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Benefits of Self-Pay

Did you know that if you use your insurance to pay for counseling services they require a mental illness diagnosis to be present to submit the claim to utilize insurance for payment? This diagnosis will follow individuals as a pre-existing condition from carrier to carrier. If a diagnosis is not present, insurance companies reserve the right to deny payment for services.

Let's take a look at 3 reasons to consider self-pay!

Self-Pay Rates May Be A Cheaper Option

Rules may vary between higher or lower deductible plans. The rate you pay towards your deductible is generally a negotiated rate set by your insurance company, some providers offer a slightly lower self-pay rate.

 

For example, if your deductible is higher, the contracted rate with your carrier could be $120 or more which would be the amount per session applied to the deductible. If the counselor's self-pay rate is lower, it may not be applied to the deductible. In this instance, it would ultimately save the client money by choosing the self-pay rate.

Self-Pay also reduces the possibility for increases to your premium. Some carriers raise rates due to receipt of a mental health diagnosis. This may lead to being placed in a different "tier" classification.

 

Every carrier has different policies so always know what your insurance carrier expects in regards to treatment guidelines and payout. 

Increased Privacy

As an advocate for mental health awareness, there should never be shame about receiving a mental health diagnosis. It is truly a way to coordinate comprehensive treatment between medical professionals and establish the best of care for every individual. 

 

Simply put, self-pay ensures that both confidentiality and your treatment stays between you and the therapist. 

 

Claims filed with insurance companies must be submitted with a mental illness diagnosis for the visit. This information becomes part of your medical record and able to be accessed or may read by varying medical providers. It is difficult enough for individuals to even seek counseling so many prefer that diagnostic information remain confidential. By choosing self-pay, no diagnosis is submitted or accessible to insurance companies or medical providers without your signed consent. 

More Freedom 

Insurance companies heavily dictate the treatment an individual can receive. This includes location, who can attend sessions with you, the length of sessions provided and most importantly whether or not they will pay depending on your diagnosis. 

Self-pay allows individuals more freedom to choose and allows the therapist more flexibility to support their patients! Here are a just a few: 

  • Location, location, location! Individuals can enjoy the freedom of an in-person session, phone or video session without concern of insurance denial. 

  • Sessions are allowed to be longer verses the standard 45-50 minutes and individuals are allowed to have as many sessions as they want verses set limits decided by the insurance carrier

  • Spouses, friends, partners, family are allowed to attend as needed without concern of insurance denial

  • You do not have to be diagnosed and if you are, the therapist is able to keep it completely confidential.

  • Some types of therapy aren't always covered by insurance. With self-pay, the therapist can utilize the treatment options that best fits the client without restrictions.