Is psychological counseling reimbursed by medical insurance?

At present, domestic routine emotional counseling psychological counseling is not generally included in the scope of medical insurance reimbursement. Only psychological treatment projects prescribed by doctors after a formal medical institution diagnoses a mental illness can be reimbursed in accordance with local medical insurance policies in some areas.

Many visitors who come to me for consultation for the first time will ask if they can take out medical insurance as soon as they sit down. Xiao Zhou, whom I met last month, is a typical example: He had just graduated a year ago and worked on projects for three months. After that, he had insomnia and shed tears for no reason every day. When he couldn't bear it, he went to the psychiatric department of a tertiary hospital for a test and was diagnosed with moderate depression. The doctor's plan was to take medication together with cognitive behavioral therapy once a week. The cost of each treatment was 180 yuan. He used Hangzhou's employee medical insurance to go to the outpatient clinic and only had to pay 72 yuan out of pocket each time. But in another situation, if you just have serious internal strife in the workplace recently, have conflicts with your partner, and want to see a counselor to sort out your emotions, but do not meet the criteria for disease diagnosis, whether you go to a hospital psychology department or a compliant private institution, you currently have to pay for this part of your own pocket.

In the past two years, there has been an ongoing discussion about whether to include routine psychological counseling in medical insurance. Many clinical colleagues around me are calling for it, saying that many people hold back and do not seek help because they feel that the consultation fee is not cheap. What is originally just a general psychological problem ends up being a mental illness that requires medication. Instead, it will cost more medical insurance funds to treat it. It is more cost-effective to intervene early. But I have talked with the staff of the local medical insurance bureau before, and they also have real difficulties: the pressure on the medical insurance co-ordination fund is already huge, not to mention that psychological counseling services are difficult to be as standardized as prescribing drugs and surgeries. How to judge whether the patient really needs counseling services? How to prevent someone from defrauding medical insurance funds by opening a reimbursement project but not actually completing it? If these practical problems are not solved smoothly, hasty expansion may lead to troubles.

In fact, many places are now testing the waters for more flexible protection methods. For example, community health service centers in some districts of Shanghai offer public welfare psychological consultations, which cost dozens of yuan per session. The cost is paid by public health funds, without having to pay a large sum personally.； There are also many commercial medical insurances that now include routine psychological counseling in their coverage. For a few hundred yuan a year in premium, you can cover the cost of consultation several times a year, which can be regarded as giving people in need more options. If you are not sure about the specific policies in your local area, just call the hotline of the Medical Insurance Bureau and ask. It is much more accurate than searching for scattered information on the Internet. After all, the reimbursement details vary greatly from place to place.