Is Using Insurance for Therapy Always the Best Choice?
What to Know Before You Decide
When people are considering starting therapy, one of the first questions they often ask is: “Do you take my insurance?” It’s a completely understandable question—therapy is an investment, and for many, insurance makes it more accessible.
But what many people don’t realize is that using insurance for mental health care comes with trade-offs. There are good reasons some clients choose to pay privately for therapy, even when they have insurance coverage.
Here’s why.
Privacy Matters
To use insurance for therapy, I’m required to submit a formal diagnosis and ongoing documentation about your treatment. That information becomes part of your permanent medical record—and, depending on the insurer or employer, may be accessible to other systems or reviewed by third-party administrators.
If you’d rather keep your mental health care completely confidential—between you and your therapist—paying privately allows for that level of privacy. No diagnosis, no reporting, no third-party review.
Some People Don’t Want—or Need—a Diagnosis
Insurance companies typically only cover therapy if it’s considered “medically necessary,” meaning a formal mental health diagnosis must be provided. But not everyone who seeks therapy meets that threshold.
You might want support around:
Relationship tension
Work stress or burnout
Life transitions
Parenting or caregiving challenges
Identity exploration or grief
These are valid reasons to seek therapy—but they may not be “billable” through insurance. Paying privately allows us to work on what you want, not what a system approves.
Flexibility Gets Complicated
Insurance plans often place limits on:
The number of sessions you can have
How long those sessions can continue
Whether you need pre-authorization to continue therapy
Which types of therapy or approaches are covered
When you pay privately, we don’t have to fit your healing into someone else’s timeline. We can work at a pace that actually supports your process.
The Right Fit Is Everything
I’m continually working to get credentialed with a range of insurance providers to expand access. But even so, insurance networks don’t cover every therapist. That means if you’re limited to in-network options, you might miss out on working with someone who really gets you.
Private pay gives you more freedom to choose your therapist based on fit, not just who your plan covers. And in therapy, that fit makes all the difference.
The Hidden Costs of Using Insurance
Even when you use insurance, there are often unexpected out-of-pocket costs:
Deductibles that haven’t been met yet
High co-pays
Denied claims you didn’t anticipate
Surprise billing issues
Private pay offers simplicity. You know exactly what you’re paying, and there are no billing surprises.
What’s Right for You?
There’s no one-size-fits-all answer. For some people, using insurance is absolutely the right choice. For others, private pay offers more privacy, flexibility, and control over their care.
If you’re weighing your options and not sure what makes sense for you, I’m happy to talk through the pros and cons in a free consultation—no pressure, just information.
Want to explore whether therapy with me might be a good fit?
