Why Many Therapists Don’t Take Insurance (And What That Means for You)

Ah, the age-old question: “Why don’t therapists take insurance?” Right up there with “Do therapists analyze people at parties?” and “Are you secretly diagnosing me right now?” (For the record, we’re not. But that thing you just did? Noted.)

A lot of people assume therapists who don’t accept insurance are just in it for the money. And while we’d love to be rolling in cash, sipping oat milk lattes on a yacht named Coping Skills, the reality is a little less glamorous. In fact, accepting insurance often makes it harder to provide good therapy. Here’s why:

1. Insurance Pays Therapists Like It’s Still 1975

Let’s get straight to the point: insurance companies pay therapists terribly. You know how people complain about BetterHelp therapists being distracted or giving low-effort responses? Well, many of them are making around $30 per hour—and that’s before taxes, student loans, and the cost of running a practice. And those sessions? Often less than an hour because the platform doesn’t even allow full 60-minute sessions. They often suggest just doing text therapy.

Think about it—therapists spend years in school, racking up six-figure debt, only to be offered a wage that barely covers rent. Meanwhile, insurance CEOs are out here making millions. Something isn’t adding up.

2. Paperwork, Paperwork, and More WORK

You know how annoying it is to be on hold with your insurance company for 45 minutes just to ask a simple question? Imagine doing that all day, but for every single client.

Therapists who take insurance spend hours on paperwork, claim denials, and back-and-forth emails just to get paid for sessions they’ve already provided. Instead of spending that time, you know, actually helping people, they’re stuck begging an insurance company to approve a session that already happened.

3. Insurance Companies Think They Know Therapy Better Than Therapists

Ever had a friend give you unsolicited life advice that’s so bad, it makes you question your entire friendship? That’s basically what insurance companies do to therapists—except they’re the ones in control of your mental health treatment.

Example: A therapist might be working with someone who has severe trauma, and the insurance company will say, “Yeahhh, we’ll cover three sessions. After that, they just need to learn how to deal with it.” I have experienced this and this is me sugarcoating what actually happened!

That’s… not how therapy works. At all. But insurance companies don’t care about long-term healing. They care about cutting costs. And that directly impacts the quality of care therapists can provide.

4. Your Privacy? Not as Private as You Think

If you use insurance for therapy, your information isn’t just between you and your therapist—it’s also in the hands of your insurance company. And let’s just say some of these companies haven’t exactly been great at keeping data secure.

Many insurance providers have been caught selling private client data or experiencing major data leaks. So if the thought of your personal struggles being stored (and potentially misused) by a giant corporation makes you uneasy, you’re not alone.

So… Does This Mean Therapy is Only for the Wealthy?

Absolutely not. Many therapists offer sliding scale fees, which means they adjust their rates based on what you can afford. Some sliding scale rates are actually cheaper than an insurance copay—you just have to ask.

And if insurance is your only option, please still use it. The system is frustrating, but getting some support is better than getting none. If your only alternative is talking to family members who think “just be happy” is solid mental health advice, then yes, use the insurance.

The Bottom Line

Therapists don’t skip insurance because they don’t care. They skip it because insurance makes therapy harder—not easier—to access and sustain. Between low pay, ridiculous amounts of paperwork, and treatment limitations, accepting insurance often makes it impossible to provide the care clients actually need.

If you can afford private pay or sliding scale, it can be a great way to get quality therapy without jumping through hoops. And if you need to use insurance, go for it—just know that your frustration is valid, and you’re not alone in it.

Either way, the most important thing? Get the help you need, however you can.