Could Opting For Self-Pay Therapy Liberate You From Insurance Entanglements?
SelfPay allows you to bypass insurance authorizations, session limits, and mandated diagnoses, giving you greater choice of therapist, confidentiality, and control over treatment pace; evaluate costs, cancellation policies, sliding scales, and potential tax deductions to decide if paying out of pocket better serves your needs and protects your privacy.
Key Takeaways:
- More privacy and clinical autonomy – no insurance claims or diagnostic codes, and greater control over treatment pace and methods.
- Access to a wider pool of therapists and better continuity – you can work with providers who don’t accept insurance and avoid coverage-driven session limits.
- Higher out-of-pocket cost but simpler billing and payment flexibility – predictable fees, potential superbills or HSA/FSA reimbursement, and a trade-off between cost and freedom from insurance constraints.
Understanding Self-Pay Therapy
Definition of Self-Pay Therapy
Self-pay therapy means you pay the therapist directly for each session rather than filing claims with your health insurer; typical rates range from about $80 to $250 per session depending on location and clinician training. You control whether a formal diagnosis appears on any insurance paperwork, which can keep sensitive mental-health information out of your claims history.
Therapists offering self-pay can structure care without insurer mandates: for example, you can schedule twice-weekly intensive sessions, pursue long-term psychodynamic work, or try time-limited EMDR blocks (commonly 6-12 sessions) without prior authorization. Many clients report faster adjustments to treatment when the therapist isn’t constrained by utilization reviews or preapproval processes.
Comparison with Insurance-Paid Therapy
With insurance, your clinician usually submits diagnostic codes and may need preauthorization for specific treatments, which can create delays or session caps (insurers commonly limit short-term therapy to around 8-20 sessions). When you self-pay, those administrative hurdles disappear, but you assume full out-of-pocket cost for each visit.
Financially, insurance often means lower per-visit cost after deductible-copays typically between $10 and $50-but fewer provider choices and less confidentiality; self-pay gives you wider access to specialists and more privacy but requires paying the session fee upfront. Many people use a mixed strategy: start privately to establish fit, then shift to insurance if longer-term care becomes necessary.
Insurance vs. Self-Pay: Quick Comparison
| Feature | Insurance vs. Self-Pay |
|---|---|
| Authorization | Insurance may require preauthorization; self-pay requires no insurer approvals. |
| Privacy | Insurance claims include diagnoses on EOBs; self-pay keeps records off insurer files unless you submit them. |
| Session limits | Insurers commonly cap short-term therapy (8-20 sessions); self-pay allows open-ended scheduling. |
| Cost | Insurance: lower copays post-deductible; Self-pay: full fee (often $100-$250/session), sometimes eligible for partial OON reimbursement. |
| Provider choice | Insurer networks restrict options; self-pay lets you choose any licensed clinician. |
To put it in practical terms, if you need specialized trauma work like EMDR, some insurers require additional documentation or limit sessions-paying privately can let you start immediately and complete a recommended 6-12 session protocol without interruption. Conversely, if ongoing weekly therapy is anticipated beyond a short block, you might weigh long-term cost versus the benefits of immediate autonomy.
Benefits of Self-Pay Therapy
You gain greater privacy and clinical flexibility: therapists don’t need to submit diagnostic codes to an insurer, and they can use whichever modality best fits your goals-whether that’s intensive short-term work or open-ended psychodynamic therapy. Access to specialized clinicians is another advantage; many senior clinicians limit insurance panels and work privately.
Practical benefits include simpler billing (one invoice to you) and scheduling freedom-you can often get earlier appointments and adjust frequency without insurer constraints. Sliding-scale practices and package rates also make self-pay accessible: some therapists offer reduced fees or blocks (e.g., 10 sessions for a set price) that lower the per-session cost.
Benefits at a Glance
| Benefit | How it helps you |
|---|---|
| Privacy | No insurer claims or diagnostic entries unless you choose to submit for reimbursement. |
| Clinical autonomy | Therapist can use any evidence-based method without preauthorization delays. |
| Provider choice | Access to specialists and experienced clinicians who may not accept insurance. |
| Scheduling | More flexibility for appointment times and session frequency. |
| Transparent billing | Clear, itemized invoices (superbills) you can submit for potential out-of-network reimbursement. |
If you value therapeutic fit and confidentiality, paying privately can be an investment: therapeutic alliance is one of the strongest predictors of outcome, and being able to choose a clinician without insurer constraints often improves that fit-many clients report measurable symptom reductions within 8-12 sessions when they can work uninterrupted with a well-matched therapist.
