Private Pay
Pros:
More flexibility in choosing a provider
No need to meet with insurance company requirements
More control over privacy and mental health record
Higher average rates per session
No delays in getting paid for services
No claims or paperwork to file
Less likely to need auxiliary staff
Cons:
Can be more expensive
Not all clients can afford it
● May be difficult to find a private pay therapist who is a good fit
Insurance
Pros:
Can be more affordable for some clients
More providers to choose from
Less paperwork for the client
May be covered by your employer's health insurance plan
Cons:
May have to meet with insurance company requirements
Less control over privacy and mental health record
Lower average rates per session
Delays in getting paid for services
Claims and paperwork to file
More likely to need auxiliary staff
Ultimately, the best way to pay for therapy is the way that works best for you and your individual needs. If you are concerned about privacy or want more flexibility in choosing a provider, then private pay may be a good option for you. If you are looking for a more affordable option, then insurance may be a better choice.
Here are some additional factors to consider when making your decision:
Your budget: How much can you afford to pay for therapy each month? If you have a limited budget, private pay may not be an option for you. However, there are some providers who offer sliding scale fees, so you may be able to find a therapist who is affordable.
Your insurance coverage: What is your insurance deductible? What is your out-of-pocket maximum? Your needs: What are your specific needs for therapy? Do you need a therapist who specializes in a particular issue? Do you prefer Telehealth sessions and are they allowed for insurance reimbursement? If you have good insurance coverage, you may be able to get mental health care at a lower cost through your insurance. However, you may be limited in your choice of providers, and you may need to meet with insurance company approval before starting therapy.
Your preferences for privacy and confidentiality: If you are concerned about privacy and confidentiality, you may want to consider private pay without requesting insurance payment through a Superbill. A Superbill is a document that provides insurance companies with detailed information about the services a therapist or other healthcare provider has rendered to a client. This information includes the client's name, insurance information, the date and time of the service, the type of service, the diagnosis, the provider's name and credentials, and the fee charged. Superbills are typically required for out-of-network providers, as they allow insurance companies to determine whether the services rendered are covered and how much reimbursement is due. With private pay, you may choose to not submit a Superbill so your diagnosis is not submitted with your insurance.
It is important to talk to your therapist about your payment options and what is best for you. They can help you understand your insurance coverage and your options for private pay.