In doing an online search for family, child, or teen therapy in Coastal San Diego, you will encounter a plethora of names and practices to sift through. It is naturally overwhelming to review oodles of information on San Diego therapy sites in an attempt to find the best fit for your family. Parents will typically type in their zip code for Del Mar, Carmel Valley, La Jolla, etc. and be faced with a long list of options. Often, parents are unsure of what to look for or how to distinguish between therapists to meet their current needs. Relying on google reviews and rankings can be misleading, as often businesses can pay for ads.
Hence, one of the first questions you should ask yourself is if you want to utilize your insurance for payments or not. If you have an HMO, your insurance will not reimburse you for any fees. If you have a PPO, your insurance will likely reimburse you a certain portion of the fee, based on your unique PPO plan. Your specific location in CA does not matter; you could live in Del Mar, La Jolla, Solana Beach, or Carmel Valley; as long as you are seeing a therapist in CA, you can ask how much your PPO plan will cover your private pay fees. If you do not want to use your insurance, you can ask the therapist if they accept HSA and FSA cards, which can be helpful.
The Difference Between Insurance-Based and Private-Pay Therapy
Another important consideration is understanding the difference between utilizing health insurance vs. private pay for child, teen, or family therapy in San Diego. Most importantly, you want to consider your privacy and confidentiality regarding your or your child’s PHI (personal health information). Insurance payments and reimbursements require a diagnosis, along with the specific date, location, and type of session it was (family, individual, parent, assessment, etc). Insurances require this information via insurance documentation by providers on the panel and via superbills for out of network providers. Hence, privacy and confidentiality is limited, which can be a huge deterrent for families to use their in-network or out-of-network benefits for child and teen therapy.
Additionally, parent, teen, and child therapy or a combination of these longer term growth approaches in family therapy can be lengthier in number of sessions compared to short term crisis oriented, symptom relief, or situational stressors interventions. Often, insurance companies will dictate how many sessions you are allowed, typically 12 sessions. Once the allowable sessions are utilized, you have to terminate therapy or your therapist has to provide more detailed information to the insurance as to why therapy needs to be continued and how additional sessions will be necessary and helpful. Many families are uncomfortable with this level of personal health information disclosure to an insurance company, and may decide to terminate or continue by paying out of pocket. Additionally, no-one knows how insurance companies store this information, use it for future health benefits or denials, or who has control over your PHI once it enters the insurance systems.
However, many families in San Diego choose to utilize their insurance benefits as they are likely paying a large monthly fee or their employee is paying for them. These health benefits can also provide many opportunities for affordable and effective health care for families.
Why Many Coastal San Diego Families Prefer Private-Pay Care
Others may choose to not use their insurance and use their HSA and FSA plans or out of pocket to pay for mental health services. There can be many advantages to this approach. HSA and FSA plans do not require detailed information from your therapist. Typically, a paid invoice with the provider’s NPI and Tax ID and with dates of services suffices. No diagnosis is required and you can use as much or as little of your HSA/FSA plan as you like, as it is in your control.
Private pay for therapy services in San Diego can have additional important benefits. In Del Mar, La Jolla, Solana Beach, and Carmel Valley there a large number of therapists to choose from. Compared to insurance panels, there are typically no long wait lists. However, sometimes with solo therapists it might be more challenging to get in as they may be full, and do not have the flexibility to offer an interdisciplinary team with easier access to immediate care.
With a larger team, it is typically faster and you may be able to access multiple services simultaneously. For example, at Aspiring Families, because we have a team of clinicians, we are able to do intakes within 24 hours and to offer appointments within a week or two. Additionally, we are able to offer a multidisciplinary approach to address multiple complex needs simultaneously. We can offer coordinated care with therapists who work with the parents, others who work with the teenager or child, and therapists who can collaborate with each other on the team for successful family work. Additionally, psychiatry services for medications, psycho-educational assessments, expressive arts therapy, educational support, and neurofeedback can be integrated as additional coordinated team resources per the unique needs of the child, teen, parents, and family members.
Our ability to offer immediate care, personalized individual and family treatment, a collaborative multidisciplinary whole child/teen/system approach, and privacy and discretion regarding your family’s PHI makes Aspiring Families a unique center in Del Mar that offers evidence based mental health care.