Benefits of Private Pay

Using your health insurance comes with certain risks and restrictions, while paying for services out-of-pocket increases flexibility and treatment options. You must determine which is best for you.

  1. You choose the right therapist for your needs, as you are not required to select from the options given to you by the insurance company.

  2. Most health insurance companies require clients to have a mental health diagnosis before they will pay for services. Approval for therapy requires clinicians to label you with a disorder (often after the first session) and then prove to the insurance company that the treatment is “medically necessary.” This diagnosis becomes a part of your permanent health record.

  3. Additionally, insurance companies frequently limit sessions to discussing only matters that pertain directly to your diagnosis. Unfortunately, this often means insurance won't cover topics you may need to address (such as relationships, work, or phase of life issues). Through private pay, therapists don't need to label you to provide services, AND they can work with you on any presenting issue.

  4. You aren't restricted to a certain number of sessions. Not everybody is ready to progress as quickly as the insurance company may like.

  5. Your therapist has the freedom and flexibility to be creative and suggest therapy options that may not be endorsed by the insurance companies. This guarantees your treatment plan is specific to you.

  6. Your mental heath records won't be used against you. All psychiatric healthcare providers are required by federal law to keep confidential records. When you choose to use your insurance, your provider requires you to sign a waiver, allowing for the communication of your confidential information to your insurance company. This may include dates of service and your mental health diagnosis. In the event your insurance company requires preauthorization for treatment and/or reviews your file, additional information, such as therapy session notes, which includes the content of the sessions, must be provided to them.

    GENERALLY, I DO NOT BELIEVE IT IS IN THE BEST INTEREST OF ANY CLIENT TO HAVE INSURANCE COMPANIES DECIDING WHAT TYPE OF TREATMENT IS APPROPRIATE FOR SOMEONE THEY HAVE NEVER MET.

  7. Another consideration is that this information becomes part of your record and could be used by insurance companies to raise your rates, as well as prevent you from obtaining life insurance or disability insurance, should the need arise. It may also prohibit you from securing private health insurance should you make the decision to become self-employed in the future. 

  8. Importantly, the personal details of therapy are often entered into a database called the Medical Information Bureau (MIB) by your insurance company. The medical information of millions of people resides in this database. Other providers, insurance companies and even non-medical services like personnel departments may have access to this information for the purposes of evaluating you and negotiating corporate group rates.