Can psychological counseling be covered by medical insurance?

At present, general psychological consultation in most areas of the country has not yet been included in the scope of overall medical insurance reimbursement. Only a few pilot cities such as Beijing, Shenzhen, Hangzhou, and Shanghai have included some standardized psychological therapy services in public medical institutions into the medical insurance payment list. The overall situation is that "partially reimbursable, but large areas are not covered."

Last year, I had a visitor who was working as a designer in Nanshan, Shenzhen. I was diagnosed with moderate anxiety. I went to the clinical psychology department of Kangning Hospital to get a consultation number from the deputy chief physician. The total cost of the 45-minute consultation was 168 yuan, and the medical insurance co-ordinator quoted 102 yuan. In the end, I only paid 66, which is less than the price of two cups of Internet celebrity milk tea. In other non-pilot cities, this cost will most likely have to be paid in full. In cities that have now opened up reimbursement, the rules are actually quite strict: those covered by medical insurance are basically psychological services provided by public medical institutions. The services of most private psychological counseling studios and commercial psychology platforms on the market are not included in the medical insurance reimbursement list. Moreover, a professional concept needs to be distinguished here. Most of the things that can be covered by medical insurance are "psychotherapy", which needs to be provided by people with psychiatrist qualifications or psychotherapist qualifications. It is a formal medical practice. ； Most of the ordinary psychological counseling we see in commercial institutions is provided by practitioners with psychological counselor qualifications. It does not fall into the medical category and does not meet the basic requirements for medical insurance reimbursement. If you just want to see a counselor to talk about career confusion and emotional problems, but do not meet the diagnostic criteria for a mental disorder, you will not be able to apply even in pilot cities.

Why hasn't it been fully launched? I have talked about this matter with a staff member of a local medical insurance bureau before, and they also have difficulties: psychological consultation is different from prescribing medicines and surgeries, and there is no unified standardized measurement scale - you may get results after six sessions of cognitive behavioral therapy, while psychoanalysis may last for one or two years. Moreover, the scope of medical insurance is so large. The first thing to be insured now is the reimbursement of critical illnesses such as tumors and cardiovascular and cerebrovascular diseases. Psychological services are not yet ranked so high in priority in many places.

But from the perspective of our clinical practitioners and visitors, this matter is indeed urgent. I had a third-year student visiting me. She lives in a small county town and her monthly living expenses are only 1,800 yuan. She was suffering from mild depression and needed consultation once a week for 300 yuan a time. After just two months of treatment, she couldn't bear to stop. I persuaded her for a long time and finally applied for a low-cost public welfare quota for her before she persisted. If she could get medical insurance, she wouldn't have to suffer this problem at all. There are also many people who have a sense of shame about psychological counseling, and feel that they "have to complain to others because they can't figure it out." If they can be included in medical insurance, it is equivalent to the official name being rectified - this is a formal medical practice, not a shameful thing. There will definitely be more people willing to seek help, and it can also prevent many mild emotional problems from turning into severe mental disorders, but will spend more medical insurance funds for treatment in the future.

However, many people in the industry are also worried that comprehensive coverage of medical insurance may not necessarily be a good thing. A friend who has been a consultant in a public hospital for ten years complained to me. Nowadays, the medical insurance reimbursement in pilot cities requires detailed diagnosis and treatment records to be written for each consultation and uploaded to the medical insurance system. Many visitors come for consultations for the sake of confidentiality. When I think about my workplace complaints and dissatisfaction with family members, I have to write them down in the formal medical records. Instead, I dare not tell the truth, and the consultation effect is greatly reduced. Some people are also worried that after enrolling in medical insurance, the pricing of consultations will be driven down so low that good consultants will not be retained, which will in turn lower the service quality of the entire industry.

In fact, it is not that there are no alternatives at all. I had a visitor from Suzhou who was diagnosed with bipolar disorder and got outpatient chronic disease certification. Although psychological counseling is not included in the local general medical insurance, the reimbursement for chronic diseases can cover the cost of psychological treatment in public institutions. After the application, I only pay a few dozen yuan at a time. There are also many cities where personal medical insurance accounts can be used to pay psychological consultation fees. Even in some private institutions, as long as the payment channel for the medical insurance account is opened, you can pay with the money in the medical insurance card instead of paying cash out of your own pocket. If all else fails, you can also ask your own company’s personnel department. The supplementary medical insurance of many large companies has included psychological counseling in employee benefits, and you can claim a limit of several thousand yuan a year.

A while ago, I saw in an industry group that the medical insurance bureaus in Guangdong, Sichuan and other places are issuing questionnaires on psychological service projects to find out the local charging standards and service volume. Maybe in three to five years, more and more cities will be able to provide reimbursement. If you have needs now, you don’t need to wait for the policy. Call 12345 first to inquire about the local medical insurance policy, or go directly to the public mental health center near your home and ask. In just a few minutes, you may be able to save a lot of money. After all, emotional health is the most important thing compared to money. If you really can't handle it, don't hold on.