Benefits of Self Pay vs. Insurance
Do you have high deductibles that must be met?
Do you want your insurance company to know your mental health diagnosis?
Does the reason in which you are seeking treatment for meet the criteria for “medical necessity”?
There are many benefits to choosing self-pay vs insurance when seeking mental health treatment.
Here are just a few:
Confidentiality.
-Your information would remain completely private and confidential between you and your therapist.
-You would not have to surrender any confidential information to your insurance company.
Confidence.
-Create a long-term relationship with your provider.
-Employers often change insurance companies to save money. You may form a bond with your therapist only to find out that he or she is not a provider on your new plan.
Control.
-You are in complete control.
-You are in control of how many sessions you want instead of the insurance company who has the right to determine if you are eligible for counseling services rather than it being your choice.
Disadvantages of using insurance instead of self pay:
Permanent.
In order for insurance to reimburse your treatment you will receive a mental health diagnosis that goes in your permanent medical record. This diagnosis constitutes a “pre-existing condition” that may be a disqualification from benefits in the future or may otherwise interfere with your coverage if you change plans.
Diagnosis.
Insurance rarely pays for marital or relationship therapy. Instead, one partner will be identified as the “identified patient” and will receive a mental health diagnosis. The insurance company will then authorize conjoint treatment for that person and his/her partner.
Red tape.
Insurance policies often limit the number of sessions you are allowed to attend each year. They may or may not authorize more sessions based on what they determine is a “medical necessity”. Your therapist will have little say in this decision and making your case may involve a lot of paperwork and footwork on your part.
Advantages of using insurance.
COVERAGE.
Could be more cost effective if you already have the coverage (no out-of-pocket costs) & if you are able to see the provider you’d prefer under your existing plan.