What are reasons to pay privately or “out of pocket”?

Because insurance companies only cover care that is “medically necessary,” i.e. that which has a recognized mental health diagnosis attached, insurance does not cover the full range of concerns people bring to counseling. People seek counseling for many reasons, ranging from diagnosable depression or anxiety to concerns with identity (spirituality, LGBT issues, self-acceptance) or phase of life (transition to a new job or relationship, parenting, occupation).

Many clients choose not to use insurance to defer the cost of counseling because they do not want their counseling to be limited by diagnoses, treatment plans, type of therapy, or session limits as dictated by insurance companies. Many clients are also concerned about privacy. In order to obtain reimbursement, the insurance company has to know personal information about you and can review your records at their discretion. Mental health diagnoses, once submitted, become a part of your permanent health care record, and could potentially lead to limitations later on, such as denial for quality life insurance or health insurance. You are encouraged to contact your insurance company if you have any questions about what records they may or may not request and what implications that may have for your future health care.