If you have health insurance, as most people do, it’s probably never occurred to you to pay for anything health-related out of pocket. Sure, we sometimes have co-pays and there are times when our doctors’ or specialists’ visits cost above and beyond what your insurance covers and you have a bill to pay. But by and large, health insurance covers most of the cost of the care we receive. So, it seems to make the most sense to use your insurance and have everything taken care of with a $25 co-pay. We understand the allure. However, do you know what you give up for that co-pay?
Here are the facts:
1. If you use insurance, we have to give you a diagnosis.
It’s not exactly common knowledge outside the counseling and therapy circle, but insurance companies require a diagnosis so they can decide if they’ll pay for your counseling or not. That’s right, your insurance company gets to pick and choose if they’ll pay for based on what we tell them about you. This means we have to give you a diagnosis, whether you really need it or not. Coming in because you’re dealing with grief over losing a loved one? You may get diagnosed with “major depressive disorder”. Struggling in a new relationship? You could get an “adjustment disorder” diagnosis.
2. Your diagnosis can follow you.
If diagnosed, as mentioned above, this diagnosis may follow you. There may be times on job applications or membership forms where you’re asked “Have you ever been diagnosed with a mental health condition?” Counseling isn’t a bad thing – but there’s still some stigma around it, even with potential employers, and you wouldn’t want that to hinder your future prospects. Also, in many cases, mental health diagnoses do not have a statue of limitations, meaning they could follow you forever as a “pre-existing condition”. As a client, it’s rare you would ever even know your diagnosis if it’s not discussed with you. Paying out of pocket doesn’t require a diagnosis.
3. Health insurance companies can choose your therapist for you.
If you’re using insurance, you’ll likely only be able to see therapists who have a contract with your insurance company. If your plan is with a major insurance company, this may not be a problem if there’s a vast network of therapists available. However, things change. Life and job situations change. If you’re working with a therapist who is In-Network with your insurance provider, and then you get a new job and switch insurances mid-therapy to a company who your counselor is not contracted with, you’ll be stuck deciding if you should find a new therapist in your network, or paying out of pocket anyway.
4. Your time and treatment can be controlled by the insurance company.
Insurance companies get to determine the time intervals they will pay for and the models of therapy they’ll accept. This isn’t a big deal if what you’re going through isn’t too severe and can be wrapped up in twelve sessions or less. Sometimes, that’s the case. But what if you need a longer treatment period? What if it lasts six months? Again, you’ll be paying privately.
For some, paying with insurance is unavoidable, whether financially or for other reasons. However, paying privately allows you to keep your own information secure. No diagnosis or label is required, and the only person dictating your level of care and length of counseling is you.
While the idea of paying a full-rate for insurance can certainly seem daunting, we work to make services as affordable as possible. We offer self-pay rates of $85 or $40 depending on the counselor’s level of experience and education. These rates fall well below the regional average for therapy. If cost is a barrier to seeking therapy, we certainly will never try to talk you out of using your insurance benefits, but believe we have this responsibility of letting you know the facts.