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FAQ: Why don’t you accept insurance?


Some drawbacks of using insurance for therapy:
  • Session Limits – Insurance companies have a vested interest in reducing their costs. It is often cheaper for them to create obstacles to treatment (that then need to be appealed by providers, patients, or both) rather than to simply authorize adequate treatment up front. Often, people will only have a handful of covered sessions in which to address and work through longstanding issues. The resulting pressure on both therapist and patient can add additional stress, and interfere with effective therapy.

  • Limited Scope– Because of session limits and other insurance requirements, many therapists are learning to narrow or limit the scope of treatment. This may seem like a good thing, because it provides incentive to keep therapy ‘on track.’ However, in real-world treatment settings where problems are often complex and interconnected, the pressure to “focus” treatment can cause important issues to go unexplored.

  • Loss of Privacy – Many insurance companies require therapists to diagnose their patients in order for treatment to be authorized. Not surprisingly, this can have important consequences. Once the diagnosis is recorded and sent to insurance, the therapist has no further ability to control the dissemination of that information. It becomes a part of a permanent record. Some diagnoses carry stigma, can be used to justify decisions about life insurance coverage, may impact security screenings for some forms of employment and other individual rights of each citizen. In addition, there are circumstances under which an insurance company can audit a therapist’s treatment notes. When therapists treat patients privately, they retain discretion over whether or not to provide an official diagnosis. The best way to ensure the highest level of privacy is to pay for therapy out-of-pocket.

  • Intrusion in the Therapy Relationship – Therapy works best when it is a collaborative and private relationship between therapist and patient. Involvement of third-party payers, such as insurance companies, necessarily intrudes on that relationship. It places the power to make critical treatment decisions in the hands of someone who may not even know the patient.


The benefits of paying out-of-pocket:
  • Depth – Mental health issues are often complex and based on multiple underlying causes. Brief, symptom-focused treatments do not usually address these underlying issues, leaving patients vulnerable to relapse after treatment has ended. When you private-pay for therapy, the duration of treatment is dictated by your individual needs. You and your therapist are free to explore and work through any underlying causes, making symptoms less likely to return after therapy has ended. Modalities that are ethically viable but not covered by insurance are open to private pay clients. 

  • Quality of the Relationship – Learning to trust someone enough to let them in takes time. Therapists have long known this and research demonstrates the benefits of the early trust-building phase of therapy so that the often more impactful later phases of treatment can be reached. This is where lasting change is often achieved. When you pay out-of-pocket, you give both you and your therapist a chance to build the trust that will be so vital in helping you to work through difficult issues that may lie further down the road.

  • Increased Value – Like anything in life, therapy has more emotional and psychological value when it requires some level of sacrifice to obtain. Budgeting and paying for therapy out of one’s own pocket makes the relationship more significant. It carries more weight because of the patient’s personal investment in the process. Research shows that clients who have to pay something for their treatment have more positive outcomes that those who receive free treatment.  Not only do you get what you pay for, but the fact that you are paying out of pocket provides extra motivation and incentive to make the most of therapy. 

Is private-pay therapy right for you?
  • Despite the benefits, many people simply can’t afford to pay out-of-pocket for therapy services. While private-pay may not be right for everyone, many therapists, including Carve Your Own Path, Inc., reserve a few low-fee spaces in their practices, both as a way of giving back to the community and in order to work with individuals who have complex cases but can’t afford the treatment they require. We are also happy to provide an out of network SuperBill for you to submit to your insurance provider for approved reimbursement upon request.

    Please feel free to contact us with any additional questions.

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