What Are the Benefits of Paying Out of Pocket to See a Therapist?

You may or may not have noticed that it is becoming increasingly hard to find a therapist who can or will accept your insurance plan. Have you ever wondered why? So they can make more money might have come to your mind, but have you ever thought that there might be more to the story?

There’s no beating around the bush – paying out of pocket for ongoing therapy can be an expensive investment in your health. Not to mention there are a number of awesome therapists who accept some insurance plans. So why do some therapists choose to opt out of accepting insurance plans and how would you benefit if you chose an out-of-network provider? I listed out a couple of the most common reasons below, because, like anything, it may not be what it seems.

Increased Confidentiality

In order for an insurance company to pay for therapy, they need some information from the therapist, including your medical diagnosis, and what type of session(s) you had, and they may even request additional records like progress notes. By not billing insurance, any clinical information (including relevant diagnoses, services rendered, and notes) are kept solely within the provider’s company. By keeping the third-party payor out of the process, there are no extra hands in your “stuff". You will likely feel more comfortable that your private information is, in fact, being kept private.

Increased Flexibility and Customized Approaches to Treatment

Because insurance tends to follow a standardized and cookie-cutter approach to treatment, they allow for only very specific session structures, will only authorize a certain number of sessions, and will hold clients to very specific timelines. By not billing insurance, you and your therapist are free to operate however will be most helpful for you and your concerns, including what you talk about, how often you meet, and what goals you set. You get to have the power. All of it. There are no meddling systems micromanaging your care.

Insurance Doesn’t Even Cover all Mental Health Diagnoses or Types of Therapy

I didn’t realize until I entered this field as a professional that insurance companies don’t even cover therapy sessions for certain types of concerns. Two of the most common types of therapy services not covered by insurance include sex therapy and couples counseling, among others. Now some therapists have tried to find their way around this and “work the system”, but others can’t get on board with that because it feels like a lie. Regardless of your beliefs around this, I think it is important as a consumer to recognize that this is another boundary imposed on therapists from insurance companies and may impact your ability to find a therapist who accepts your insurance depending on your concern.

If the word “diagnosis” scares you, fear not! As an out-of-pocket payor, therapists don’t need to diagnose. Now, providers may have a professional opinion on whether or not they would like to find a diagnosis that feels most appropriate for your concerns as a way to assist with treatment planning, but it is not a necessity. And remember, even if the therapist does diagnose you, 1) they should discuss this with you and 2) it is staying within their system, not going anywhere else.

Also, important to note: there are many, many people who come to therapy who don’t meet the criteria for a diagnosis anyway! So, by opting out of using insurance, you rid yourselves of the dilemma of needing to put a less than accurate clinical diagnosis in your medical chart.

Clear and Straight Forward Payment Options

Insurance is confusing to a lot of people. So, by avoiding it all together, you are giving yourself the gift of no-nonsense payments. Your therapist charges x, so you pay x. Some will do billing every day, others every month, but you can always anticipate, and therefore, budget for your therapy costs. With insurance, there is confusion of deductibles, co-insurance, and fears they won’t cover the service. Not to mention your share of the cost changes throughout the calendar year. This can cause a lot of stress for clients, and no one needs more stress in their life.

Fun fact: Private pay can actually be cheaper in the long run for people sometimes, especially those with high deductible insurance plans.

LAST BUT MOST IMPORTANT

The focus remains on you: The energy and effort it takes to interact with insurance companies, especially if the therapist is a one-(wo)man shop, is extreme. The insurance companies generally have hour-long hold times, poor customer service, and push back on why they are requesting more sessions with you, their client. As therapists, we try to be an advocate for you making sure that if we accept your insurance that the insurance company will, in fact, cover the cost of therapy sessions. However, on the back end of it (including denied claims, limiting session numbers, requesting clinical information, etc.), all of this time interacting with them takes away from what therapists truly want to be doing – speaking with and supporting you.

By not accepting insurance, therapists can pour all of their time and energy back into you so they can respond to your email, research some other supportive resources, or educate themselves on a new topic you recently brought up in a session. With re-distributing this time and energy in this way, therapists can give higher-quality care to you. Isn’t that what this is about anyway? Personally, I take a lot of pride in caring for my clients that I want all of my energy and attention to be focused on them, not just some of it.

I recognize that even if these benefits sound appealing to you, you truly may not be able to afford an out-of-pocket therapist right now. I assure you, there are plenty of qualified, fantastic clinicians who still accept insurance and can give you great care! Perhaps, if or when your financial situation changes, you can re-evaluate your stance then. I just want to make sure you get the help you want and need, however, that looks. A good starting point in locating a therapist is https://www.psychologytoday.com and you can filter by accepting insurance and/or private pay only.

I wish you well on your therapy journey! Contact Therapist in Minnetonka