Pros and cons of therapist not covered by insurance!
August 9, 2017 10:01 AM   Subscribe

I am a graduate student and money is tight. I have been working with an amazing therapist who is outside of my insurance's network. I am trying to decide whether or not to pay out of pocket to continue with her. Perspectives, experiences, any number of cents welcomed!

Here is my preliminary pro/con list for paying out of pocket to continue with Amazing Therapist.

1. Amaznig Therapist (henceforth AT) has helped me more in mere four sessions than all of my previous therapists combined (five total, trained in different schools). This is a combination of AT's personality "clicking" well with me, and the types of therapy she specializes in being exactly what I need. I contacted AT out of desperation, having given up on therapy (and maybe myself) altogether, and am very pleasantly surprised.

2. Private pay means I don't have to go to my family doctor and get a diagnosis and referral, and once again explain why I don't want to just use medication. I'd like to avoid a diagnosis is possible (although I don't know if there is already one in my file). AT's office is also completely off campus. I don't have to worry about running into my students or professors in the waiting room (this has happened before. It was not great).

3. I will admit that because I am paying, I take it more seriously. Oops.


1. Mainly, money. AT has a sliding scale and has generously let me pay the low end of her scale. But continuing would still mean a monthly expense that is roughly double my grocery bills-- i.e. quite substantial.

I am very frugal in general. My overall low expense helps, but it also means there's not that many expenses I can cut-- I have already given up my whisky and coffee habits, and have been trying to buy only the absolutely necessary books. I have some savings, and can pick up more TA work to offset this expense. Still, I feel bad spending money on myself, even though I suspect at this point therapy is becoming a necessity (This is probably something I can bring to therapy, but obviously that'd be awkward).

2. I might run out of money and have to cut therapy short.

I know the Hivemind constitutes many strangers on the internet, but I just want some perspectives, especially from folks with experiences!
posted by redwaterman to Health & Fitness (9 answers total) 1 user marked this as a favorite
I am hearing you say that this is a pricey but worthwhile gift you are giving yourself, and if you need an internet stranger's permission to continue: here, you have it. I was in a very similar position myself once, chose to continue the pricey therapy, and haven't regretted it for a moment over the last decade. As for running out of money and having to stop, you can cross that bridge when it comes.
posted by zebra at 10:11 AM on August 9, 2017 [5 favorites]

I'm like you: very frugal, hate to waste, and also very rarely click with a therapist.

If working with her is making you happier, better, healthier, then it's the best investment you can make. You've been to several therapists already, so you are the expert on evaluating your progress.

You only get one life. If working with this therapist gives you the tools you otherwise lack to make it good, then hell yeah keep paying her.

In my experience therapists that really help are very rare. Like as rare as finding-true-love rare. You're a grad student, you won't always be poor, but you'll always live in your own mind, so make it as good as it can be to lay groundwork for the rest of your life, and take advantage of your lucky find.
posted by fingersandtoes at 10:37 AM on August 9, 2017 [5 favorites]

So first off - check your insurance plan & benefits -- they may cover some amount of out of network care. You'd have to deal with paying upfront, submitting bills, and getting reimbursed, but "out of network" doesn't necessarily mean "not covered"

Second off - even if it's not covered, if you can afford it it is almost certainly worth it. This is like, the best self-care thing you can possibly do for yourself.
posted by brainmouse at 10:49 AM on August 9, 2017 [5 favorites]

Can you create a budget plan that makes it manageable to commit to, say 10 -12 sessions. I picked 10-12 because that is usually the definition for 'brief therapy' and should be enough to allow you to make some real progress even if you are nowhere near done. If you and she produced so much good in 4 session, think how much further along you will be in three times as many more.

Then you can go ahead and not feel guilty knowing that you haven't committed to a long-term expense and you can re-evaluate at that time if it makes sense to re-up for another chunk. Then you don't have to keep second guessing yourself every week about the expense. Also then you don't have to worry about running out of money (unless there is a surprise emergency).

Obviously talk to the therapist about this - if she needs you to make a long term commitment, then you need to know that ahead of time. Otherwise, she should be very supportive of you making a commitment for now and then re-evaluating on a regular basis.
posted by metahawk at 10:51 AM on August 9, 2017 [2 favorites]

I'm in a somewhat similar situation-- student, paying for a therapist on a sliding scale, can barely afford therapy. (Obvious, but) I find that future budgeting for therapy is helpful; it's a necessary expense. I frontload some extra work at the beginning of the quarter when my schedule is lighter; I know that I need to work X extra hours each quarter to be able to pay for therapy. I like doing tutoring because it's flexible and pays pretty well. And if you go to a selective university, you can make good money by being a college counselor to a couple of high school seniors, and it won't add to you workload exponentially.

Ok, on rereading the question-- it seems less of a money problem and more of a "I feel bad spending money on myself" thing. I think you should definitely continue going to AT. Spending money on your mental well-being isn't frivolous or ill-spent. It's probably the best thing you can "buy."
posted by typify at 10:53 AM on August 9, 2017 [1 favorite]

Tough situation. Was recently in it. I ended up exploring options that are covered by my insurance, and, lo and behold, found an /amazing/ therapist in network. Now, finding a good therapist is *really* hard for me, so I hear your concern about finding a different one when you like yours so much. For me, it turned out that having a different perspective was just what I needed, but then, I'd been seeing my old therapist for quite a while. However, one thing to consider is how much the financial sacrifice will cost you in terms of stress. For me, I decided that paying the full fee when she was no longer in my network would create enough stress to cancel out the benefits of therapy. Just consider that there are other therapists out there, and, while not all of them will be a great fit, there may be someone in your network that is worth at least trying. You don't have to make this decision immediately--so might consider exploring what else is out there for a few (cheaper) sessions. Good luck!
posted by dubhemerak3000 at 11:39 AM on August 9, 2017

I pay my shrink out of pocket and it's also a big expense. He lets me break up the payments between appointments. Depending on how often you see your therapist, maybe they would do something similar. (I'll admit I'd feel awkward bring it up, but when I called to cancel an upcoming appointment because I didn't have the money, he offered to break it up.)
posted by Room 641-A at 12:01 PM on August 9, 2017

I've seen the same therapist for over 20 years, paying out of pocket for well over half the time, and I've never, ever thought that the money spent was a waste. Amazing Therapists are hard to find!
posted by Napoleonic Terrier at 6:46 PM on August 9, 2017

Amazing Therapists are amazing. TBH, I think the feeling of not feeling like you're worth spending therapy dollars on is a major conversation that your AT can definitely help you with. It can be difficult to think of therapy as a priority because it means you're spending money on yourself, but why then are you in grad school?

Isn't grad school at least partly a way of improving your life by giving you work that you love and potentially a chance to improve your income? You're "treating yourself" to grad school for some reason and I'm guessing if you look at your motivations there's a sense of purpose or fulfillment that it will bring to your intellectual self. Don't you also want to take care of your emotional self? If nothing else your improved mental health can boost your intellectual potential and vice-versa.
posted by bendy at 9:23 PM on August 9, 2017

« Older Modern classical for philistines   |   Moving the scenery during the take? Newer »
This thread is closed to new comments.