The Pros and Cons of Using Insurance


  • Depending on your plan, private insurance will either pay a portion of the charge for psychotherapy, the entire amount, or apply the amount towards a deductible you currently have.  This makes sense to some individuals, if the deductible is one that they can meet.
  • Provides you access to mental health services that you may not otherwise be able to afford.


  • You must be given a mental health diagnosis in order for insurance to pay.  If you don’t meet the medical criteria for one, insurance doesn’t pay, and yet you want to live life more fully, are struggling emotionally and need support. that increases the quality of your life and is proactive.
  • Since the insurance company pays, they have a right to audit  your clinical records and have access to all of your information.  They do this to ensure that a therapist is not committing insurance fraud, providing appropriate services to the given diagnosis, and for quality assurance.  However, what they do with that information is unknown, and a therapist has no control over how they use it once it is in their hands.They can at any point, after review of treatment, decide they won’t pay, even if the therapist disagrees.
  • There is some level of concern that mental health diagnoses can be used to deny life insurance, jobs or viewed as pre-existing conditions allowing a future insurer to deny coverage.

Pros of private pay

  • Your information shared with me in session remains confidential ,with the exception of court subpoena, reporting abuse, and imminent risk of harm to self or others(see Professional Disclosure).  Your insurance company has no right to access your information if they are not paying the bill.
  • You can benefit from psychotherapy even if no mental health condition is present.
  • You can be proactive and use therapy to improve your quality of life.
  • Your insurance company cannot dictate how long your therapy should last or when therapy is done. You and I will make that decision together.
  • If you have a high deductible insurance plan that you rarely meet, you are essentially paying out of pocket while allowing your insurer the right to access your information.  Considering the low reimbursement rates for therapy in general, an otherwise healthy person may not meet their deductible solely seeing a therapist.

Cons of private pay

  • Out of pocket costs can be higher and limit how much, if any, therapy you might be able to afford.
  • Those who choose to pay out of pocket often want to space sessions out to once every two weeks or once a month.  That’s a reasonable arrangement once therapy is well underway, but for me to really get to know you and to  sin our work, several weekly visits are optimum.initially it’s hard to gain any momentum in the work (or a therapist to really get to know you well enough) if you don’t meet weekly for the first 6 weeks.