Self-pay vs. Insurance

Advantages of using insurance to pay for therapy are obvious:  the insurance company pays some or all of your fees.  Simple right?  Well, not exactly.  Insurance plans have fine print which reads: "approval for services is no guarantee of payment". 

 

You may have to satisfy a deductible before insurance will pay, so you will need to pay out of pocket until the deductible is satisfied.

 

Depending on your policy, you may be restricted in the number of therapy sessions you can have in a calendar year. 

You are limited to choosing a therapist in your insurance network, so if your insurance changes or if your therapist leaves the network, you will need to find a new therapist.

Your therapist will be required to provide a diagnosis and treatment plan following your initial session, when you are just getting to know one another.  This diagnosis becomes part of your medical record which can be a privacy issue for some individuals. 

Insurance companies will not provide coverage for all conditions, so if your therapist does not diagnose you with a “covered condition” your insurance company doesn’t have to pay for your therapy.

The insurance company gets to decide if the treatment your therapist is using is covered or "appropriate" and can refuse to cover it, even if it is working for you.  This includes therapy using Telehealth.

Advantages to self-pay, that is, paying for your therapy out-of-pocket, include having your privacy protected, being able to see a therapist of your choosing, and being able to decide together with your therapist what treatment to use and how long and how often to meet.

 

Your therapist does not have to provide any information about your treatment to your insurer, or to anyone else (with a few legal exceptions - feel free to ask me about these). 

 

With self-pay, your therapist can get to know you before developing a diagnosis and treatment plan.  Your work with your therapist need not be limited to "covered medical conditions" but can cover any issue you and your therapist decide together would benefit you.

You are able to see a therapist for as many sessions as you and your therapist deem necessary for achieving your therapeutic goals.

Clients who pay out of pocket tend to be
more motivated to see results sooner and often invest themselves (no pun intended!) more fully in their therapy.

 

Have more questions about self-pay?  Call me at (609) 248-0536 or send a message to Lina@CounselingForResilience.com