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  • Writer's pictureKelsee Keitel

How To Pay For Therapy (With or Without Insurance)

Why is it so hard to find a therapist who accepts insurance? Why is therapy so expensive??

Insurance and pricing are HOT topics amongst both therapists and clients alike.

In the short episode 47 , I'm explaining a few reasons why some therapists (myself included) choose not to panel with insurance, and some tips on how to make therapy more affordable for yourself as a client whether you are paying with or without insurance!

The 3 main reasons I personally choose not to accept insurance are:

  1. Clinical Autonomy 

  2. Administrative Time Management

  3. Affordability

Let's break these down:

1. Clinical Autonomy. When involving insurance in your care, the insurance company calls the shots. They can determine how many sessions you qualify for, how long those sessions are allowed to be, what modalities are allowed to be used, etc. etc.

In my opinion, while insurance companies are a business and they are experts when it comes to laws and taxes and finances, they are NOT experts when it comes to providing intuitive mental health care.

Additionally, in order to use insurance, I would be required to give you a diagnostic impression. which would become a permanent part of your medical record. I believe that not everyone meets (or needs) a formal diagnosis; some people just need to talk and explore or are going through a challenging life circumstance.

Its also worth noting that insurance companies only cover certain kind of therapy and (for example) couples therapy is NOT usually covered. 

2. Administrative Time Management. I am able to spend more time working directly with clients rather than paperwork and billing, which allows me to give you the highest standard of care. I am able to spend even more time working DIRECTLY with clients, sending them resources, researching techniques, preparing for sessions, and doing the administrative work that I already have to do. Could I hire someone to do my billing? Yes. Would that expense cause me to raise my prices? Yes, which leads us to the next point...

3. Affordability. Believe it or not, I am able to offer more reasonable price for therapy by not paneling with insurance. I break this down with a numbers example in the podcast episode this week. The insurance companies also can take a VERY long time to pay clinicians. I’ve known some clinicians who have waited months to receive 10s of thousands of dollars. Honestly, I don’t know how those folks keep their doors open. So to put it simply, one of the reasons I do not panel with insurance is that I cannot afford to as a small business owner.

With that said, I understand that therapy can be expensive for some folks. Let’s talk about ways to make it more affordable and what to do if you find a therapist you love who doesn’t take insurance. This will vary based upon what your counselor offers, but definitely worth asking for. 

Here are some options for making therapy more affordable!

  1. Ask if they offer a sliding scale based upon proof of income. Some therapists can tailor the cost of service to your financial needs. 

  2. Ask if they can provide you with a Superbill. Here is what a Superbill is: you pay Out of Pocket (OOP) but then the therapist provides you with a “bill” that shows proof of payment and then YOU submit to your insurance company to seek reimbursement directly between you and the insurer. The dx impression will still be there, but this is a way to work with the company directly to get reimbursed.

  3. Use your HSA or FSA card for payment!! Most therapists accept these as forms of payment. Sure, you are still paying out of pocket, but you can at least be paying pre-tax! 

  4. If you don’t have insurance OR really need a cheaper option, check out the company “Open path Collective.” Annual fee of $59 to access a network of therapists who have registered to offer sliding scale of 30-70 sessions. You’ll provide proof of your income, etc, and explain why you need this, and then you’ll have access to high quality therapists with a heart for meeting folks where they are financially. These are good therapists! (PS, if you are a therapist reading this, and you sign up to be listed as a part of the Open Path network, please mention that Kelsee Keitel referred you!!).

  5. Ask the therapy practice if they have any interns that you could work with. SOMETIMES interns have a slightly discounted rate while they practice under training. We dont want to exploit them, but if they offer this discount, take advantage of it. 

  6. Look for a subsidized counseling collective or non-profit (for example, Irvington Counseling Collective in Indianapolis). 

I hope this gives you a solid idea of how counselors are navigating insurance/payment and some tips on how to make it work FOR you and not against you. 


If you are a resident of Indiana and are interested in hiring Kelsee as your therapist (virtually or in person in Indy) visit her website: To connect further with Kelsee, find her on instagram @kelseekeitel and @evergreenthinkingpod or visit the show's website: If you're all caught up on Evergreen Thinking and looking for some other shows that hit on similar themes (aka meaningful conversation and outdoor inspiration) follow @plugtoneaudio on Instagram and Spotify to check out the other shows involved with Kelsee's podcast community. You'll love these insightful, adventurous, and hilarious folks as much as we do.

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