There are several benefits to paying out-of-pocket for counseling. When paying with insurance there is the possibility your insurance company may request your personal health information and/ or try to dictate diagnosis, session limits, etc. While a diagnosis may be empowering to some clients, other clients may find it stigmatizing or limiting. Further, when paying with insurance your diagnosis becomes a part of your permanent health record. Insurance companies have full right to all your records. Out-of-pocket therapy sessions do not limit you to a diagnosis, rigid treatment plans, or a set number of sessions. My current out-of-pocket rate for a 50-minute counseling session is $140.