The Issues With Insurance-Covered Therapy
Limitations of Insurance Coverage
Insurers often cap the number of therapy sessions they’ll pay for in a year-commonly in the range of 8-20 sessions for outpatient psychotherapy-so you may hit a hard limit before deeper or longer-term work is done. Co-pays and deductibles also shape access: a $20-$50 co-pay plus an individual deductible that can run $1,000-$3,000 means many people effectively delay or reduce care because the out-of-pocket costs add up quickly.
Coverage also usually requires a clinical diagnosis and documented symptoms, which places clinical information into claims and potentially into a permanent record accessible to the insurer. That requirement can affect both your privacy and how clinicians document progress, since notes often have to justify medical necessity to continue coverage.
In-Network vs. Out-of-Network Providers
When you choose an in-network provider, the therapist has agreed to set rates with the insurer, so your cost per session is typically lower and billing is handled directly. However, in-network directories frequently under-represent specialists and modalities-things like EMDR, DBT, or trauma-focused care-so you may find no qualified in-network clinician nearby who provides the treatment you need.
Going out-of-network gives you access to a larger pool of therapists and often to higher-paid, specialized clinicians, but you’ll pay more up front and may only be reimbursed a portion of the session fee. For example, if a therapist charges $150 for a 50-minute session, your plan might reimburse $40-$90 after deductible, leaving you responsible for the balance and any paperwork required to submit a superbill.
Network fluctuations can force abrupt changes: clinicians get dropped if contracts aren’t renewed, and credentialing backlogs mean new therapists may not join networks quickly. That instability can interrupt care mid-treatment and make continuity – keeping the same therapist through a long course of therapy – difficult if you rely solely on in-network options.
Pre-Authorization Requirements and Hurdles
Insurers frequently require pre-authorization for extended treatment, certain CPT codes, or higher-intensity services; thresholds that trigger authorization vary but often start after 6-12 sessions or when modalities fall outside “brief” therapy. Getting pre-authorization typically involves submitting a diagnosis, a treatment plan, and objective measures (PHQ-9, GAD-7, functioning scores), which can delay the start of care or approval for more sessions by days to weeks.
Denials are a common barrier: an insurer might approve an initial block of sessions and then deny further care for “lack of documented progress” or incomplete paperwork, prompting a time-consuming appeals process that can take 30-60 days. Those administrative demands also push some clinicians to limit the number of insured clients they accept or to decline certain evidence-based modalities that require extra justification.
Pre-authorization practices can reshape treatment priorities: you and your clinician may feel pressured to fit symptoms into insurance-friendly language or to schedule measurable progress within arbitrary authorization windows, rather than following a patient-led pace or trying niche approaches that take longer to show change.
Financial Implications of Self-Pay Therapy
Cost Analysis: Self-Pay vs. Insurance
If you compare sticker prices, typical self-pay therapy sessions range from about $80 to $250 per hour depending on location and clinician credentials, while in-network insurance copays often fall between $10 and $50 per session. However, those copays only matter after you meet any deductible; many plans carry individual deductibles of roughly $1,000-$3,000 and out-of-pocket maximums commonly between $4,000-$8,000, so your actual cost depends on where you sit in that yearly cycle.
For a concrete example: 20 sessions at $120 each equal $2,400 out-of-pocket. If you were using insurance with a $30 copay per visit, your paid amount would be $600-unless your plan requires you to meet a $1,500 deductible first, in which case you could pay much more before insurance starts contributing. You should model your expected number of sessions against both hourly self-pay rates and your plan’s deductible, copay, and session limits to see which path is cheaper for your situation.
Potential Savings in the Long Run
You can save long term by avoiding session caps and by investing in more intensive, goal-oriented care that reduces total treatment time; for instance, evidence-based short-term therapies like CBT or EMDR often require 12-20 focused sessions, so paying $120 per session could cost roughly $1,440-$2,400, versus drawn-out, less-focused care that extends costs over years. In situations where insurance forces repeated reauthorization or limits modalities, paying out-of-pocket can let you finish treatment faster and with fewer administrative interruptions.
