Insurance vs. Private Pay in Therapy: Finding the Right Fit for You

Choosing to start therapy is a big step — and deciding how to pay for it can feel like an equally important decision. In today’s mental health world, clients often face the question: Should I use my insurance benefits or pay out-of-pocket?

There’s no one-size-fits-all answer. Both options have their benefits and trade-offs, and the best choice depends on your needs, priorities, and goals for therapy.

Using Insurance for Therapy

Insurance can make therapy more affordable, allowing you to access services with a lower immediate cost. If your therapist is in-network with your insurance provider, you’ll typically pay a copay or coinsurance, and the remaining balance is covered according to your plan.

Pros:

• Lower session costs

• Ability to attend more frequent sessions with less financial strain

• Makes therapy accessible for those who may not otherwise afford it

Things to Consider:

• Insurance companies require a formal mental health diagnosis to cover therapy. This becomes part of your medical record.

• Your care is shaped by the “medical model” — treatment plans and session frequency may be influenced by your insurer.

• Certain types of therapy, like adventure therapy or non-traditional approaches, may not be covered.

Paying Privately (Cash Pay)

Private pay means you cover the full cost of your therapy sessions yourself. While it’s a larger investment upfront, it also comes with flexibility and privacy that insurance-based therapy doesn’t always allow.

Pros:

• No required diagnosis

• Freedom to choose the type, frequency, and duration of sessions

• Greater privacy — your therapy stays between you and your therapist

• Ability to access unique services, like adventure therapy (walk-and-talk sessions, paddleboarding, or nature-based therapy)

Things to Consider:

• Higher out-of-pocket costs per session

• May not be affordable for long-term, high-frequency therapy without budgeting for it

Making the Best Choice for You

For some, using insurance makes therapy financially sustainable and consistent. For others, private pay is worth the investment for the flexibility, privacy, and expanded treatment options it provides.

At Flowing Connections Counseling, I offer both options:

• In-Person Traditional Therapy & Telehealth: In-network with Blue Cross, Select Health, and St. Luke’s Health Plan, or cash pay at $180/session.

• Adventure Therapy: Cash pay only, $180/session ($120 for students with valid ID).

There’s no wrong choice — only what’s best for your needs, values, and resources. Whether you’re seeking affordability through insurance or the freedom of a more holistic, prevention-focused approach through private pay, the most important step is simply starting.