to help- but as they get a little older, everyone becomes the same “oink-oink” and is just looking to cover their own mortgage or their kid’s piano lesson.
Bear in mind!…Just cause a therapist does not accept insurance does not mean they are more qualified (by
whatever metric you want to use).
At the end of the day everyone from palm readers and dream interpreters have something to sell, and it is prudent to be a an informed consumer.
I wish the mailbag writer a happy life in the fullest sense of the word.
Remember! Nothing can replace your own one minute meditation on the acceptance of your own life coupled with a little change in your own environment.
It’s your life and nobody else’s.
I second what Abe_S said.
If someone beleives he/she or someone else needs mental health services there are organizations and private therapists who accept insurances.
I also second those saying nobody jas a right to anyone’s services without paying.
I would also add that it’s true probably true that people initially get into the field cause they want to help- but as ypu get a little older everyone becomes the same oink oink and is just looking to cover their own mortgage or their kid’s piano lesson.
Just cause a therapist does not accept insurance does not mean they are more qualified (by whatever metric you want to use).
At the end of the day everyone from palm readers and dream interpreters have something to sell, and it is prudent to be a an informed consumer.
I wish the mailbag writer a happy life in the fullest sense of the word.
Remember! Nothing can replace your own one minute meditation on the acceptance of your own life coupled with a little change in your own environment.
It’s your life and nobody else’s.
I just checked with my insurance Private Empire Blue Cross and they would pay for out of network therapist in the tune of $150a session.
Please someone make an “RCCS” for mental health. The organizations that claim they are helping are barely helping some. I tried them . There is no funding for all. There is no money. Insurance covers way too little. Then organizations recommend insurance providers to the rest. The good ones leave clinics once they have a good name and go private only. I had a generous person fund private psychologist because the insurance ones didn’t give enough time needed for my close relative. And less talent. When that generous person stopped for a while – things went down the drain. I cannot sleep!
I am a mental health professional, from insurance my maximum income can be maybe $3500 weekly, that $90 x 35 sessions. If you take your job seriously and care about your clients no you cannot do more than that coupled with the phone calls you have to return, and not billable time) deduct cancellations, missed appointments, vacations and holidays, at best maybe there’s about 47 working weeks = 153k take off taxes I’m left with $120k annual income…
There’s no way that I can live and make ends meet with that income, so I have two choices either I leave my training and skills leave it aside and become a real estate agent, mortgage broker, business consultant, or any other job and earn much more income yearly and help no one in the way.. OR charge what I need to charge to make an income to live with peace of mind so I can divulge my time energy to properly help my clients…
I may not be able to help those who can’t afford it, but at least I can help some who can.
This whole talk on YW news is Ludacris to me, any person that seeks to accomplish anything wouldn’t just be posting here…
You want to do something? Do, don’t just mock the people devoting theirs lives to help other and just try to make a living in the meantime…..
To become rich, the potential is bigger in any other field than being a mental health professional private practice….
Mental health crisis is very really and unfortunately, many in our community are suffering. Thankfully, many practitioners have sliding scall fees where one can pay less based on what they can afford. Generally, private practitioners will state on their website if they offer sliding scale fees, and for those who don’t have a website, one can call and ask. Furthermore, in New York there are several, frum mental health agencies that all take insurance and provide quality care. Those agencies include Interborough Development & Consultation Center, Jewish Board of Child & Family Services, Ohel, Achieve, Ezra Medical, Rambam Family Health and Achieve. Thankfully, there are plenty of resources and nobody should feel they are without recourse to seek help.
The difference is, that you can see results from a doctor. There is treatment and within a period of time you can see improvement. With mental health, improvement could take years, but there are also mental health professionals that will string someone along since there is no specified metric of improvement. This along, with a requirement that a patient in mental health has to do most of the work, which may not happen and prolongs the treatment. Insurance companies are wary of paying out when there is no metric to show improvement or cure. There is no guarantee or right to health insurance or mental care.
You’re not taking into account the overhead costs of accepting insurance.
“Imagine if general practitioners and pediatricians suddenly refused insurance, demanding cash payments for every visit.”
There’s a reason why GPs and pediatricians are all employees right now instead of owning their own practices. It’s because it’s not worth it to deal with insurance. They can do it this way instead because their salaries are high enough. Insurance reimbursements for therapists aren’t high enough for them to make salaries that would enable them to stay at an insurance based clinic forever.
Bottom line: blame insurance, not practitioners. They are only trying to survive.
No one has a right to someone else’s services without paying what that person wants in compensation for those services. The type of service is irrelevant to the conversation. When one agrees to use the service provided they enter a compensatory contract for the service provided. It is your choice to choose your service provider based on the quality of the service provided vs the price you will be charged. The customer does not get to unilaterally set of the rates of service provided. The provider does that by contractual mutual agreement. We’ve been so conditioned to healthcare being free or low cost by getting on to Medicaid that we are indignant when it doesn’t cover what we feel is vitally necessary. Everyone has different needs in life. They aren’t a right that entitle us to get them for free. Nothing in life is free. Someone is paying for it. Man up and pay for your own needs. If you can’t afford it then figure it out. If you don’t want to pay for a therapist then talk to your friend/uncle/brother etc. Same with a plumber/electrician/landscaper etc. Do it yourself or find a buddy who is willing to trade those services for a cold beer.
I just googled it. The average insurance reimbursement is $60-120 per session.
Your plumber makes much more.
Dr Cantor wrote an article recently. I just googled the average Medicaid reimbursement for a filling. It’s under $100. And your dentist has much more overhead than a therapist and certainly your plumber.
So when you demand treatment, I demand that you make sure that the person you insist treats you gets paid fairly. They shouldn’t have to work at wages that can’t even pay student loans, let alone make a parnassah.
The same way there are certain doctors who don’t take insurance there are mental health professionals who don’t as well.
Without specifically listing them, 3 of the major insurance companies pay at maximum $110 for a 60 minute session. It’s not a charity. If you want the community to step and help they need to make it a lot less taboo to begin with.
Lastly, nothing will ever come from a letter signed “anonymous”.