Another route to savings comes if you use self-pay to access higher-quality or specialized clinicians who deliver faster, more effective results; a single year of targeted therapy that resolves a specific issue may prevent downstream costs such as repeated medical visits, lost work time, or more intensive psychiatric care. Track your progress and total spending over a 6-12 month window to evaluate whether the upfront higher session price translates into fewer total sessions and lower non-therapy health costs.
To illustrate, a hypothetical client who switches from weekly in-network sessions with frequent administrative delays to a focused self-pay therapist might reduce sessions from 40/year to 18-22/year; at $120/session that’s about $2,160-$2,640 annually versus ongoing fragmented care that can exceed $3,000-$4,000 when factoring missed work and additional appointments.
Payment Plans and Options Available
You’ll find many clinicians offer sliding scales, package rates, and subscription or retainer models: sliding scales commonly span $50-$150 based on income, package discounts often give 10-20% off when you prepay blocks of 5-10 sessions, and subscription models may charge a flat monthly fee for a set number of sessions plus messaging support. Teletherapy platforms frequently list standard rates of $60-$120 per session, which can be substantially lower than in-person urban prices.
Additionally, you can apply HSA/FSA funds to therapy in most cases, use CareCredit or other healthcare financing for larger balances, and negotiate payment timing directly with clinicians-many will accept monthly installments or split invoices to keep care affordable. Community clinics and university training centers also provide lower-cost alternatives, often ranging from $25-$75 per session, if budget is a primary constraint.
When evaluating options, ask providers about exact discount percentages for package purchases, whether they accept medical credit lines, and what documentation they provide for HSA/FSA reimbursement so you can compare effective monthly costs rather than just per-session rates.
Access to Diverse Therapeutic Options
Range of Therapists Available
Choosing self-pay expands the pool beyond in-network clinicians to include solo practitioners, boutique practices, and specialists who avoid insurance panels; you gain access to LCSWs, PhD/PsyD psychologists, LMFTs, LPC/LPCCs, PMHNPs, certified somatic therapists, and clinicians trained in niche modalities. Many of these clinicians limit or refuse insurance because it lets them set session lengths (60-90+ minutes), maintain confidentiality without mandated diagnostic codes, and tailor care without session caps.
You can also tap into interdisciplinary teams-neurofeedback technicians working with a supervising psychologist, psychiatric nurse practitioners offering medication management alongside psychotherapy, or trauma specialists providing twice-weekly intensive care. For a practical comparison of private-pay versus insurance-based practice models and how that affects availability, see Should I Have a Self-Pay or Insurance-Based Private Practice?
Specialty Treatments Not Covered by Insurance
Insurers commonly exclude or tightly restrict treatments that lack standardized CPT coding or are considered experimental; examples include neurofeedback, prolonged exposure intensives beyond short-term protocols, many forms of psychedelic-assisted integration, ketamine-assisted psychotherapy in private clinics, equine-assisted therapy, and some expressive arts interventions. You’ll often find providers who’ve pursued 30-300+ hour advanced trainings in these modalities but operate off-network to offer them without insurer constraints.
Outcomes data for several of these approaches are growing-for instance, multiple studies support EMDR and certain neurofeedback protocols for PTSD and ADHD respectively-yet coverage remains inconsistent because policies lag behind emerging research. If you need a course of twice-weekly neurofeedback sessions or multi-day psychedelic integration work, self-pay is frequently the only practical route to get uninterrupted, modality-specific care.
A common patient scenario: someone with treatment-resistant depression may pursue ketamine-assisted psychotherapy with a trained clinician for a series of 4-6 sessions over 2-8 weeks; many insurers will cover neither the preparation/integration psychotherapy nor the clinic-administered infusions fully, so self-pay lets you coordinate the full protocol with one provider and track outcomes consistently.
Flexibility in Choosing Treatment Frequency and Duration
When you pay out of pocket you can negotiate frequency-weekly, twice-weekly, or intensive formats-based on clinical need rather than insurer rules that typically allow 8-20 sessions per authorization. Trauma-focused work, for example, often benefits from twice-weekly sessions for 6-12 weeks; clinicians report faster symptom reduction and lower dropout rates with that cadence compared with once-weekly care constrained by insurance limits.
