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We all have have health insurance to protect us against the expensive cost of healthcare. In return for paying a premium, whether it may be coverage bought on your own or coverage through your employer, we expect our insurance companies to pay for the cost of healthcare after meeting a certain deductible and paying the copayment when we visit a doctor. We also expect our health insurance to keep details of the diagnoses and treatment rendered confidential.

But what you will see can surprise you. This is especially if you need to see a mental health provider for an issue you may be having.

Before I go on any further, I want to say that the decision to use your health insurance, especially for mental health conditions, is yours. Rather, this page is meant to make you aware before you consider using your health insurance, especially for mental health coverage.

How health insurance is supposed to work, step by step

Considerations when you use health insurance

1. Loss of confidentiality. When was the last time you went to the doctor for a checkup and the doctor found a condition for which you were diagnosed for? When you use your insurance, a claim is initiated and sent to your health care insurer from your doctor. Once the claim is received by your insurer it is reviewed by a lot of people within the insurance company before the claim is approved and the claim is paid.

2. A diagnosis is required. Before your health insurance company will pay a claim, it will require a diagnosis. That diagnosis becomes part of your permanent health record, and there is no way to seal or expunge your permanent health record as such. This can create a lot of problems down the road especially if you apply for life insurance or health insurance that is not covered under the Affordable Care Act.

3. Your health insurer dictates the treatment you get. Your health insurance company dictates your treatment, including how many times you can see a mental health professional and the duration of your sessions as such. Exceed these limitations and your claim will more than likely be denied.

4. The potential of being placed in an involuntary guardianship. If at any time a petition for guardianship is ever filed against you, the attorneys seeking the guardianship will subpoena not only every physician you have seen but your health insurance insurer as well as the Medical Information Bureau, known today as MIB. Your medical records will contain every diagnosis made and certain conditions such as diabetes, Alzheimer's Disease and dementia - as well as practically any mental health diagnosis - can be justification for your rights as an adult taken away and made a ward of the state by a probate judge. Imagine for a moment your entire life being dictated by a total stranger more known as a private professional guardian costing upwards of $600/hour that is represented by an attorney costing $1,000/hour, if not more.

5. Your condition goes on your permanent health record. Once a claim is paid by your health care insurer the diagnosis goes onto your permanent health record. This includes any condition including diabetes, Alzheimer's or dementia. These medical conditions are a goldmine for a court petition for involuntary guardianship (in Florida, the Petition to Determine Incapacity and the Petition for Appointment of Guardian). Whatever is in your permanent health record can be potentially used against you.

6. If you are admitted to a mental health facility under the Baker Act in Florida, it goes on your permanent health record which, unlike a criminal record, cannot be sealed or expunged. Once the mental health facility knows you have insurance, the facility can file within the 72 hour Baker Act hold period the petitions to have you committed to the facility for the maximum six months allowed as well as appoint a substitute decision maker called a guardian advocate to oversee your treatment in the hospital. Besides, that guardian advocate could potentially be a total stranger professional guardian advocate who may or may not have your interests in mind.

Keep in mind that certain aspects of a Baker Act could be potentially public knowledge: While the medical aspect of a Baker Act is confidential pursuant to federal HIPAA (Health Insurance Portabulity and Accountability Act) laws, the law enforcement aspect of a Baker Act could be public knowledge as police reports are generally public record. Keep in mind too that if the healthcare facility files a petition for involuntary commitment with the court then the court record can be public knowledge too. Additionally, if a petition to appoint a guardian advocate is filed along with the petition for involuntary commitment it could become public knowledge as it is public record.

Two court petitions on Florida Department of Children and Families (DCF) forms filed by the health care facility's administrator get the patient committed to a mental health facility on an inpatient basis not to exceeed six months:

• Petition for Involuntary Inpatient Placement, Florida DCF Form MH 3032
• Petition for Adjudication of Incompetence to Consent to Treatment and Appointment of a Guardian Advocate, Florida DCF Form MH 3106

If that mental health facility knows you have insurance, that facility has struck a goldmine. It becomes a case of do it for the money. In other words, maximize the six months Baker Act involuntary commitment period.

7. Limits on how many times you can see a medical or mental health professional. Make no mistake, insurance companies do set limits on how many times you can see your medical or mental health provider. Exceed that limit and before you know it your claim will more than likely be denied.

How to see a Medical or Mental Health Provider and keep things Confidential

Again, the decision to use your insurance for medical or mental health conditions is yours. If you do not want to use your insurance, there are ways to help with the cost:

1. Use your Flexible Spending Account (FSA) or your Healthcare Spending Account (HSA). These are tax free monies that are set aside by your employer to help cover health care costs. More than likely if you have health insurance with a high deductible (which, according to IRS guidelines as of 2025, is $1,650 for an individual and $3,300 for a family) you have an HSA to help you with the deductibles. You get a debit card to access the monies in your FSA or HSA accounts and all you have to do is to save your receipts for services rendered. Practically no medical diagnoses are shared as opposed to when you or your health care provider files a claim on your insurance.

2. See if your provider can use a sliding fee scale. It might save you some money when you go for your visits. In fact, you can even pay for your visits using your FSA or HSA accounts as mentioned previously.

The bottom line on using your insurance for medical or mental health coverage

The choice to use your health insurance for medical or mental health coverage is purely yours and yours alone. Rather, what is discussed here are considerations that should be taken into account should you decide to use your health insurance coverage for any medical or mental health condition. When a healthcare professional such as a primary care doctor or mental health professional tells you that he or she does not take insurance, the key takeaway here is potential loss of confidentiality when it comes to medical or mental health treatment.