Why I Don’t Take Insurance as a Therapist — And Why Private Pay Creates Better Care

If you’ve been searching for a Waco therapist, you’ve probably noticed that many providers don’t take insurance. As a therapist specializing in Waco eating disorder therapy, body image work, and trauma-informed care, one of the most common questions I’m asked is:

“Why don’t you take insurance?”

It’s an important question — especially if you’re trying to understand the difference between insurance vs private pay therapy.

The truth is simple:
I don’t take insurance because it protects your privacy, your treatment, and the quality of the care you receive.

Below is an honest breakdown of why.

Insurance requires a diagnosis — even when it doesn’t fit

Insurance only pays for therapy if there is a billable mental health diagnosis.
But many people seeking Waco eating disorder therapy or support for body image, food guilt, stress, trauma, or postpartum emotions don’t meet diagnostic criteria.

Insurance will not cover therapy for:

• Life transitions
• Body image concerns
• Disordered eating (without a full ED diagnosis)
• Stress, burnout, or identity work
• Relationship issues
• General self-esteem
• Nervous system regulation
• Postpartum adjustment

To get paid, many therapists are forced to diagnose clients with something permanent — even if it’s not clinically accurate.

I don’t believe in labeling clients unnecessarily.
You deserve therapy without being pathologized.

Insurance reduces your privacy

When insurance is involved, they can:

• Review your records
• Request clinical notes
• Audit your sessions
• Decide if they will cover further treatment

This means people who have never met you get to decide:

• How long you can stay in therapy
• What symptoms “count”
• Whether your progress is “good enough”
• Whether you’re “sick enough” to qualify

As a private pay Waco therapist, your information stays between us — not an insurance reviewer.

Insurance limits the type of therapy I can provide

Insurance prefers short-term, symptom-focused treatment.
But the work I do — especially around:

• Eating disorders
• Disordered eating
• KAP preparation and integration
• Trauma
• Nervous system healing
• Postpartum mental health
• Deep body image work

Requires time, safety, and flexibility.

Real recovery doesn’t happen in six insurance-approved sessions.

Insurance restricts session length and frequency

Many insurance-based therapists are required to provide:

• 38–45 minute sessions
• Limited appointment frequency
• No extended sessions
• No depth work outside a diagnosis

In my Waco private practice, we can:

• Meet weekly or more often
• Stay longer when needed
• Go deeper without rushing
• Follow your timeline, not an insurance company’s

This freedom is a core benefit of private pay therapy.

Insurance reimbursement rates lead to burnout

Insurance pays therapists significantly less than private pay — often 30–70% below market rate. This forces many providers to:

• See 25–35 clients per week
• Shorten sessions
• Spend unpaid time fighting denied claims
• Burn out quickly

A burned-out therapist cannot provide grounded, attuned, high-quality care.

By staying private pay, I’m able to:

• Maintain a smaller caseload
• Show up fully present
• Think about your case between sessions
• Offer deeper, more intentional work
• Stay in this field with longevity

This directly improves your therapeutic experience.

Private pay therapy gives YOU more control

When insurance is removed, you gain:

• More privacy
• More flexibility
• More freedom in your goals
• More trauma-informed, client-centered care
• More room for depth, nuance, and long-term healing

Many clients still receive reimbursement through superbills for out-of-network benefits. I personally use a company called Thrizer that will do all the work for my clients in getting reimbursed through their insurance.

If you’re unsure whether private pay therapy is right for you, I’m happy to walk through your options and help you understand your choices. Book a free call with me here!