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Insurance vs Private Pay

 

 

Regarding Insurance...

Why should I choose to pay for therapy myself?

There are both advantages and drawbacks to out-of-pocket private payment and to using insurance.  The initial drawback of out-of-pocket private pay is that it is an immediate out-of-pocket expense.  However, there are several advantages of private pay that may make the expense a choice you may choose for yourself and your family.

Confidentiality and Privacy

Clients who pay out of pocket are guaranteed that the only people who know any of the details of therapy are themselves and their therapist.  Aside from normal limits to confidentiality, therapy is completely confidential, without any third party being privy to information exchanged in session.

Service Without Hindrances, Pressure or Stigma

Most insurance providers require a mental health diagnosis in order for therapy to be covered.  This means that many issues (such as martial problems, life stress, or personal growth) often are not covered by insurance. . Presenting issues brought into therapy will only be covered if they are deemed “medically necessary” by your insurance carrier.  When clients pay out-of-pocket, there is no requirement of a mental health diagnosis for treatment, which means that anyone can seek treatment.  Private pay also carries the additional benefit of reducing pressure to pathologize normal individuals who simply need help coping with some area of life.  Finally, treatment without the necessity of a mental health diagnosis means that the stigma of some diagnoses can often be avoided.

It is important to understand that once a diagnosis becomes a part of your permanent medical record it can potentially affect the consideration of future policies, such as, life insurance, short and long term disability.

Freedom in Treatment

Private pay clients have complete control of the duration and style of their treatment.  Modalities that are ethically viable but not covered by insurance are open to private pay clients.  Private pay clients are able to choose the focus of their therapy, the duration of therapy, and the frequency of therapy, and even the length of individual sessions.

Treatment Efficacy

Research shows that clients who pay something for treatment may have more positive outcomes than those clients that those who receive free treatment.  Not only do you get what you pay for, but the fact that you are paying out of pocket provides extra motivation and incentive to make the most of therapy. 

Potentially Reduced Service Costs

For some clients, their insurance providers require a co-pay and a large deductible to be met when seeking treatment, with the additional feature that standard rates for service apply.  By not taking insurance, I am free to set my own rates to my clients.  This means that privately paying clients may pay less than those who pay with insurance, how long treatment lasts, and the details of an individual's insurance plan.

Therapy, especially when you are paying out-of-pocket, is always an additional expense, in more ways than one.  There are travel expenses and the time commitment that it takes to make therapy effective.  However, the rewards can greatly outweigh temporary monetary costs.  How much is too much to pay for peace of mind, the renewal of a relationship, or finally finding freedom in an area of life that has previously seemed unattainable? $500?  $1000?  $5000?  Some people would pay ten times that to experience the real progress and change that can happen in therapy.  What is the change you are seeking worth to you?

 

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