A Guide to Healthcare Coverage in Private Practice (for Business Owners in the U.S.)
Does this resonate with you as a private practice owner, “I want to do private practice full-time, but I can’t afford to lose my health benefits.”
Today, zynnyme goes over how to get healthcare coverage when you’re in private practice, how to enroll, as well as how to pick and pay for the right healthcare coverage for you and your family.
Why Therapists Are Concerned About Healthcare Coverage
It’s something we’ve heard time and time again from new Business Schoolers in our program, how do you get healthcare coverage when you open your private practice. This is a real, HUGE concern for a lot of clinicians, especially in the U.S. where healthcare isn’t provided to all who live here.*
Until the healthcare system changes, we want to:
Empower mental health clinicians in understanding their current healthcare options.
Make it known that you can have a private practice AND take care of you and your family.
**This guide is for therapists and other mental healthcare providers in the United States.
Where Do You Get Healthcare Coverage When You’re in Private Practice?
Clinicians can find healthcare coverage at the federal website healthcare.gov — it’s where you’ll discover the different plans available to you. Some national associations link to this database, and some even offer discounts on plans!
When Should You Enroll in Healthcare Coverage as a Therapist?
Open enrollment for 2023 is November 1st - January 15th. However, you can enroll when you have a “life event” that qualifies for special enrollment, such as having a baby, getting married, or moving.
There are also other types of coverage through health share accounts, short-term health plans, and supplemental plans. These are less known and do require a bit more research to weigh the cost and benefits.
How Do You Choose a Healthcare Coverage Plan as a Therapist?
Picking a plan is a balance between what you can afford (refer to the next question where I discuss that more) and what you need in terms of coverage.
I, for example, know that I have certain tests done annually that need to be covered by insurance because they’re too expensive to afford out of pocket.
Some people who have the privilege of not needing to go to the doctor often have health insurance to cover them more if there was an extreme circumstance that would require them to seek out care. Others of us may need more coverage for ongoing health issues.
How Do You Pay for a Healthcare Coverage Plan as a Therapist?
When you’re the only clinician in your practice, you will pay for healthcare coverage with your own money. But that doesn’t mean your business isn’t responsible!
In our How to Set Fees training, we discuss how your business should give you the income you need to provide for yourself. This includes allowing you to afford healthcare coverage. We know it can be scary to pay for coverage; however, for the cost of just 1 client a month, you could cover the expense.
When you own a group practice, this can get more complex, as you may choose to offer benefits to your employees. You can also give yourself benefits through the company, but you need to be on payroll.
What we want you to do is really look at the fee you’re charging and make sure it covers the expense of healthcare plus all of your other needs. This might mean you need to raise your fee or stop offering so many sliding scale slots.
Should You Stay Employed as a Therapist So You Don’t Have to Worry About Health Insurance?
Going into private practice is a personal decision. It’s a risk. But so is staying in your job. Your benefits can be changed, you could get laid off, and anything could happen.
Sometimes we just need more information to make a solid decision for ourselves and our future.
The cost of healthcare may feel insurmountable, and it really depends on your needs, but we recommend you research the cost and see what you could do in your private practice plan to make it a possibility.