Private pay versus insurance can be a confusing concept in the medical field, but even more so with mental health. In this article, we'll take a comprehensive look at private pay for clients, what it entails, and why private pay may be a better choice for some people.
On this page:
Why do some therapists take insurance while others don’t?
Pros and Cons of Private Pay Therapy Sessions
Choosing a Therapist That's Right for You
Therapy in Williamsburg, Brooklyn
Why do some therapists take insurance while others don’t?
For the mental health professional, choosing whether to go private or accept insurance can be a big decision to make. Here are some reasons a practitioner may decide to accept self-pay clients rather than work with an insurance company:
- Depending on their area, they can expand their client base. Some private pay clients don't have insurance or prefer self-pay for privacy or control of care.
- There's less of a burden with billing and administration. Taking insurance can lead to a lot of extra paperwork and hassle.
- Financial transparency between client and professional, with no insurance company middleman.
- No health insurance to dictate number of sessions, timing of sessions, and other limitations. When the client pays, it allows greater freedom.
- Due to personalization and privacy factors, clients pay higher fees for sessions and the provider can set their rates based on demand.
- Improved therapeutic relationship without insurance company interference in care.
- Greater privacy for confidential records, which many individuals appreciate when it comes to mental health care.
- Allows the practitioner to work with specific needs, and create a niche clientele.
- To avoid submitting documentation that can create a lot of extra work, especially if insurance panels decide to change future insurance coverage.
Pros and Cons of Private Pay Therapy Sessions
Mental health services are incredibly personal, and the factors involved in choosing the right therapists are highly individual. There are both pros and cons to working with a private pay therapist, so let's take a look at both sides.
Why a Person May Choose Private Pay
A client may choose to work with private pay therapists for mental health support for any of the following reasons.
- A private pay practice offers greater confidentiality. An individual may not want an insurance company to have access to their mental health records or other confidential information.
- Some people simply do not have insurance coverage, or their health insurance plans do not cover mental health diagnoses, and they must find a private pay therapist.
- Working outside of insurance companies can allow many individuals to get an appointment more quickly.
- An individual may want to meet with a specific mental health care professional who is outside of their insurance networks. This can include a therapy practice that offers specialized care like LGBTQ-friendly, or a therapist who works with religious trauma.
- Providers that work with an insurance company often have to adhere to time limits or session limits for care. Many individuals require more therapy sessions for their mental conditions than the insurance billing allows. Private pay can offer more therapy sessions for these clients.
- For those who have maxed out their insurance use for mental health, private pay can be the more economic options, with some offering sliding scale rates.
- Allows potential clients to get around pre-existing condition complications, which insurance companies will often use to deny care.
- Continuity of care is more stable because neither the client nor the provider is required to work through an insurance company. This can lead to a better therapy experience.
- Better customized care for the client because they are not relying on insurance coverage for treatment of their mental health diagnosis, and offers greater control over the treatment process.
Why a Person May Choose to Use Insurance
On the other hand, some people will seek a therapist who is part of an insurance network. Here are some reasons that a person may choose to use a therapist who accepts insurance.
- They may pay less out of pocket, depending on what the mental health coverage looks like with their insurance benefits.
- They may receive employer insurance benefits, and find that managing care with those accepting insurance saves them money.
- Some insurance networks offer strong coordination of care, making it easier for some to manage their healthcare needs.
- For a certain mental health diagnosis, an insurance company may offer in-network provider that covers their needs on an ongoing basis
Choosing a Therapist That's Right for You
The bottom line for those looking for a therapist is to find the therapist that's right for you, regardless of insurance providers. Research shows that one of the top reasons therapy can fail is that a client discontinues sessions. With private practice, you gain more control over the therapist you choose, as well as the number and duration of therapy sessions necessary. Private pay offers this control outside of insurance companies demands to justify treatment or decisions to discontinue coverage.
Some people may have to work through insurance companies for financial reasons, which is fine. The most important thing is to get therapy sessions when you need them. Just remember that you have options and to explore all payment options before making a decision. Especially if you are looking for a type of therapy that may not be common, you want more control over your therapy, or if you live in a rural area.
Some private pay therapists can work with you on the session fee or can help you find a way to cover costs if you are unwilling or unable to work through insurance companies. To find a private pay therapist who is right for you, you can simply type "private pay therapists in my area" and add any additional factors that you want to be addressed, such as medical conditions or specific diagnoses or specialties.
Therapy in Williamsburg, Brooklyn
Williamsburg Therapy Group is a private pay therapy group in Brooklyn with the city's finest doctoral-level mental health therapists.
Give us a call or book online to get the mental healthcare you deserve. Feeling better may be closer than you think.