Insurance-Based vs Private Pay Therapy
Understanding Insurance and Coverage
Will Insurance Cover Me?
Insurance may cover therapy, but eligibility depends on whether your mental health struggles meet the criteria for "medical necessity." Typically, this requires a diagnosable mental health condition, such as Major Depressive Disorder, PTSD, or Generalized Anxiety Disorder.
Unfortunately, common challenges like complex trauma, relationship issues, racial trauma, or burnout are not always recognized by insurance providers as billable conditions. That said, if these struggles cause significant distress, they might contribute to a diagnosis that qualifies for insurance coverage. An initial consultation and assessment will help determine if your situation could qualify for insurance-based care.
I am currently in-network with the following insurances in New York:
Aetna
Anthem Blue Cross and Blue Shield
Cigna
Oscar
Oxford
United Healthcare
If you do not have the insurances above OR are in New Jersey, and have out-of-network benefits, I can provide a "superbill" for you to request potential reimbursement from your insurance.
The Hidden Disadvantages of Using Insurance for Therapy
While insurance can make therapy more affordable, there are some potential drawbacks to consider:
Diagnosis and Permanent Record. I’m required to assign a mental health diagnosis, which becomes part of your permanent medical record. This can potentially impact:
Your ability to secure life or disability insurance
Certain job opportunities
Legal proceedings (e.g., family law cases)
Retroactive Repayment ("Clawback"). Insurance companies can demand repayment if they later decide the care didn’t meet their standards.
Limited Therapy Approaches. Insurance dictates which therapy methods are covered, and their standards often lag behind the latest advances in the field. This means cutting-edge, highly effective therapies might not be approved, limiting your treatment options.
Session Limitations. Insurance often imposes restrictions on:
Session length
Frequency
Focus of therapy
Additionally, a portion of each session may need to be spent on documentation and assessments, shifting focus away from your healing and making the process feel less flexible and collaborative.
Pathologizing and Invasive. Some clients feel uncomfortable with the pathologizing nature of a diagnosis, and the necessary documentation may feel invasive and detract from their healing process.
Private Pay: A Therapy Experience Centered on You
If you don't meet insurance criteria or if you're looking for a treatment experience that truly centers your needs, private pay is the best option. Private pay offers a more personalized and flexible therapy experience, allowing us to tailor every aspect of your care entirely on your needs—without insurance limitations, required diagnoses, or third-party oversight.
With private pay, you get:
Freedom from Diagnosis Requirements – No need to meet insurance criteria for “medical necessity.” Therapy is accessible based on your needs, not a diagnosis.
Complete Confidentiality – Your mental health care stays private, with no documentation shared with insurance companies.
More Flexibility – We can adjust session length, frequency, and focus to fit your evolving needs, without interference from insurance companies.
Access to the Best Therapy for You – Cutting-edge, holistic, and somatic approaches like Brainspotting and decolonized practices—without worrying if they’re “covered.”
A Therapy Process That Honors Your Whole Self
Unlike insurance-based therapy, which often requires fitting your experiences into narrow diagnostic categories, private pay allows us to take a deeper, more integrative approach:
✔ Liberation and choice over rigid clinical frameworks
✔ Healing that centers your wholeness rather than a diagnosis
✔ A safe, collaborative space focused entirely on you
This is the freedom private pay offers: where your healing journey is not dictated by a third party, but by your needs, aspirations, and vision for your future.
If you value confidentiality, flexibility, and a truly personalized healing experience, this option may be the best fit for you.
By stepping away from insurance restrictions, we can focus entirely on creating a space that’s fully dedicated to your healing journey—on your terms.
I offer a trust-based sliding scale to make therapy as accessible as I can while maintaining fairness and sustainability. See the details of my sliding scale here.
Ready to Explore Your Options?
Take the next step by exploring the services I offer or scheduling a consultation. Let's work together to create a path tailored to your unique healing journey.