Therapy Basics Part 3: How to Pay for Therapy

So you’ve decided you need therapy, and have found a therapist, but now you’re worried that cost will hold you back. Often your insurance provider might be the first place you go to find a therapist. While many therapists still accept insurance, more and more do not. I do not accept insurance, and I receive many calls from prospective clients who want to use their insurance to pay for therapy. There are many reasons a therapist might choose to do this, including less hassle, less paperwork, and better pay. But why is self-pay better for clients than using insurance to pay for therapy?

Here are some of the benefits of paying for your therapy sessions out of pocket (called self-pay or private pay) over insurance:

1. It might be the same cost. Unfortunately, many insurances have poor coverage for mental health treatment. If you have a high deductible plan, you have to meet the deductible before insurance will cover a majority of the session cost anyway. Many therapists are willing to offer a reduced fee for those who are paying out of pocket. For many clients, the co-pay when using insurance is about the same as a sliding scale self-pay fee.
2. Self-pay allows you and your therapist greater control over your treatment. Many times, insurance will limit your number of sessions or require a certain diagnosis in order to receive therapy. Instead of letting your insurance provider dictate how many sessions you get, how long you can be in therapy, or who you see, you and your therapist have the freedom to decide that for yourself.
3. Insurance requires a diagnosis. For some clients, they may be experiencing a mental health diagnosis, such as major depressive disorder or post-traumatic stress disorder. But for many people, they do not fit one clear diagnosis. Couples therapy or counseling for a life transition or grief after a death, for example, may not warrant a diagnosis. Insurance will not pay without certain approved diagnoses, meaning you might miss out on the help that you need.
4. Greater privacy and confidentiality. Many clients do not want a mental health diagnosis on their insurance record. Some people work jobs that require extra privacy for mental health treatment. Some life insurance applications require you to admit a mental health diagnosis, and may change your policy based on this “pre-existing condition”. When you self-pay, you are ensuring that all of your personal information stays private and is not released to any third party (with the legal exceptions of harm to self or others and child abuse).
5. Better client experience. To be fair, many therapists who take insurance provide the same level of professional and competent care as self-pay therapists. However, if you are willing to pay out of pocket, you can often see someone who is more experienced and specializes in your area of concern. You may have an easier time scheduling and greater freedom to tailor your treatment, leading to an overall better experience.

How to Self-pay for Therapy

So how can you afford a private pay therapist when their fee is normally $100 or more per session? Ask your therapist if they offer a reduced fee based on financial need. Based on your needs, discuss biweekly sessions instead of weekly. You could also your HSA to pay for therapy. See if your therapist provides out of network courtesy billing, in which the therapist submits an insurance claim on your behalf. Or see if they will provide a “superbill” to you so you can submit a claim yourself. These two methods may allow for some insurance reimbursement to you, after you have paid the therapist’s self-pay fee.

Like all professional health services, therapy is an investment of time, effort, and yes, money. Therapists must make a living from their practice, but many are willing to reduce their fees for a motivated client in need. Don’t shy away from private pay because you think insurance is better. Find a therapist that fits your needs and specializes in your concerns, then see how you afford to work with them even if they don’t accept insurance payment.

Interested in learning about my therapy practice in Knoxville? Contact me for more information.

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