When seeking behavioral health treatment, one of the most important questions is: Should I use insurance or pay out of pocket? In Massachusetts, patients have access to both self-pay and insurance-covered options for mental health and substance use treatment—but which is right for you?
Below, we break down the key differences, benefits, limitations, and decision-making tips to help you choose the best path forward.
Understanding Insurance-Covered Treatment in Massachusetts
Health insurance can significantly reduce the cost of care. In Massachusetts, most commercial insurance plans are required to cover mental health and substance use treatment under the Massachusetts Mental Health Parity Law and the federal Mental Health Parity and Addiction Equity Act (MHPAEA).
Common Insurance Plans We Accept
At Freedom Health Treatment, we are contracted with most major commercial insurance providers, including:
- Blue Cross Blue Shield of MA
- Aetna
- Cigna
- UnitedHealthcare
- Harvard Pilgrim
- Tufts Health Plan
- UMR
- Modern Assistance
- Mass General Brigham
- & More!
Tip: Always verify your benefits first. Contact our admissions team to run a free, confidential insurance check.
Benefits of Using Insurance
Using insurance has several advantages, especially for long-term treatment programs like PHP (Partial Hospitalization) or IOP (Intensive Outpatient).
✅ Lower Out-of-Pocket Cost
Depending on your deductible and out-of-pocket maximum, you may only pay a fraction of the full cost—or nothing at all after reaching your plan limit.
✅ Broader Access to Licensed Providers
Licensed mental health and substance use programs that meet insurance standards typically offer more structure and oversight.
✅ Legal Protections & Coverage Requirements
Massachusetts law mandates that insurance providers cover behavioral health care equally to physical health care.
➡️ Learn more about mental health parity protections from NAMI.
Drawbacks of Using Insurance
Despite the benefits, there are downsides to using insurance that you should consider.
❌ Limited Privacy
Insurance billing creates a medical record that could be accessible in future employment or legal situations.
❌ Restricted Duration & Frequency
Insurance companies often authorize care week-to-week, which can create uncertainty or prematurely end treatment.
❌ In-Network Limitations
Not all treatment centers are in-network like Freedom health,, and many programs may only take self-pay clients or work out-of-network.
How Insurance Approval Can Affect Your Recovery Timeline
One major concern with using insurance for behavioral health treatment is the approval process. Many insurance providers only authorize treatment for a few days at a time. For instance, you might be approved for 5 days of PHP, with further treatment contingent on reviews.
This adds stress to the recovery process. Patients often worry about whether their stay will be extended, which can detract from their focus on healing.
What Happens When Insurance Denies Coverage?
Insurance providers can deny coverage for several reasons:
- They determine the treatment is not medically necessary
- They claim your condition doesn’t meet clinical criteria
- They believe you’ve already received enough care
Even with an appeal, delays in care can lead to early discharges and setbacks in recovery. In contrast, self-pay clients never have to worry about authorization interruptions.
The Case for Self-Pay Treatment in Massachusetts
Self-pay means you cover the full cost of treatment without involving insurance. This allows for more control, confidentiality, and continuity.
✅ Full Confidentiality
No diagnostic codes, no insurance paper trail. Your treatment remains private.
✅ Greater Freedom of Choice
Choose the provider that aligns with your values and treatment goals—regardless of network restrictions.
✅ Customized Length of Stay
Self-pay clients can participate in care as long as clinically appropriate, not just until insurance stops covering it.
Common Self-Pay Pricing in Massachusetts
At Freedom Health Treatment in Framingham, we offer flexible payment options and transparent pricing. Please call our admissions team to go over available options.
We also offer sliding scale rates and monthly payment plans to ensure access for clients from various financial backgrounds.
Using Out-of-Network Benefits for Maximum Flexibility
Many clients are unaware they can use out-of-network benefits. While this often means paying upfront, clients can request reimbursement from their insurer using a superbill. This hybrid option provides more flexibility while still leveraging your insurance.
Our team at Freedom Health can help verify out-of-network benefits and guide you through the reimbursement process.
Real-World Example: Self-Pay Client Experience
One client came to Freedom Health struggling with severe anxiety and substance use. Through self-pay, they accessed 6 weeks of uninterrupted PHP and transitioned into 8 weeks of IOP.
Because their treatment wasn’t dictated by insurance reviews, they completed the full program, participated in holistic therapies, and worked with a consistent care team. The result was a sustained recovery with no relapse during the following year.
The True Cost of Not Getting Help
Avoiding treatment due to cost concerns can have serious long-term consequences:
- Job loss
- Legal issues
- Relationship breakdowns
- Medical complications
Whether you choose insurance or self-pay, the investment you make today in your mental health could prevent thousands of dollars in future expenses—and most importantly, protect your well-being.
Which Option Is Best for You?
Here’s a comparison to help you decide:
Criteria | Insurance | Self-Pay |
Cost | Usually lower upfront | Higher upfront |
Privacy | Less private | Fully confidential |
Flexibility | Limited by policy | Customizable |
Provider Access | May limit options | Choose any provider |
Approval Needed | Yes, ongoing | None |
Length of Stay | Insurer controlled | Clinician guided |
Making the Right Financial Decision for Your Health
No matter how you choose to pay, the most important thing is to get help. If you’re unsure which path is right for you, our team is ready to help evaluate your benefits and discuss self-pay options.
Click here to speak to our admissions specialists today
Final Thoughts
In Massachusetts, both self-pay and insurance can offer access to quality treatment. Your decision should be based on your clinical needs, privacy preferences, and financial goals.
At Freedom Health Treatment, we provide personalized, effective care for mental health and substance use disorders—whether you pay with insurance or out of pocket.
