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Does Insurance Cover Couples Therapy

Couple Therapy Can Save A Marriage

Does Insurance Cover Marriage Counseling? Does Insurance Cover Life Coaching?

In many cases, couple therapy can help save a marriage which is on the verge of divorce. It can help couples deal with their differences and overcome the problems they are facing. For that reason, insurance should cover its cost.

Couple therapist, a third person can help the couple to resolve issues in a better way. Therefore, he/she can help them to understand each other in a more balanced way and can also provide some much needed balance.

Moreover, It is an equilibrium that is all which is much needed to save a marriage. Marriage therapy is a form of counseling that helps couples deal with their differences to overcome the problems they are facing.

Are You Thinking Of Using Health Insurance To Cover Counseling

With the current state of healthcare, you are indeed fortunate to have coverage. Many people feel that therapy is an expense that they cannot manage without it. If you are looking for information on using health insurance to cover counseling you can find a comprehensive overview of what it means for couples and individuals here. While its great to be covered, we dont accept health insurance. Why wouldnt we accept health insurance for individual or couples counseling?

I encourage you to investigate all options and arrive at an informed decision regarding your health care BEFORE using your benefits. That may mean using your insurance, and it may mean making another choice. You can always decide to use your benefits, but you cannot undo many of the negative consequences of using them. What are the risks of using your health insurance?

How Does Paying For Therapy Work In Connecticut

There are several options for paying for therapy in Connecticut. For many people, the most affordable way to seek mental health services is to look for a provider who is in-network with your insurance. Due to high demand and low availability, in-network providers often have long waitlists to widen your options and start therapy sooner, you might also consider looking for an out-of-network provider. When you see an out-of-network couples counselor inConnecticut, you can ask for a sliding scale if you are unable to afford their typical session fees, or seek reimbursement from your insurance company if you have a PPO or POS plan. For clients who have an insurance plan with a high deductible and low medical costs, therapy costs are often comparable when you see a couples counselor in- or out-of-network. While paying for therapy can be a substantial investment, its also a great way to improve relationships, boost self-esteem, address symptoms of mental illness, and ultimately live a happier, more self-directed life.

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When Should You Go To Couples Counseling

Many relationships will go through periods of stress, which can sometimes lead to fighting or disagreements. However, if these incidents are happening frequently and getting in the way of your day-to-day life, itâs a good idea to see a therapist for couples therapy. Often people avoid couples counseling because they feel like they donât need it or that the situation isnât important enough. However, couples therapy is one of the best ways to strengthen your relationship and make sure you are both on the same page about what you want in life.

Considering Return On Investment: The Immense Value Of Couples Therapy

Marital Counseling

If your marriage counseling insurance covers the cost of seeing a couples therapist, you are in luck, but if you have to pay out of pocket, you may want to think carefully about the potential return on investment that you will get by paying for couples therapy. The mental health community recognizes that many issues are easier to treat when they are dealt with within the context of a family environment. Family counseling sessions can be effective when dealing with marital issues, depression, alcoholism, schizophrenia, and more. In most cases, family or couples therapy takes less time than individual therapy, which means you are likely to spend less money throughout your treatment.

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Can You Direct Bill My Insurer


We cannot check if your plan covers a particular insurance provider. Only the insurance provider holder can find out what types of therapists they are covered for.

Most of our clinicians can direct bill Alberta Blue Cross, Alberta School Employee Benefit Plan and Green Shield.

Some of our clinicians can direct bill Medavie Blue Cross and Criterion Group . These insurers give approved psychologists and mental health therapists an internet portal to use, so we can do the invoicing and provide you with a receipt at the end of the session.

Some of our clinicians can direct bill for clients with Treaty Status who are covered by Indigenous Services Canada Health Benefits. Firefly Counselling may also direct bill for individuals who have attended a Residential School listed in the 2006 Indian Residential Schools Settlement, the client’s spouse or partner, or those raised in the household of a former Indian Residential School student, or any relation who has experienced the effects of inter-generational trauma associated with a family member’s time as an Indian Residential School.

Some of our clinicians can also direct bill other insurance providers such as Great West Life, Chambers of Commerce Group Insurance Plan, CIMUP, Desjardins, First Canadian, GroupHEALTH, GroupSource, Industrial Alliance Insurance and Financial Services , Johnson Group, Manion, Maximum Benefit,

What Is A Typical Frequency Of Sessions In Couples Counseling

Every other week is a standard frequency in marriage therapy. It allows couples enough time to incorporate what they learn in counseling sessions into their routines and communication with each other. This frequency also helps mates keep forward momentum. When there is too much time between sessions, it is easy for couples to fall back into their old patterns.

In my practice, I find that with couples whose marriage is on the verge of suddenly ending, as can be the case with infidelity, angry, aggressive outbursts, or severe threats of divorce, it is best to see the couple weekly until they stabilize. Once there is less likelihood of a sudden exit by one of the partners, an every-other-week schedule will follow the initial weekly sessions.

As partners can incorporate what they learn in marriage therapy into their daily lives, it is usual for them to get along much better. Therefore, the frequency of sessions may be backed down. In my practice, I encourage every three weeks for a few sessions, then monthly for some time, so improvements continue, and old patterns do not re-emerge. Another three or four monthly sessions could be ideal before ending the marriage counseling.

While the time frames outlined above are typical, the frequency of sessions is impacted by unpredictable schedules due to the health of the couple and their kids, babysitter, and daycare complications, holidays, changing work schedules, and a great many other unpredictable factors.

