At this point in my life, I no longer use insurance to cover therapy. In the past, I have seen therapists who take my insurance, those who offer sliding scale ($25-$60), and those who charge $150/session. Different life situations require different choices. Whether it’s a $20 co-pay or $200 a session, there isn’t a wrong or shameful option. I am not embarrassed that I needed to use insurance or pay a sliding scale fee at certain points. When I was making $28,000/year as a case manager and paying back my graduate school loans, I didn’t have much choice. But now that I’m earning more than $30,000, I can confidently say I will no longer use my insurance to pay for therapy.

Why choose a full fee over a co-pay?

The most important component to success in therapy is the “therapeutic relationship” (how well you connect with your therapist). When you use your insurance, your options are limited. There are a lot of subpar, poor-fit, and even bad therapists out there. And, when you use your insurance, it narrows the pool of therapists that you can choose from. For me, that often meant that I was seeing someone who wasn’t the best fit for me. And a $20 copay is too much to spend on bad therapy.

Now if $150/session is too expensive, you always have the option of using your out-of-network benefits. Most therapists are happy to provide an itemized receipt called a superbill that you can submit to your insurance company for partial reimbursement. Many insurance companies will reimburse 60-70% of the fee. Which means you get to see a therapist you really like for only $45-$60 a session once reimbursed. So there are ways to make it work. But that’s only if it’s a priority for you.

Is your mental health a priority for you?

Mental health is a priority for me. If I don’t have my sanity, I can’t do my job. So that’s pretty important. But, also, I like feeling centered and connected. I’ve been overwhelmed and stressed out before and I’d prefer not to go back to that point. Right now, I have a sufficient toolbox for handling my stressors. But as soon as it seems like I need that support, I’ll be the first one lined up to pay $150 a week for a therapist who gets me. Because that’s a priority for me. My sanity is worth a lot. And, because I value it so highly, $600 a month is a small amount to invest in being my best self.

But everyone has different priorities. If you’re choosing between a roof over your head, food on the table, utilities turned on, or paying for therapy, then it really makes sense to use insurance. But if you find yourself making impulse purchases to make yourself feel better, you might consider if there’s a better way to spend that money that might help long term. That being said, at the end of the day, it’s your life and your decision. And I respect whatever decision you make on the matter.

Why private pay therapy is worth the investment

The amount of progress that you make with the right therapist is generally worth the extra cost. If it’s the wrong fit, you find yourself missing sessions, disagreeing with your therapist in session, and generally stagnant in therapy. And if you’re coming in to actually address stuff, this can be very frustrating. And can lead people to drop out of therapy and feel like therapy won’t help. Which is not what you want.

You may even find that your therapist is not qualified to treat your specific concern. I can’t even tell you how many fake “couples therapists” there are out there! Not everyone has the training for that type of work and, when they don’t, people and relationships suffer. I see many couples who come to me having seen LCSWs, LCPCs, or PsyDs who haven’t received the additional training required to do couples counseling. These couples have often have sunk lots of money (copays add up if you’re in long-term, insufficient treatment) into something that doesn’t work.

You and your relationship are worth the investment. It’s like retirement savings, you put a lot in now so that you can be comfortable later. And, in the future, when you’re loving your life and your relationship, you’ll be so glad that you did! I know I am!