Insurance
Why Choose Private Pay vs using insurance?
Utilizing private pay is a huge advantage over most insurance since you will not be term-limited in your therapy, your insurance company will not be given any details of your therapy and you will not be given a diagnosis (this is helpful in case you are ever sued and your medical records are subpoenaed). You may also be able to claim mental health as a medical expense tax deduction.
Private pay offers clients greater control over their treatment.
Unlike insurance, which can limit the type of treatment modalities, the number of sessions, and their frequency, private pay ensures that care decisions are driven by the client’s needs rather than cost-cutting measures.
Private pay provides an additional layer of confidentiality, protecting sensitive information.
When using insurance for mental health services, records of treatment may become part of your medical history, potentially impacting life insurance applications or legal proceedings.
HSA or FSA accounts can be used to pay for private pay therapy sessions.
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Out-of-Network Benefits (OON)
If your insurance plan OON benefits, it means they will cover a portion of the cost when you see a therapist who doesn’t have a direct contract with your insurance company.
What you need to know
Insurance companies often reimburse a percentage of the therapist’s fee, usually after you meet an out-of-network deductible.
Questions to ask your health insurance provider about out-of-network
• Do I have mental health benefits?
• What is my deductible and has it been met?
• How much does my plan cover for an out-of-network provider?
• What is the coverage amount per therapy session?
• Is approval required by my primary care physician?
• Check out Thrizer — they help file for out-of-network benefits