6 Reason Why Private Pay Therapy Can Be Significantly Better than Using Insurance
You may be looking for a therapist who is in-network with your insurance. Using your insurance benefits for therapy can be a wonderful way to save money, but there could also be some downside risks that you have not considered. In this blog, I highlight some reasons why I believe paying out-of-pocket for therapy is worth the investment.
Perhaps you’ve already called dozens of in-network therapists, and no one has called you back. When someone finally does, they can’t fit you in their schedule for another month. Once you begin therapy with them, you discover they have limited expertise treating what you are needing help with. You try scheduling a follow-up appointment, and they don’t have availability for another three weeks. Maybe you feel like you are finally starting to make a little progress, and your insurance denies a claim, resulting in a huge bill that was much higher than expected. What’s worse, your therapist seemed to be nodding off in your last session and even called you by the wrong name, which didn’t make you feel very good. You decide that therapy really isn’t that helpful, and that you’re better off on your own, so you drop out before you get the real help that you need. While this might sound like a worse-case scenario, it’s honestly a similar story from what I have heard from many clients and colleagues who have tried seeking therapy from in-network providers. Here are some reasons why I believe private-pay therapy (especially at Clarity Christian Counseling) is often the best and most beneficial route.
1) Private pay therapists are more likely to call you back and get you scheduled in a timely manner. You need help now. You can’t wait a month. Because we do not accept insurance at Clarity Christian Counseling, we are able to take on smaller caseloads. This allows us to have the time and availability to serve our clients within a reasonable amount of time from when they first contact us. You may be tempted to wait a month so you can use your insurance and save money, but it is important to consider what it might cost you to delay your mental health needs for that long.
2) You may find that private pay therapists offer more flexibility with scheduling and can see you more regularly in order to meet your treatment goals as quickly and efficiently as possible. I have heard of many people attending an initial therapy session and being unable to schedule a second appointment for several weeks because their therapist does not have the time to see them sooner. Therapists who take insurance often see an unsustainable number of clients every week. Perhaps this is because insurance reimbursement rates are below the market value of a therapy session, so they need to see a high number of clients in order to make a living. This can lead to over-booking, resulting in clients being unable to maintain the necessary consistency in treatment. At Clarity Christian Counseling, we value consistency of care and the ability to offer our clients sessions at the frequency that meets their needs. While we may be unable to offer appointments on certain days or times, this is not due to overbooking or taking on an unsustainably high caseload.
3) Your therapist may be more emotionally present and engaged with you in every session. Taking insurance leads to a large number of referrals, and some therapists struggle to set healthy boundaries and only see the number of clients in a day that is sustainable to them. Can you imagine being the 8th or 9th client a therapist has seen in a single day? At Clarity Christian Counseling, we will show up as our best therapist-selves for you in every session, as we make it a point to know our healthy limits and not over-schedule.
4) Your therapist may be more experienced or specialized than insurance-based clients. This is not always the case, as there are many skilled and experienced therapists who take insurance. But, because insurance reimburses therapists at a lower rate than market value, many more experienced therapists choose to forgo it. Meanwhile, newer and less-experienced therapists feel comfortable working at a lower rate and will often panel with insurance. When looking for a therapist, it is a good idea to ask questions about their experience and areas of expertise. The therapists at Clarity Christian Counseling are fully licensed and have been working as therapists since 2010 or longer. We will assess your needs during your complimentary consultation call to ensure that we have the skills and expertise to treat your specific concerns, so you don’t waste time and money seeing a therapist that is not a good fit for you.
5) When you pay out-of-pocket, your insurance company does not get to dictate your treatment. Insurance companies generally have specific requirements that need to be met in each session in order for them to agree to cover the cost of your treatment. This means that if you do not meet criteria for specific diagnoses, or if the insurance company thinks you no longer need services, they will refuse to pay for your sessions. While you can fight with the insurance company and argue for continued coverage, this causes stress and can still result in a claims denial. Furthermore, it can take months for insurance companies to reject a claim. You may be participating in therapy for several sessions without the knowledge that insurance will refuse to pay for it, resulting in quite the unexpected bill that you will be responsible for. If you pay out-of-pocket, you will already be aware of the cost of therapy and know how to budget accordingly so you do not have any financial surprises.
6) Using insurance for therapy can result in pre-existing medical conditions on your medical record. Insurance companies will generally require a mental health diagnosis to be listed on your claim in order for them to approve coverage. While there is no shame in a diagnosis, it can cause some unexpected problems in future, including increased insurance costs or denials if you switch insurance companies, as well as other restrictions. Private pay therapy allows you to avoid these potential issues.
It is important to consider the risks and benefits of using insurance or opting for private pay when looking for a therapist. Finances do prove a significant barrier for many, however, if you are able to invest in private pay, you may get better treatment faster. If finances are a concern, explore other means that might make private pay therapy doable. For example, you can generally use your Health Savings Account (HSA) or Flexible Spending Account (FSA) to make therapy payments tax deductible. Many insurance companies will also offer out-of-network benefits. This means that you can often submit what is called a superbill (a special receipt for the services you receive) to your insurance company and receive partial reimbursement. This can be a great way to reduce the financial cost of therapy.
At Clarity Christian Counseling, we value excellence and offer high quality therapy to our clients so they can receive the help they need and achieve their mental health goals in a timely and effective manner. We strive to demonstrate care for our clients through making room for them in our schedules, not double-booking, and showing up fully present as therapists.
In my experience as a therapist, the majority of my clients see significant improvement after attending 8 consistent sessions. While this is not a guarantee as success in therapy is dependent on a variety of factors, it is purely an observation. Therapy works when you go to the right therapist, have an openness and desire to change, and put in the effort. Think about it. Eight weeks and a $1500 investment could drastically improve your quality of life by helping you heal and equipping you with the skills you need to cope effectively with the challenges you are facing. That’s less than the root canal I had last summer.
We want you to get the help you need. Contact us today to schedule your free 15-minute phone consultation by completing the form here. We will get back to you within 1-2 business days, and probably sooner!