Sometimes it can be confusing to understand the difference between services covered by insurance and self-pay services. There are many reasons why people prefer self-pay therapy services. A few reasons are: Most insurance companies require a mental health diagnosis within the first few sessions to meet criteria for insurance coverage. This information becomes a part of your permanent health record, which can impact qualifications for life insurance and security screenings for employment. Insurance companies decide how many sessions you are allowed per year. This can be difficult for individuals who want to see a therapist more frequently. Therapy is a collaborative and private relationship between the therapist and client. Self-pay allows you to take your mental health into your own hands, without insurance deciding the “necessity” of treatment.