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  • Self-Pay Versus Insurance

    Cost may be the first reason you are thinking of using insurance for counseling, but we believe it is important for you to stay informed of all of the factors that go into this decision. Here are some things to consider when choosing whether to use your insurance or self-pay for counseling services.

    Using Insurance:

    •  Diagnosis Required – Often, a person’s reason for seeking counseling is not related to a mental health diagnosis. However, most insurance companies require a diagnosis in order to pay for treatment. A counselor who is functioning ethically and in your best interest will not diagnose exclusively to utilize insurance. Additionally, there are some diagnoses that may be appropriate to what you are experiencing that insurance companies will not cover if they do not deem counseling to be ‘medically necessary’. Paying out of pocket allows you to access services regardless of diagnosis status, and you have the power to determine if sessions are necessary.
    • Session Duration– Insurance companies ultimately decide the number of counseling sessions you are able to receive, dependent on your diagnosis and benefits package. At the end of that number of sessions, your case will be re-evaluated by your insurance to determine if counseling continues to be ‘medically necessary’. Unfortunately, there is never a guarantee of receiving insurance approval to continue. Self-pay allows you to make the decision of continuing in counseling if it is working for you.
    •  Decreased Privacy – Information that is communicated to your insurance for reimbursement is part of your medical record. This includes any diagnosis you received, as well as any other information the insurance requested to determine coverage. When paying privately, you have increased control over where, when, and how your information is shared.

    We understand the financial and personal commitment involved in counseling with or without insurance, and do not take the responsibility of your care lightly. If you have more questions as you are trying to choose between insurance versus private pay, please give us a call at (940)312-7110.

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