Why do I only accept out-of-pocket payments (“self-pay”), rather than insurance?

• I can offer longer and/or more frequent sessions, depending on what is in the best interest of my client(s). Insurance companies often do not allow for more than one session per week, unless need is specifically proven & outlined in client’s chart.

•Some insurance companies have a limit on the amount of sessions a client can have over the course of treatment. By paying out-of-pocket, the client and therapist can collaborate on how long the course of therapy might be.

•Insurance companies require a diagnosis in order to cover an individual’s therapy sessions. While diagnoses can be helpful in conceptualizing one’s experience, they are not always necessary. I tend to keep one on file and prefer to collaborate with my clients on a diagnosis, as I believe it is important for one to feel agency over any label in order for it to make sense, and in this case, potentially help de-stigmatize it.

•Self-pay allows for greater confidentiality (aka more privacy), as any diagnoses, treatment plan, and/or progress notes are for your benefit alone, not for insurance companies.

•Paying out-of-pocket avoids the mess that is deductibles, co-pays, paperwork, and pre-approvals. You know what and who you are paying for, what you owe, and what to monetarily plan for when it comes to your mental health treatment.

•From the perspective of living wages, you are paying an ethical wage to your highly-trained and skilled mental health professional, who has spent several years and many, many more unpaid hours learning and practicing to earn their graduate degree, and thousands of hours more of post-graduate work. Self-paying your therapist means they are being paid appropriately for the work they do, instead of much of that money going to the billion-dollar corporations that are insurance companies.