As a therapist, my primary goal is to provide you with the best possible care.

I have chosen not to work directly with insurance companies for several important reasons. Understanding how insurance works and its drawbacks can help you see why paying out of pocket can be more beneficial for your therapeutic journey.

How Insurance Works for Therapy

When you use insurance for therapy, you will want to consider certain factors that come into play. Please contact your insurance directly for specific steps if you would like to find a therapist within your insurance network.

Diagnosis Requirement

Insurance companies require a mental health diagnosis that meets the full diagnostic criteria to cover therapy sessions for you to pay a co-pay.

You may be feeling anxious or depressed but you may not qualify for the full diagnostic criteria needed for a diagnosis because you are feeling down, sad and fatigued but still able to function fine at work or you have being feeling anxious in your relationship but it has not been half a year yet and your anxiety is not generalized to other areas of your life. A diagnosis may not reflect your true needs. You may be seeking therapy for reasons that do not qualify for a diagnosis such as help navigating significant relationships including your partner, family or friends, recovering from a break-up, goal planning such as career counseling, uncovering life meaning and purpose, seeking personal development and growth, focusing on your overall health and wellbeing.

Limited Sessions & Types of Treatment

Insurance often limits the number of sessions you can have, which can hinder progress, especially for those needing long-term support. Insurance can also limit the type of treatment that you receive to certain methods that are easy to research such as Cognitive Behavioral Therapy. Cognitive Behavioral Therapy is an effective structured treatment for many and can be beneficial, but it may not be the treatment for everyone. Those who want a less structured approach may prefer Person-Centered therapy, which may not be covered by insurance. Insurance request progress notes and may deem for you the amount of sessions they think is necessary for you to recover from a diagnosis such as depression or anxiety. You may be starting to feel better after a couple months of sessions and know you would benefit from more sessions to feel at your best, but insurance may decide that is enough treatment. You or your therapist can petition for more sessions but it can be an added stressor and the request may be denied.

By choosing to a private pay therapist, you may have treatment as long as you and your therapist, who knows you and your unique situation and needs personally, determine that you are receiving benefits. You can have conversations with your therapist direction about how treatment is going and collaboratively decide when it is time to decrease frequency and complete therapy.

Privacy Concerns

Therapists must share detailed notes and private health information with insurance companies, compromising your confidentiality. Notes are required to be shared without notice to you, other than you initially signing a notice of privacy practices when you start therapy. The notes can be used to determine if insurance companies continue to accept your treatment. By going through insurance, you are authorizing insurance professionals to read your progress session notes that detail the goals, circumstances that bring you to treatment, interventions, your responses to treatment in therapy and what you generally report occurs outside of therapy. More detailed personal notes should be kept private and separate from insurance companies.

All therapists must follow mandated reporting state and federal laws including if you present as a potential danger to others or for child, depedent, and elder abuse, and therapists may breach confidentiality if you are a potential harm to yourself. Beyond the mandated and permitted reporting laws, with private pay therapists, what happens in the therapy room or Zoom, stays in the therapy room or Zoom.

Couple Therapy Challenges

Getting insurance to cover couple therapy is notoriously difficult. Many insurance plans do not cover it at all, making it inaccessible for couples seeking help. Relationship distress is not considered an individual mental health diagnosis and insurance companies rely on an individual diagnosis to cover your therapy sessions to demonstrate an individual mental health need. Sometimes, insurance companies will cover some sessions, although that is the exception and notes will likely be needed to demonstrate there is an individual mental health need. Even if you or your partner has a diagnosis of anxiety or depression, that may not qualify for coverage for couple therapy services and you would instead seek individual therapy to cover the diagnosis.

With all that in mind, it makes a lot of sense for couples seeking therapy to go with a private pay therapist that specializes in working with couples and has the expertise to assist you and your partner on working through the challenges you face.

Benefits of Paying Out of Pocket

Choosing to pay out of pocket for therapy comes with significant advantages that I want to reiterate:

Enhanced Privacy

Your therapy records remain strictly between you and your therapist, ensuring complete confidentiality, with the exception of when it is mandated and permitted to breach confidentiality.

No Diagnosis Needed

You can receive support without a mental health diagnosis for issues ranging from relationship and family challenges, to goal planning to finding purpose and fulfillment to personal growth to support with your holistic health.

I work with many clients who do not fit a qualified diagnosis and that receive great benefits from going to therapy to better themselves, their lives, and positively impact those around them.

Flexible and Personalized Care

Without insurance restrictions, therapy can be tailored to your specific needs, including the frequency and type of sessions, such as couple therapy.

As a Licensed Marriage and Family Therapist, I work with many couples to create more harmony and intimacy in their relationships and being a private pay therapist enables me to do this freely.

Access to High-Quality Therapists

Many experienced and specialized therapists choose not to work with insurance companies that may limit the type of therapeutic treatments offered. Paying out of pocket gives you access to a wider range of highly qualified professionals.

I have specialized education, training and experience studying spiritual psychology, training in meditation and yoga modalities, training and experience as a female empowerment and holistic coach, and specialized training for couples.

Why I Am an Out-of-Network (OON) Provider

As an out-of-network (OON) provider, I aim to offer you the benefits of insurance reimbursement while maintaining the flexibility and privacy of private pay therapy for those that qualify for a diagnosis. Here’s how it works:

Cost Savings

You can save on average 60% per session after meeting your PPO OON deductible.

Convenience

After your deductible is met, you won’t have to pay my full rate upfront. Thrizer allows you to only pay your co-insurance. They handle the reimbursement upfront and wait to receive the amount from your insurance company.

You can sign up to check your PPO OON benefits and learn more about how Thrizer can help at Thrizer.

Making Therapy Financially Approachable

I understand that therapy can be a financial commitment, so I offer several options to make it more accessible:

Sliding Scale Fees

I have a limited number of sliding scale fee spots based on what you can afford for weekly or biweekly sessions. You may qualify if you have a financial need, do not qualify for a diagnosis, and either do not have an insurance plan with OON benefits, or have a high deductible. Note that your fee may increase if your household income rises or if your health insurance changes.

Client Packages

For new clients who pay in full on the day of their first session, I offer a package that includes 3 free sessions. This package is available to you if you are not using OON benefits and do not qualify for sliding scale fees.

Choosing to pay out of pocket for therapy ensures that you receive the most personalized, confidential, and flexible care possible. By working together outside the constraints of insurance companies, we can focus entirely on your unique needs and goals. If you have any questions or want to discuss how these options can work for you, please feel free to reach out. Your mental health and well-being are my top priorities!