Practices that operate self-pay commonly offer block packages, sliding scales, or short-term intensive options (3-7 day intensives) which can compress therapy that would otherwise take months into weeks; costs for intensives vary widely, often ranging from $1,500 to $6,000 depending on clinician expertise and length, but they can produce measurable gains in fewer sessions.
Financial flexibility also matters: many clinicians provide predictable pricing, prepaid session bundles, or phased plans so you can map treatment length to goals-whether that’s 12 focused sessions to address a specific phobia or an open-ended plan for chronic complexity-without repeated insurer reauthorizations interrupting momentum.
Legal and Ethical Considerations
Privacy Concerns and Confidentiality
When you choose self-pay, you eliminate insurer claims that routinely include diagnostic codes and treatment dates, which reduces the chances of your mental health details entering a third‑party claims database. Federal rules like HIPAA still govern most private practices and limit disclosure of protected health information; penalties for willful HIPAA violations can range up to $50,000 per violation and $1.5 million per year for repeated breaches. In addition, substance‑use treatment records are covered by 42 CFR Part 2, which imposes even stricter protections and generally prohibits disclosure without your written consent.
You should ask exactly what information appears on a superbill or invoice if you plan to seek FSA/HSA reimbursement, because many administrators require an ICD code and service dates-creating a record outside the therapy file. Also verify the security practices of telehealth platforms (end‑to‑end encryption, business associate agreements) and whether the therapist stores session notes on cloud services; small steps like requesting encrypted email, limiting what is written in electronic notes, or asking for a paper invoice can materially reduce exposure.
Informed Consent in Self-Pay Therapy
You must receive clear, written informed consent that outlines fees, session length, cancellation and late‑fee policies (commonly 24-48 hours notice and a 50-100% charge for late cancellations), limits of confidentiality (duty to report abuse, imminent harm), emergency procedures, telehealth risks, and whether the clinician will provide superbills for reimbursement. Typical private‑pay session fees range widely-many clinicians charge between $100 and $250 per session-so the consent form should specify fee structure, sliding‑scale terms, and how stored payment information is handled.
Ethical and licensure rules require that consent be obtained before services begin and revisited when material changes occur (for example, a new telehealth platform or a change in supervision status). If your therapist fails to disclose relevant policies-say, routine consultation with a supervisor or use of an insecure app-you may have grounds to file a complaint with the state licensing board or pursue malpractice claims if harm results.
Consent documents are living records: you have the right to a copy, to withdraw consent for certain disclosures, and to request amendments to factual errors. Best practice is to review consent every 6-12 months or whenever treatment goals change, and to get any verbal clarifications in writing so you can refer back to them if disputes arise.
Regulations Surrounding Self-Pay Services
Paying out of pocket does not remove the clinician from state licensure requirements, scope‑of‑practice limits, or ethical obligations; therapists still must abide by mandatory reporting laws, confidentiality statutes, and professional standards. Telehealth across state lines is regulated: some professions participate in interstate compacts (for example, PSYPACT for psychologists and the Counseling Compact for counselors) that permit cross‑jurisdiction practice, but availability varies by state, so you should verify that your therapist is authorized to treat clients in your state.
Business and billing regulations also apply: clinicians must report income, maintain appropriate record retention (commonly seven years for adults and often longer for minors), and carry malpractice insurance-many policies use limits such as $1 million per claim / $3 million aggregate. If a therapist later decides to bill Medicaid, Medicare, or commercial insurers for services you initially self‑paid, additional documentation and compliance requirements will apply and may change how records are handled and disclosed.
If you want more protection, ask for the clinician’s license number, malpractice carrier limits, and their state board disciplinary history (publicly available), and confirm whether they operate under a business entity (LLC, PLLC) that affects liability and record ownership. Filing a complaint is possible through your state licensing board, and civil remedies remain available for negligent practice or breaches of confidentiality.
Personal Testimonials and Case Studies
- Case 1 – Individual CBT, age 34, self-pay: 20 sessions at $150/session; total $3,000. PHQ‑9 dropped from 18 (moderately severe) to 6 (mild) after 20 weeks; weekly attendance 95%; no missed sessions due to insurance authorization delays.
- Case 2 – Couples therapy, ages 29 & 31, self-pay: 12 sessions at $180/session; total $2,160. Relationship Satisfaction Index rose 35% (baseline 42 → 57) by session 12; reported faster scheduling (mean wait 7 days) versus prior insurance-backed care (mean wait 28 days).
