Should I Use My Health Insurance To pay for Therapy?

You’re ready to start therapy (yay!), but now comes the big question: Should I use my health insurance to pay for it? If you're an adult child of immigrants, chances are no one taught you how to navigate this system—especially when it comes to something as personal and vulnerable as your mental health. Let’s walk through the benefits and trade-offs so you can make the best decision for you.

Pros of Using Insurance for Therapy

• Lower Cost per Session

  • Sessions are often partially or fully covered, making therapy more accessible.

  • Your therapist can provide an overview of plan coverages, copay, and deductibles that you are responsible for paying if you use your insurance plan for counseling services.

• Access to a Network of Providers

  • Insurance directories can help you find credentialed therapists.

  • Some plans include telehealth options, which is helpful if you’re managing time, energy, or cultural stigma around in-person visits.

• Improve Consistency in Care (in some cases)

  • If you’ve been diagnosed with a condition like anxiety, depression, or PTSD, using insurance can make ongoing therapy more financially sustainable. When therapy is more affordable, it can reduce the pressure to “get better fast” and instead allow for a deeper, more attuned, and transformative healing process.

    Consistency is key in trauma-informed and attachment-focused work. Regular sessions over time create a secure, trusting relationship—a core part of what makes therapy effective. For some clients, insurance coverage helps make that long-term commitment possible.

Cons of Using Insurance for Therapy

• Diagnosis Required

  • To be reimbursed, you’ll need a clinical diagnosis, which becomes a part of your permanent medical record.

  • This can feel pathologizing, especially if you’re dealing with grief, life transitions, or cultural stressors that don't feel like a "disorder."

  • Therapists are ethically obligated to issue the lease severe/restrictive diagnosis and to only issue a diagnosis when a client truly and fully meets diagnostic criteria according to the DSM-5. The fact that insurance companies put restrictions on what diagnostic codes they will pay for and which they won’t, creates an ethical conundrum for your therapist and may limit what care is covered.

• Limited Session Numbers or Types

  • Some plans only cover a certain number of sessions per year.

  • Many do not reimburse for couples therapy, trauma-informed work, or somatic/attachment-focused modalities unless it fits neatly into a diagnosis.

• Less Privacy

  • Insurance companies can audit your records and request progress notes.

  • For adult children of emotionally immature families, privacy can be deeply important—this may feel intrusive.

• Hard to Find a Good Fit

  • Here’s the truth: Insurance companies, not therapists, determine how much your therapist gets paid. And often, that rate is well below market value, especially for providers with advanced training in trauma, cultural competence, or specialized care.

    This means that even though you’re paying your copay, your therapist may be receiving significantly less than what they would through private pay or a sliding scale.

    And while therapists choose to be in-network for accessibility reasons, it can come at a cost to their time, energy, and emotional bandwidth (i.e., more paperwork, shorter sessions, less freedom in treatment planning).

Other Options to Consider

• Out-of-Network Benefits

  • Many therapists offer “superbills” for partial reimbursement if your plan allows.

  • It gives you more choice in provider while still using some insurance support.

• Sliding Scale or Open Path Collective

  • Some therapists (including those focused on BIPOC and immigrant communities) may offer reduced rates for a short period of time.

  • This avoids diagnosis, gives more confidentiality, and allows for more customized care.

How to Decide:

Ask yourself:

• Do I feel comfortable having a diagnosis on file?

• Am I looking for a specific kind of care that isn’t always covered (like trauma-informed or culturally sensitive therapy)?

• What’s more important to me right now: affordability, privacy, or flexibility?

Closing Encouragement

You don’t need to have all the answers today. Just being curious and informed is already a powerful step toward reclaiming your mental health. Whether you choose to use insurance or not, what matters most is that you're getting the care you need in a way that feels safe, affirming, and aligned with your values.