Why Many Patients Choose Private Pay Over Insurance
Megan Davidson
Care Should Be Based on Your Needs—Not Insurance Rules
Insurance can be helpful, but it also comes with rules that often affect care in ways patients don’t expect.
When using insurance, treatment is typically limited by:
● Required authorizations before care can begin
● A set number of visits decided by the insurance company
● Restrictions on diagnoses or services
● Delays or denials that happen after treatment has already started
These decisions are made by your insurance plan—not by you and your provider together.
Private pay removes those limitations, allowing your care to be based on what’s clinically appropriate for you.
Faster Access, Fewer Delays
One of the biggest advantages of private pay is how quickly care can begin.
With private pay:
● There are no authorizations to wait for
● You can often be scheduled sooner or more often
● Care moves forward without administrative interruptions
This means you can focus on making progress instead of waiting on your insurance.
No Visit Limits or Surprise Changes
Many patients are surprised to learn that insurance often caps the number of visits they can use—sometimes before meaningful progress is made. The reality of Pediatric Therapy is that it can often take several months, years, or for some children, a lifetime.
Private pay means:
● No visit limits
● No sudden stops in care
● No unexpected “not covered” notifications
Your treatment plan can evolve naturally, based on how your child is responding—not on what an insurance policy allows.
Clear, Predictable Costs
Insurance can feel confusing. Copays, deductibles, and coverage changes often make it hard to know what care will actually cost.
With private pay:
● Costs are clear and upfront
● There are no surprise bills
● You’re not at risk of retroactive denials
Many patients appreciate knowing exactly what to expect financially, without uncertainty.
More Control Over Your Care
Private pay puts you in the driver’s seat.
You and your provider can decide:
● How often your child is seen
● How long care continues
● What approach best fits your goals for your child
There’s no need to fit your experience into a billing code or justify your care to a third party.
As we often say: private pay lets us treat you—not your insurance policy.
What If I Want to Use Insurance?
That’s a very common question—and insurance is always an option.
Some patients choose to start with insurance and later transition to private pay if visit limits, authorizations, or delays become an issue. Others choose private pay from the start to avoid those barriers entirely.
There’s no pressure either way. Our goal is to help you understand your options so you can choose what feels right for you.
The Bottom Line
Private pay isn’t about paying more—it’s about removing obstacles to care.
For many patients, it means:
● Faster access
● Fewer interruptions
● More personalized treatment
● Greater peace of mind
If you have questions about whether private pay or insurance is the best fit for your situation, we’re always happy to talk it through with you—clearly, honestly, and without pressure.
Your care should work for your child.