Why Some Therapists Don't Take Insurance

A straight-up conversation about access, money, and what we’re doing about it

I've seen the posts. You've probably seen them too - on Twitter, Reddit, TikTok, everywhere people gather to vent. "Why can't I find a therapist who takes my insurance?" "Therapists only want rich clients." "Mental health care is only for people who can afford $200 a session."

I get it. The frustration is real, and it's valid. When you're struggling and finally decide to reach out for help, hitting that insurance wall feels like the system is working against you. Because in many ways, it is.

But it's not your therapist.

Let me pull back the curtain on what's really happening, and then I'm going to tell you exactly how we're trying to meet you where you are.

The Truth Insurance Companies Don't Want You to Know

Insurance companies reimburse therapists between $40-80 per session, sometimes less. Let me break that down: I spent years in graduate school, completed thousands of supervised clinical hours (often unpaid or barely paid), maintain multiple licenses, carry liability insurance, pay for ongoing continuing education, office space, electronic health records, and all the overhead of running a practice.

And insurance wants to pay me less than a salon haircut.

A 2023 Government Accountability Office report found that low insurance reimbursement rates are one of the main reasons mental health care has become so inaccessible. Rates haven't meaningfully increased in decades while everything else - rent, student loans, health insurance, cost of living, has skyrocketed.

But it's not just the money. Here's what else happens when therapists work with insurance:

Insurance dictates your care. They can limit how many sessions you receive, what conditions they'll cover, and even what treatment approaches your therapist can use. Your healing has to fit into their budget, not your actual needs.

You must have a diagnosis…immediately. Insurance requires a mental health diagnosis to cover sessions. Sometimes people just need support navigating life transitions, relationship challenges, or personal growth. But insurance won't cover "I want to be a better version of myself." Many therapists end up diagnosing on day one, before they really know you, just to get your care covered.

Your information isn't fully yours. Insurance companies require detailed documentation about your treatment. That diagnosis goes on your permanent medical record. It can follow you - potentially affecting future insurance rates, employment in certain fields, and more.

Therapists face payment uncertainty. Insurance companies can take months to pay claims, deny them arbitrarily, or "claw back" payments years later claiming the service wasn't covered. Imagine doing your job, getting paid, spending that money on rent and groceries, then being told two years later you have to give it back.

The experienced therapists who have been doing this work for decades? Most of them have left insurance panels entirely. A recent survey found that less than 20% of therapists listed in some areas accept insurance. The ones who do are often newer clinicians still building their practices, which isn't inherently bad, but it limits your options.

What we hear (and what we want you to know)

"Therapists are just greedy."

Listen, no one becomes a therapist to get rich. We sit with people's deepest pain. We hold space for trauma, grief, generational wounds, and the slow, hard work of healing. We're not choosing between a yacht and your copay. We're choosing between sustainable practice and burnout that forces us out of the field entirely.

When therapists take insurance at those rates, they often have to see significantly more clients to make ends meet. That means shorter sessions, less availability, and therapists running on empty. You deserve better than a burned-out clinician checking the clock.

"Mental health care should be accessible to everyone."

Absolutely. We agree. But the system is designed to maximize insurance company profits, not your access to care. The Mental Health Parity and Addiction Equity Act is supposed to ensure equal coverage for mental health, but insurers routinely violate it, delaying and denying claims to discourage people with chronic mental health needs.

Your frustration shouldn't be aimed at the therapist charging what they need to survive. It should be aimed at the insurance companies making billions while people can't access care, and at a healthcare system that treats mental health as optional.

How we’re meeting you halfway 

Here's where I stop explaining the problem and start offering solutions. Because understanding why doesn't pay your bill or get you support.

12-Session Therapeutic Arc

Real change takes time. I personally begin with a 12-20 session arc, a minimum commitment that gives you enough time to build rapport, dig into the work, and start developing lasting skills. Twelve sessions is the foundation, not the finish line. Most of our clients continue beyond that initial arc because healing isn't linear and life keeps happening. You'll know what you're investing to get started, and we'll build from there based on what you actually need.

Single Sessions for Established Clients

Completed your therapeutic arc but something came up? Life doesn't stop throwing curveballs just because you've done the work. For established clients, we offer single sessions when you need a check-in, want to process a new challenge, or just need to reconnect with the tools you've built. You don't have to start from scratch, you already have a foundation with us.

Out-of-Network Benefits

If you have a PPO plan, you likely have out-of-network benefits. We provide superbills - detailed receipts you can submit to your insurance for partial reimbursement. Many people get 60-80% of their session cost back. It's extra paperwork, yes, but it can make private-pay therapy much more affordable.

(P.S ask your therapist about a service clients can use to navigate their insurance benefits)

Community Support Between Sessions

Therapy doesn't have to be your only source of support. Between sessions, connecting with peer support groups can provide community, shared understanding, and ongoing encouragement at no cost.

NAMI (National Alliance on Mental Illness) offers free peer-led support groups nationwide - NAMI Connection for individuals with mental health conditions and NAMI Family Support Group for loved ones. Find groups at nami.org/findsupport.

ADAA Online Communities (Anxiety and Depression Association of America) provides free, anonymous peer support available 24/7 at adaa.org/find-help/support.

7 Cups offers free emotional support through trained volunteer listeners and community chat rooms. Available anytime at 7cups.com.

HeyPeers provides over 1,000 free virtual support groups monthly led by certified peer specialists at heypeers.com.

Open Path Collective connects people in financial need with therapists offering $40-70 sessions after a one-time $65 membership fee. Visit openpathcollective.org.

DBSA (Depression and Bipolar Support Alliance) hosts free in-person and online support groups specifically for those dealing with mood disorders.

These aren't replacements for professional therapy when you need it, but they're powerful supplements. Community heals. Shared experience validates. You don't have to do this alone, even when therapy sessions aren't possible.

Moving Forward Together

The mental health system is broken. Insurance companies have created a landscape where the people who need care most often can't access it, while therapists who accept their rates burn out trying to help. Neither of us wins, except the insurance companies.

We're not asking you to stop being frustrated. Channel that energy. Advocate for mental health parity enforcement. Push your employer to demand better mental health coverage from their insurance providers. Vote for policies that treat mental health care as the essential service it is.

And in the meantime, reach out. Check your out-of-network benefits. Connect with a support group. You deserve care, and we're committed to finding ways to make it happen.

Your healing matters. Let's figure this out together.

—Cardinal Counseling Group