Understanding Insurance, Out of Pocket Costs, and Private Pay Options

Navigating healthcare costs can feel overwhelming, and we understand that insurance benefits are not always easy to understand. At Coastal Plain Therapy & Wellness, we want you to feel informed and confident about your care before beginning therapy.

When you provide your insurance information, our team will verify your benefits and provide an estimate of your expected out-of-pocket costs based on the information available from your insurance company. However, insurance benefits are not a guarantee of payment. The final amount you owe is determined by your individual insurance plan after claims are processed.

Because every insurance plan is different, two patients receiving similar services may have very different out-of-pocket costs. Your responsibility is determined by your specific plan, including your deductible, copayment, coinsurance, and coverage limitations.

Common Insurance Terms Explained

Copayment (Copay)
A copay is a fixed amount you pay each time you receive therapy services. The amount is determined by your insurance plan and may vary depending on your coverage.

Deductible
A deductible is the amount you must pay out of pocket before your insurance begins contributing toward covered services. For example, if your deductible is $1,000, you may be responsible for the full allowed cost of services until you meet that amount.

Coinsurance
Coinsurance is the percentage of the cost you are responsible for paying after your deductible has been met. For example, if your plan has a 20% coinsurance, you would pay 20% of the allowed amount and your insurance would cover the remaining portion.

Why Do I Have to Pay at the Time of My Appointment?

At Coastal Plain Therapy & Wellness, payment is collected at the time services are provided. Insurance companies require healthcare providers to collect the patient responsibility amount determined by the individual insurance plan.

While we understand that medical expenses can be frustrating or unexpected, waiting for insurance payments is not an option because claims processing can take weeks or months. Our goal is to make this process as simple and transparent as possible.

What Are the Benefits of Private Pay Therapy?

Some patients choose private pay therapy because it provides greater flexibility and allows care to be centered completely around their goals.

Private pay may be a good option if you:

Have a high deductible or limited therapy benefits
Want to begin therapy without waiting for insurance approval
Have reached your insurance-covered visit limit
Need services that may not be covered by your insurance plan
Prefer a more personalized approach without insurance restrictions
Want to pursue wellness, prevention, or maintenance-focused services

Private pay allows you and your therapist to focus on meaningful outcomes and the care you need without being limited by insurance guidelines.

We Are Here to Help

We know insurance can be complicated. Our team is happy to answer questions, review your options, and help you determine the best path for your therapy journey.

At Coastal Plain Therapy & Wellness, our priority is providing compassionate, evidence-based care that helps you achieve your goals and maintain your independence.