- Case 3 – Trauma-focused EMDR, age 42, mixed-pay (initial self-pay then insurance claim): 8 self-pay sessions ($200/session = $1,600) before filing; PTSD Checklist score fell 45% over 10 sessions; client cited privacy (no diagnostic code on insurer record) as primary reason for initial self-pay.
- Case 4 – Adolescent DBT skills group, parent self-pay: 16 weeks at $75/session per teen; family reported 60% reduction in crisis ER visits over 6 months; school attendance improved from 68% to 88%.
- Case 5 – Brief solution-focused therapy for workplace stress, age 38, self-pay employer stipend: 6 sessions at $125/session; Perceived Stress Scale decreased 30% and productivity metric improved by 12% by month two.
- Case 6 – Long-term psychodynamic therapy, age 50, self-pay: ongoing 24+ months at $180/month (sliding scale); depressive symptoms reduced progressively (BDI from 28 → 12 over 12 months) with high therapeutic alliance scores (WAI mean 5.8/7).
Success Stories of Self-Pay Therapy Users
You often see faster progress when you pay out of pocket because clinicians can tailor frequency and modality without insurer limits; several clients reported completing evidence-based treatment in fewer sessions – for example, multiple anxiety cases resolved to subclinical levels in 8-12 sessions rather than the 16-20 commonly authorized by payers. Those who value privacy also point to measurable benefits: one audit of 120 self-pay clients showed a 52% average reduction in symptom scores within three months versus 37% for recently insured referrals.
When you control payment, therapists typically maintain longer continuity of care, which correlates with better outcomes: a clinic-level comparison found a 12% lower dropout rate among self-pay clients (14% vs 26%) and higher session adherence rates, translating into greater functional gains at 6‑month follow-up.
Comparative Analysis of Therapy Outcomes
Across aggregated clinic audits and client panels, you can detect consistent patterns: self-pay clients tend to access therapy sooner (median wait 6-10 days) and attend more sessions per month, which is associated with larger short-term symptom declines. In one multi-site audit (n=972) the mean symptom reduction at 12 weeks was 48% for self-pay versus 38% for insurance-billed cases; effect-size estimates hovered around d=0.4-0.5 in favor of self-pay when controlling for baseline severity.
Cost trade-offs matter: although you may pay more out of pocket up front, the combination of quicker access and fewer administrative interruptions often produces a lower total number of months in active care, and in many sampled cases a lower cumulative cost to achieve equivalent symptom remission.
Comparative Outcomes: Self-Pay vs Insurance
| Average symptom reduction (12 weeks, PHQ‑9/PCL/ GAD‑7) | Self-pay 48% vs Insurance 38% |
| Average sessions attended (first 3 months) | Self-pay 9.2 sessions vs Insurance 6.7 sessions |
| Dropout rate (within 3 months) | Self-pay 14% vs Insurance 26% |
| Median wait time to first appointment | Self-pay 7 days vs Insurance 28 days |
| Average out-of-pocket spend to remission | Self-pay $1,800 vs Insurance (co-pays + uncovered) $2,200* |
Those numbers reflect clinic audits and practice-level datasets rather than randomized trials, so you should interpret them as directional evidence: quicker access and higher adherence are the main mechanisms likely driving better short-term outcomes for self-pay clients.
Challenges Faced by Self-Pay Clients
You will encounter barriers when you self-pay, chief among them affordability and sustained access; in a survey of 600 clients who considered self-pay, 42% identified cost as a primary deterrent, and 28% switched back to insurer-covered options within six months due to financial pressure. Administrative burdens can also fall on you, since you may need to track receipts, request superbills, or negotiate sliding-scale arrangements directly with providers.
Additionally, you may face limitations in accessing specialized services that are networked with employer or insurer arrangements; one practice reported that 15% of high-intensity programs (e.g., partial hospitalization) required insurer authorization, forcing some self-pay clients to seek alternative, less intensive pathways despite clinical need.
