What are the benefits of paying privately for counseling versus using insurance?


Paying privately may be a better choice even if you have health insurance. Most clients seek therapy to improve relationships or transition through "rough patches," but to an insurance company review board, these are not acceptable reasons. To be approved for therapy sessions, the therapist must make a case that therapy is "medically necessary" which includes accentuating the problems the client is experiencing and labeling the client with a mental illness. This is often required after the first visit, and then becomes part of the client's permanent health record. 

 

Your mental health records won't be used against you.


Did you know that your health records may limit your ability to qualify for health or life insurance or require that you pay substantially higher premiums in the future? The personal details of therapy are often entered into a database called the Medical Information Bureau (MIB) by your insurance company. The medical information on over 16 million people is currently housed in this database. Other providers, insurance companies and even non-medical services like personnel departments may have access to this information for the purposes of evaluating you.

Mental health diagnoses, even the temporary use of anti-depressant medication, have been reported to backfire on consumers who have applied for individual insurance coverage. It is unclear to what extent the personal health information in the MIB may be used or for how long it is stored in the database.

Your confidentiality will not be compromised.


My commitment to care for my clients includes a desire to maintain their confidentiality. To be reimbursed by an insurance company, I would have to label you with a diagnosis and submit frequent updates on symptoms and what is happening in therapy. These may be scrutinized by the insurance company so in order to ensure continuation of treatment, I have to stress all the things that are not going well rather than focus on your strengths.

You (not a managed care panel) are making decisions about your treatment.


Many insurance companies provide payment only for certain approaches of therapy (short-term and problem-focused) and many others won't pay for family therapy, even when the client is a child and the parents are vital to the therapeutic process. Obviously, it is in the best interest of the insurance company to pay as little as possible for services, work only with the same group of providers rather than a broad range of specialists and to end therapy as quickly as possible. None of their motives address the best interest of the client.

You may save money in the long run.


Your insurance plan most likely includes a co-pay and then covers only a percentage of the therapist's fee which means you would be paying cash for a portion of the therapy anyway. You might be surprised to find that the difference between private pay and insurance co-pays are not that much more. Therapy will ultimately save you money in the long run: less money spent on stress-related illness, fewer problems at home or with your child's school behavior which may result in less time off from work. 

According to the National Institute for Mental Health, half of all lifetime mental health cases begin by age 14. If left untreated, these issues may become more severe (requiring much more extensive therapy) or progress into other unhealthy behaviors (substance abuse, suicidal behaviors, etc.). Can you put a price tag on peace of mind and happiness?

You can set your priorities for what is most important.


We find the money to pay for what's important. We pay cash for important services like car repairs, club memberships and salon visits, all of which are valuable services but meet only short-term needs. If it seems you can't afford weekly or bi-weekly therapy sessions for a period of time (therapy does not have to be a long-term commitment), there might be ways of re-prioritizing expenses to address this important service. A few adjustments to your family budget may ensure that you can receive the professional counseling that is needed to help make life-long changes.

Therapy has the potential to create lasting change and to avert more serious problems later on. 


The teen years is such an important stage of life and parents should have choices over what is in their child's best interest. When you or your teen is struggling, there are many important factors to take into consideration. Finding the right provider who is the best match for you or your teen is important and a decision only YOU should make. Since we don't know if or for how long the personal information of your child's mental health record could be kept on file with the MIB, we encourage you to take this risk into account. Consider making the choice to adjust your budget to include this important service for your child's well-being with the assurance that it will remain completely confidential both now and through your child's future. 

In summary, here are good reasons to pay privately for therapy:

  • You choose the therapist best suited to your needs rather than the insurance company telling you who to see.

  • You have flexibility in the type of therapy, who to include in the therapy session and the length of services.

  • You will have complete confidentiality. Your records will not be shared with anyone without your permission. In fact, no one else will know you are even in therapy unless you tell them!

  • You won't have to worry that your health records will be included in the MIB and possibly create problems for you or your family in the future.

  • You will be able to stay with your therapist even if your insurance plan coverage changes.

​© 2019 by Sidney Gaskins, LPC

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  • Fostering Health Alliance
  • Sidney Gaskins
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