The cost of medical insurance, like everything else, is extremely high.  A lot of people carry only enough insurance to protect themselves from catastrophic medical expenses, and use the saving on their insurance to set up a budgeted savings account for other medical expenses.  When they decide that they could benefit from quality psychological services, they have the money available, and they pay for their treatment as they go.  This method, of course, is easiest for us.   We simply put together a treatment plan that outlines the issues that we are going to deal with; we deliver the service; if all goes well, they enjoy the benefits of the service, and they leave feeling that that received something that cannot even have a price tag put on it--the resolution of an important life crisis.  Obviously, everyone is not in a position to receive psychological services in this manner, and most of the time we are dealing with some kind of insurance plan.