Counseling is an investment! It’s an investment in yourself, your relationships, your career and your happiness. It’s an investment in your future and let’s be honest, it can be transformative...if you put the work in.
One of the common questions clients asks when they first call to schedule is, “Why should I pay out of pocket for counseling if it’s covered under my insurance plan?” First, let me tell you that it’s not my job to convince you to use or not use your insurance but I like to be transparent and upfront with my clients. Let’s break this down so that you can make the decision that’s best for you and your family.
Why should I use my insurance? I feel like insurance is a budgeted expense that many people have to plan for in their lives so using your insurance can and often does make sense. Insurance is expensive and it’s a good idea to use it if you can find a provider that’s in network that you feel comfortable working with to address your concerns. It’s important to remember, that in order to use your insurance for counseling services that you need to have a qualifying mental health disorder that is the focus of the counseling in order for your services to be covered through your insurance. This includes individual counseling AND couples counseling. IF you’ve ever seen a therapist before and they’ve billed your insurance you’ve been diagnosed with a mental health disorder. Period, no if’s and’s or but’s.
Why should I consider paying out of pocket for counseling? Well, for starters, you do NOT need a qualifying mental health disorder if you’re paying out of pocket for counseling! For a lot of people, this is a really big deal. With healthcare in flux and the growing concern that pre-existing conditions will impact your future healthcare costs, many people are choosing to pay out of pocket when possible. Another reason many people choose to pay out of pocket is that your care isn’t limited by what insurance companies authorize or agree to pay for as a part of your services. It’s frustrating to try to get pre-authorization for necessary medical care and paying out of pocket for services allows people to avoid these types of hassles. Additionally, a counselor that has the specialized training to provide you with the care you’re seeking may not be “in network” with your insurance and paying out of pocket for your care allows you access to work with anyone counselor that meets your needs. This next one is huge and most people aren’t even aware of it. Most insurance companies have a benefit they offer to their members called, “OON or Out of Network benefits.” Basically, this allows people to see any provider they want and they can submit a receipt for payment of those services to their insurance company for partial or full reimbursement. This receipt is called a superbill and can be given to clients by any therapist. Furthermore, a lot of people have insurance plans with high deductibles which can be frustrating. But, when clients educate themselves and realize that their out of pocket expenses for counseling services can be used to meet their already high deductible, paying out of pocket for services doesn’t seem so prohibitive.
Obviously, you can see that there are many reasons to consider paying out of pocket for counseling services. However, if you’re not detracted by being diagnosed with a mental health disorder and you feel like your insurance plan has a good network of providers for you to work with, using insurance can be a great option for you!