Does My Health Insurance Cover Therapy?

There can be various costs that go into therapy and mental health services. When looking for a therapeutic service that works for you, you might consider the overall treatment cost per hour, insurance coverage, possible co-pays, and types of treatment needed.

Does health insurance cover therapy? 

Is therapy covered by health insurance? Most health insurance providers have in-network therapists and other mental health professionals. This allows clients to reach providers who have experience providing counseling and treating mental illness. If you have a primary care physician, they may also help refer you to in-network providers. Working with an in-network therapist, as opposed to a provider who is not included in your health insurance coverage, can help you save money. Still, you could face outside factors that affect your overall therapy cost, depending on the deductible or plan you signed up with when you first obtained your insurance policy. 

Some of these outside factors may include:

• Counseling co-pays
• Added therapy and counseling session costs that are not covered by insurance
• Online or in-person therapists who charge upfront fees
• Online or in-person therapists who require you to submit invoices for insurance reimbursement for therapy

If you have Medicaid or Medicare through the US government, it's possible that your plan covers therapy, depending on your need for it and what the provider covers. Some providers offer a selective list of companies covered under their plans, so check with them before signing up for therapy. 

It is also important to understand the Mental Health Parity and Addiction Equity Act of 2008, which is a federal law preventing companies that offer health insurance from restricting mental health coverage more than they do physical health coverage. Even though therapy can be expensive, this Mental Health Parity Act helps ensure that mental health benefits are as comprehensive as physical health benefits.

The Affordable Care Act is another law that deals with insurance for mental health services. The Affordable Care Act outlines government policies to provide equal way to health coverage, including plans through a health insurance company like Medicaid or Medicare. This care act may ensure insurance covers some or all of your treatments as a low-income individual. Some government plans cover online therapy as well as in-person counseling. 

In-person counseling

Health insurance may or may not cover your treatment for traditional in-person talk therapy. In personal practice, therapists often have the right to choose which insurance plans to accept, and not every therapist will accept the same plans. Additionally, depending on your policy, you may be limited to seeing mental health professionals in your state or county. 

Some insurance plans may also limit you by:

• Setting a fixed cost for each in-person or online therapy session
• Covering a limited number of therapy or counseling sessions
• Providing a specific list of therapists who they will cover
• Requiring a mental health diagnosis before covering any therapy or counseling sessions
• Lack of coverage for alternative mental health therapy, such as online counseling or CAM therapy

Many insurance plans have mental health care, online counseling, or therapy as a coverage item. However, they might not cover the entire session. In some cases, you might have to pay an upfront cost, such as the entire cost of the session, and your insurance plan may reimburse you afterward. If you have not been diagnosed, an insurance policy could also require you to have a diagnosis and underlying need before covering your therapy sessions. You might also require a medical doctor’s referral for any mental health treatments.

If your budget is limited, you can try alternative treatments such as CAM therapies or utilize them as complementary therapy under the supervision of your doctor or therapist. The National Center for Complementary and Integrative Health offers materials if you do wish to learn more about CAM therapies, aka complementary and alternative medicine.

Online counseling

Many special practice providers have moved to online therapy, aka online counseling, to offer more convenience for clients experiencing mental health concerns. However, not all internet practitioners offer psychotherapy care through insurance plans. If you're searching for individual therapists or therapy companies that offer telehealth therapy, check the insurance page or section of their biography or website. You can also reach out by phone to ask if that therapist does offer online counseling. If the therapist is licensed in your state and can accept your insurance, you may be able to attend online counseling. 

If you attend therapy through an online platform, you may not be able to use insurance cover options due to the site's terms and conditions or policies. For example, someone in the UK may not be allowed to see a therapist in the United States due to differing laws about practice locations. However, many online platforms are hundreds of dollars cheaper than in-person therapy per month, which can benefit those with high co-pays, upfront costs, or barriers to traditional therapy.

Treatment centers

Insurance companies, like Blue Cross Blue Shield, may cover treatment centers like rehabilitation centers, psychiatric hospital stays, eating disorder treatment and therapy centers, or outpatient therapy groups. These centers may be costly without insurance, however. Depending on your insurance company, you may be required to pay an upfront registration fee and the rest through your insurance. For rehabilitation centers in the US, there is an average cost reaching upwards of $30,000. However, it's important to remember the impact that location can have on cost. Rehabilitation and counseling centers in the UK typically cost up to £14,000.

Psychoanalysis testing

If you are looking for a mental health evaluation and official psychoanalysis testing from a licensed psychiatrist, you may have to pay the amount out of pocket, even if your insurance covers therapy. Many insurance companies do not offer coverage for official psychological evaluations. These tests may cost around $1,500-$3,000 or more, depending on the area and the provider you select. You might be able to find cheaper testing if you go through a student program at your local university or contact local vocational rehabilitation services for financial support. 

Psychiatry

Insurance does often cover psychiatry as a behavioral health medical service, as psychiatrists are medical doctors. However, depending on your plan, your medications may or may not be covered. Talk to your local pharmacy to find out if your insurance plan is accepted and how much you might pay in co-pays for your medication if you are prescribed any. Psychiatrist visits can cost between $100-$400 per session. You may pay more for an initial consultation and mental health diagnosis. 

The costs of therapy

Depending on where you live, out-of-pocket costs can vary. However, Forbes notes that the national average in the US is $100-$200 per therapy session without insurance. This cost can be around $400-$800 or more per month. 

For those covered by insurance, your co-pay or upfront service cost can depend on the overall deductible or premium you signed up for with your policy coverage. For example, if you have a high monthly payment on your insurance plan, your insurance policy might cover mental health services. 

You may have to pay more out of pocket for your sessions if you have a high deductible and lower monthly cost. For some, that amount might be around $100 per session. If you have a co-pay plan, you might pay $15-$45 in co-pays. If you are prescribed medication, that could add costs, depending on whether your insurance covers your medication.