Understanding Your Payment Options: Insurance vs. Private Pay

I want you to feel fully informed so you can make the best decision for your care. You have the option to use your insurance (if I am in-network with your plan) or choose private pay.

Using Insurance

If I am in-network with your insurance and you choose to use your benefits, session fees are adjusted based on your plan. Your out-of-pocket cost may include a copay, coinsurance, or deductible.

Pros:

  • Lower out-of-pocket cost for covered services

  • Helps make therapy more financially accessible

  • Claims are submitted on your behalf

Considerations:

  • A mental health diagnosis is required and shared with your insurance company for billing

  • Insurance may request treatment records or documentation to determine medical necessity

  • Limits on services may apply (e.g., session length, number of sessions, types of services covered)

  • Certain services may require prior authorization or may not be covered at all

  • Your care is subject to your insurance plan’s policies and medical necessity criteria

Private Pay (Self-Pay)

With private pay, you pay directly for services without involving insurance.

Pros:

  • Greater privacy (no diagnosis shared with insurance, no records submitted)

  • No restrictions on session frequency, duration, or treatment approach

  • Access to services not typically covered by insurance, such as cognitive training for attention

  • Option for package rates or bundled services

  • More flexibility in tailoring treatment to your individual needs

Considerations:

  • Higher out-of-pocket cost

  • Payment is due at the time of service

  • You are responsible for managing any reimbursement if you choose to submit claims independently (if applicable)

Making the Right Choice for You

Both options have benefits and limitations. Some clients prioritize affordability, while others value privacy and flexibility. There is no one-size-fits-all approach—what matters most is what aligns with your needs, preferences, and goals for treatment.

If you’d like, I can help you review your options so you can make an informed and confident decision.