Advantages of Self-Pay
- You won’t receive mental disorder diagnosis. Did you know that for most insurance companies and many employee assistance programs to pay for services, the provider has to give you a diagnosis of a mental disorder? This diagnosis will be a part of your medical record, even if you only see the provider for a few sessions. Many people are denied or charged higher rates for certain types of insurance policies (for example, life insurance) if they have ever received a mental disorder diagnosis. This can happen even if you saw the provider many years ago and have not had any problems since that time. I saw one college student for just one session when he was covered by his parents’ insurance. When he was out of college and needed his own health insurance, he was denied because of his previous mental health treatment. His mother said, “I wish I would have known.” Now I feel it is my obligation to point out these possibilities for future clients. In addition, people in certain types of jobs (for example, law enforcement or military) may be concerned that any diagnosis will affect their employment status of their ability to be promoted at some point.
- Your confidentiality is better protected. As mentioned above, most insurance companies require me to give a diagnosis to provide services. In addition, sometimes other clinical information such as a treatment plan or summary, or in rare cases, a copy of the entire record is requested. This information will become part of the insurance company files, and, in all probability, some of it will be computerized. All insurance companies claim to keep such information confidential, but once it is in their hands, I have no control over what they do with it. In some cases they may share the information with a medical information data bank.
- You can see the professional of your choice. Did you know that your insurance company or EAP companies decide who you can and cannot see for your mental health care? They don’t know you, your personality, your needs or your preferences, when it comes to finding a therapist. This is a very personal decision--one that you should be able to make for yourself.
- You are in control of your care. Did you know that when you see a provider through your insurance or EAP program, decisions about your care are often made by a person in another state, often over a telephone, typically with less experience than the therapist. This “case manager” decides how many sessions you can attend, what your treatment should entail, and so on. When you pay for your own care, you are in control. You select your therapist. You decide how many sessions you attend. You decide what kind of therapy works best for you. Of course, your therapist helps you think through these decisions, but ultimately, you’re in charge.
- You may make faster progress. Not always, of course, but people who are not paying for their own sessions are sometimes not as invested in the outcome of their treatment. I worked with one gentlemen who said he came to see me because it was free and he wanted an hour off of work! Because you are taking more responsibility for your care, you may find that you are more motivated and make faster progress in meeting your goals.
Many people come for just a few sessions to gain some insight and direction. In this case, it seems to make sense to pay for the sessions directly and avoid having a diagnosis attached to your medical records. Most people attend for approximately six sessions, which again, in the grand scheme of things, may be an investment worth making. However, only you know your financial situation, and I am certainly happy to file with your insurance company. If you are not sure what to do in your particular case, I’m happy to discuss the various options with you.