There are important factors to consider when deciding whether to use insurance or pay for care out of pocket. We want to support you in making an informed decision.

Self-Pay Versus Insurance

Cost may be the first reason you are thinking of using insurance for counseling, but we believe it is important for you to stay informed of all of the factors that go into this decision. Here are some things to consider when choosing whether to use your insurance or self-pay for counseling services.

Diagnosis Required

Often, a person’s reason for seeking counseling is not related to a mental health diagnosis. However, most insurance companies require a diagnosis in order to pay for treatment. A counselor who is functioning ethically and in your best interest will not diagnose exclusively to utilize insurance. Additionally, there are some diagnoses that may be appropriate to what you are experiencing that insurance companies will not cover if they do not deem counseling to be ‘medically necessary’. Paying out of pocket allows you to access services regardless of diagnosis status, and you have the power to determine if sessions are necessary.

Session Duration

Insurance companies ultimately decide the number of counseling sessions you are able to receive, dependent on your diagnosis and benefits package. At the end of that number of sessions, your case will be re-evaluated by your insurance to determine if counseling continues to be ‘medically necessary’. Unfortunately, there is never a guarantee of receiving insurance approval to continue. Self-pay allows you to make the decision of continuing in counseling if it is working for you.

Decreased Privacy

Information that is communicated to your insurance for reimbursement is part of your medical record. This includes any diagnosis you received, as well as any other information the insurance requested to determine coverage. When paying privately, you have increased control over where, when, and how your information is shared.

Out of your network? 

No problem! You may file for reimbursement from your insurance company in 3 easy steps.

• Call the member phone number on the back of your insurance card.

• Ask if you have out of network mental health benefits. If you do, ask what insurance is willing to reimburse.

• Submit your superbill (what we can give you after each paid session), to your insurance company to be reimbursed what your insurance company covers.