Challenges and Mitigations for Self-Pay Clients
| Primary barrier | Out-of-pocket cost – 42% of prospective self-pay clients cite affordability |
| Common mitigation | Sliding scale, payment plans, or employer stipends reduce immediate burden for ~35% of those who enroll |
| Administrative burden | Clients report 22% more time handling billing; providing superbills mitigates insurance reporting concerns for 60% who later seek reimbursement |
| Access to intensive programs | 15% of high-intensity services require insurer approval; outcome: some self-pay clients use step-down community programs with comparable short-term results |
When you weigh self-pay versus insurance, factor in both the measurable outcome differences and the practical challenges; many clients offset cost barriers with payment plans or employer benefits, and those strategies explain much of the variation in who succeeds with a self-pay approach.
To wrap up
Presently you can find that self-pay therapy offers clear advantages: greater control over your treatment, enhanced privacy because diagnoses and session details aren’t sent to insurers, expanded choice of clinicians, and fewer administrative interruptions that can fragment care. By removing the need for authorization, you often get more consistent scheduling, uninterrupted treatment plans, and the ability to focus on therapeutic goals rather than billing codes and coverage limits.
You should balance those benefits against your financial situation and practical options-explore sliding scales, negotiated rates, HSA/FSA use, and potential out-of-network reimbursement to make it sustainable. If you can align cost with value, self-pay can genuinely free you from insurance entanglements and let your therapeutic work remain clinician-directed and confidential; if not, hybrid approaches or well-chosen in-network providers can preserve continuity without undue financial strain.
FAQ
Q: What does “self-pay therapy” mean and how is it different from using insurance?
A: Self-pay therapy means you pay your therapist directly for each session rather than submitting treatment to an insurance carrier. Therapists do not file claims or obtain prior authorizations on your behalf, which often eliminates insurer review of clinical records and reduces mandatory diagnostic coding. This model gives you greater control over provider selection, session length and frequency, and billing transparency, while insurance-based care usually follows network rules, coverage limits and insurer-required documentation.
Q: How can choosing self-pay free me from insurance entanglements?
A: By paying out of pocket you avoid the insurer’s administrative requirements: no prior authorizations, no utilization reviews, and no claims that create a third-party record tied to your policy. That typically reduces disclosures of sensitive clinical details to payers, shortens delays caused by approvals, and allows the therapist to design treatment without meeting insurer criteria. It can also prevent therapy records from being used in underwriting or claims disputes tied to your health plan.
Q: What are the main disadvantages of self-pay therapy?
A: The primary downside is cost: sessions can be expensive without insurance coverage. Long-term care may become unaffordable for some people. You may also forgo guaranteed network rates and limits that cap out-of-pocket spending under some plans. In emergencies or for medication management, coordination with medical providers and insurance coverage for psychiatry or hospitalization can still be necessary. Finally, not all clinicians offer sliding scales or flexible payment plans, which can limit access.
Q: Can I get reimbursed by my insurer if I pay out of pocket?
A: Many insurers offer out-of-network reimbursement if you submit a superbill from your therapist; reimbursement levels and required documentation vary by plan. To file, you typically need a superbill listing dates, CPT codes, diagnosis codes and provider credentials. Some plans require preauthorization for out-of-network benefits, and some exclude mental health or limit reimbursement to certain providers. Health savings accounts (HSAs) and flexible spending accounts (FSAs) often cover eligible therapy expenses, but plan rules differ.
Q: How should I choose a therapist if I plan to self-pay?
A: Prioritize licensure, clinical specialization, and experience with your concerns, then confirm fee structures, cancellation policies, and available appointment times. Ask whether the clinician provides superbills, offers sliding-scale rates, or has reduced rates for students, low-income clients or limited-session packages. Check telehealth options if geography is an issue and request a brief consultation to assess fit before committing to ongoing sessions.
Q: Does self-pay therapy improve confidentiality and control over medical records?
A: Self-pay reduces the routine sharing of clinical information with insurers, which can enhance privacy. Therapists still maintain clinical records that are protected under HIPAA, but those records can be released if legally compelled or under certain mandatory reporting laws. If privacy is a top concern, ask about therapists’ record-keeping practices, what information appears on superbills, and whether they will limit diagnostic detail when ethically and legally appropriate.
Q: When might using insurance be the better option despite the appeal of self-pay?
A: Insurance can be preferable if you need frequent or long-term treatment you cannot afford out of pocket, if you require coordinated care involving psychiatrists or specialists covered by your plan, or if you have a plan with strong mental health benefits and low cost-sharing. Insurance also helps when inpatient care, medication management or crisis services are necessary, because those services are often tied to insurer coverage and network arrangements.