Cash Pay

Cash pay (also called self pay) is when you pay a provider directly instead of using insurance. Policies vary by facility. Some centers accept self pay for all services, some only for certain programs, and others require insurance. Ask the provider what they accept and what forms of payment they take.

Why some people choose cash pay

• Faster access to care without plan approvals

• More choice of programs if your plan has a narrow network

• Privacy preferences for those who do not want to use insurance

Tradeoffs include paying the full charge unless the provider offers a discount or you later get reimbursed by your plan for out-of-network care. (Cigna, CMS)

Your rights as a self-pay patient

Under the No Surprises Act, if you are uninsured or choose not to use insurance, you are entitled to a Good Faith Estimate (GFE) before care. If your final bill is $400 or more above the GFE for any one provider or facility, you can start a patient-provider dispute resolution process within 120 days of the bill. (CMS)

What to ask providers before you commit

1. Do you accept self pay for this service or level of care

2. What is the cash rate and what is included in that price

3. Will I receive a written Good Faith Estimate and when

4. Are there available discounts or financial assistance

5. Can I get an itemized receipt or superbill if I submit a claim to my insurer for out-of-network benefits

6. Do you offer payment plans and what happens if a payment is late

For claims you submit yourself, ask for a superbill and your plan’s out-of-network claim form. (HealthCare.gov, Blue Cross NC)

Typical costs and how to research them

Prices vary by service and location. Use trusted cost-lookups to see typical local charges and to reality-check your GFE:

• FAIR Health Consumer cost look-up. (FAIR Health)

Discounts, payment plans, and financial aid

Many providers offer self-pay discounts, sliding scale rates, or payment plans. For medication costs, check patient assistance resources from national organizations. (NAMI)

A note on medical credit cards: read terms carefully. Deferred interest offers can add large finance charges if the balance is not paid in full by the promo deadline. Consider alternatives before using these products. (Consumer Financial Protection Bureau)

Taxes, HSAs, and FSAs

Out-of-pocket mental health care is often an eligible medical expense for tax purposes and can typically be paid with HSA or FSA funds. Always confirm with your tax advisor and plan. See IRS guidance on allowable medical expenses. (IRS)

Good Faith Estimate checklist

Ask for the GFE in writing and keep it. If your bill comes in higher than expected:

• Ask the provider to update or correct the bill

• Negotiate or ask about financial assistance

• If the bill is $400+ above the GFE for that provider, you may file a PPDR dispute (fee applies) within 120 days. (CMS)

If you plan to seek out-of-network reimbursement

Some insurance plans reimburse part of self-paid services. Check whether your plan includes out-of-network benefits, what documentation is required, and how to file a claim. (HealthCare.gov, Aetna)

How to verify and get started

1. Call the provider and confirm they accept self pay for your service.

2. Request a written Good Faith Estimate.

3. Ask about discounts, payment plans, and what your payment covers.

4. If you may submit a claim to your insurer, ask for a superbill and your plan’s claim form. (CMS, HealthCare.gov)

Find programs that accept cash pay Use our directory filters to view facilities that list self pay or cash pay options, then contact the provider to confirm current pricing and payment policies.

Helpful external resources

• Good Faith Estimate and patient-provider dispute process overview, CMS. (CMS)

• Consumer guide to Good Faith Estimates and $400 dispute threshold, CMS. (CMS)

• FAIR Health Consumer medical cost lookup. (FAIR Health)

• IRS Publication 502, medical and dental expenses. (IRS)

• NAMI tips on paying for care and medication assistance. (NAMI)

• CFPB alerts on medical credit cards and financing risks. (Consumer Financial Protection Bureau)