Insurance VS. Out-of-Pocket

Not sure which option is the best for you? There are distinct advantages (and disadvantages) to each.

Insurance Benefits:

You’re already paying for insurance, it is nice to be able to “get what you pay for” and have services covered. For some this is major advantage, especially if you have a relatively low deductible or have met your deductible for the year. In these cases you can expect to pay your co-pay, which is usually 1/3rd the cost of a full pay session or less (on average).

Insurance Disadvantages:

1.Insurance sets the rate, so if you have not met your deductible… your insurance company determines your rate until you have reached your deductible, at times this can be equal to or higher than out of pocket rates. 2. Using insurance requires a mental health diagnosis. For some, this might be problematic as it could affect their jobs or certain life-insurance policies down the line. 3. Insurance can dictate treatment at times (i.e- you may benefit from a 1 or 2 day intensive, or you feel you would benefit from an additional hour, insurance will not pay for these.)

Out-of-pocket Advantages:

Since the rate is determined by the therapist, out-of-pocket allows for maximum flexibility. Out-of-pocket also allows for maximum flexibility regarding scheduling (i.e.- 2 hours sessions, intensives, etc.) Finally, Out-of-pocket does not require a mental health diagnosis… and out of pocket treatment does not necessarily appear in your official medical record.

Out-of-pocket Disadvantages:

You’re already paying an arm and a leg for insurance each month… it is shame to not be able to use it if you can. With out-of-pocket you are paying full market value for services, which might be cost prohibitive for some.