Self-Pay vs Insurance: Quick Comparison
Insurance
Requires a mental health diagnosis that meets coverage criteria.
Session length may be limited; longer sessions need extra documentation and approval (i.e., justification of medical necessity).
Records and diagnosis are shared with your insurance company and stored in their databases.
Treatment must be considered “medically necessary” and tied to your diagnosis.
Coverage and frequency of sessions can change suddenly after insurer review.
Involves more paperwork: claims, authorizations, and progress notes for approval.
Self-Pay
No diagnosis required — you can seek therapy for any reason.
Flexible session length and format based on your needs.
Privacy maintained between you and your therapist (with standard legal safety exceptions*).
Can address personal growth, life transitions, relationship work, and other areas beyond insurance coverage.
Consistent care plan — you control the pace and duration.
Minimal paperwork — just scheduling and payment.
*Legal safety exceptions apply to all therapy: imminent harm to self/others, suspected abuse of a child, elder, or dependent adult, or certain court orders.