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How Long Does Each Session Last

The most common length of each marriage counseling session in the United States is about 50 minutes. Most psychotherapists schedule on the hour, leaving only 10 minutes to jot down a few notes and take a restroom break. It may be closer to 45 minutes if the marriage counselor is also responsible for scheduling the next appointment and transacting the payment for the session.

A minority of marriage therapists provide their clients with a full hour of therapy by scheduling every hour and 15 minutes. Doing so is a more honest representation of therapy time than stating that sessions are an hour in length when, in fact, they are scheduled on the hour, allowing for only 50 minutes.

An even smaller percentage of couples counselors plan client sessions at intervals of 1.5 hours, allowing sessions to run a little over an hour when helpful.

All of my sessions, with individuals and couples, are scheduled every hour and a half. I have the flexibility to continue the session, when helpful, rather than having to abruptly cut the session off.

Does Insurance Cover Couples Therapy

Insurance Billing for Couples Therapy – Ask a Biller Webinar, presented by SimplePractice

Insurance is not typically required to cover marriage counseling.

Under the Affordable Care Act, the Mental Health Parity and Addiction Equity Act, and other federal laws, insurers must provide equitable coverage for mental health conditions. This means they must treat mental health conditions like physical health conditions, must not exclude them from coverage, and must not charge higher co-pays for these conditions.

Insurance equity laws dont usually apply to couples counseling. Thats because mental health parity laws treat mental health conditions as a medical diagnosis. The need for couples counseling is not a medical diagnosis, so it is not analogous to a physical health issue.

In some cases, an insurer might be required to cover couples counseling if the need for counseling directly arises from a mental health condition. For example, some insurers might cover marriage counseling for a person with a sex addiction or another condition that affects their marriage. Even then, it can be difficult to get insurance coverage.

Though plans are not required to cover marriage counseling, some offer it as an additional benefit. Its important to read your plan documents to get a clear understanding of what is and is not covered. In most cases, youll have to choose from a pre-approved list of providers. You might have to reach a deductible before coverage kicks in. Or you might have to apply for reimbursement instead of paying a copay.

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Location: How Marriage Counseling Cost Varies By State & Region

The price of couples counseling varies by state and generally will cost more in larger, more populated cities where the cost of living is higher. For example, marriage counseling in New York City costs on average $150-$250+ for a one-hour session.2 In Denver, marriage counseling costs between $100-$200 per hour on average.2 Other states/cities may charge less if the cost of living is lower.

To find out the average cost of marriage counseling in your location, perform a Google search for couples counseling near me and review their pricing. This will give you a better idea of the range you can expect in your particular location.

Does Health Insurance Cover Couples Therapy

Insurance is not always required if you would like to have couples therapy. This is because there are federal laws, the Mental Health Parity and Addiction Equity Act as well as the Affordable Care Act that can be taken into consideration. A personâs insurers must provide coverage for some mental health conditions. In other words, they are required to treat mental health concerns in the same way that they treat physical health concerns. In addition to this, the insurance company must also refrain from excluding people from insurance coverage and refrain from charging high co-pays.

However, many insurance equity laws do not tend to apply when it comes to couples therapy. This is because mental health parity laws always treat mental health conditions as a medical condition. What this means is that couples therapy is not considered to be a requirement as part of a medical diagnosis. In other words, it cannot be compared to any physical health condition.

Some health insurance providers might need to cover couples therapy if the therapy is required as a direct result of a mental health concern. For example, if an individualâs mental health causes them to refuse to communicate with their partner, it can affect their marriage. Unfortunately, it can prove to be hard to get any insurance coverage. Please make sure that you always read and understand the terms and conditions of your insurance coverage.

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How To Verify Blue Cross Blue Shield Couples Therapy Coverage

Athena Care is in-network with most major insurance plans. Filling out our free and confidential online insurance verification form is the easiest and quickest method to determine if BCBS couples therapy is covered.

Find a doctor and get the help your relationship needs without all of the difficulties of contacting your insurance carrier. Let our highly experienced, expert care coordinators handle getting more information about couples therapy Blue Cross Blue Shield may cover. After completing the form, a care coordinator will review your policy and thoroughly explain your options. Rest assured, all submitted or discussed information will remain confidential.

Does Insurance Cover Marriage Therapy


Usually, marriage counseling is not covered by health insurance because most insurance companies do not treat relationship issues as a mental health problem. However, couples can use health insurance benefits if one of the partners has mental health diagnosis, such as depression, anxiety, etc.

Your emotional well-being starts to deteriorate if the central relationships in your lives are adversely influenced. When there is existing tension or building pressure between partners or other relationships, your body will start exhibiting signs of strain through mental stress. Because of this, couples therapy is encouraged and offered to create an uncomplicated experience for most of the partners. It allows you to find a practical and evenhanded explanation to work through matters that benefit both partners through an existing compromise by finding a middle ground. However, capital counseling can be somewhat overpriced however, there is no need to worry about finances if health insurance is covered. More than 45 million Americans dwell in mental uncertainty, according to the 2020 report published by Mental Health America. Among these, 26 million people cannot treat their mental issues, most likely due to financial reasons.

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How Often Is Marriage Therapy Covered

Because insurance equity laws dont normally extend to cover , what type of coverage you can expect often depends largely on why youre going to therapy. It may be covered if the decision to seek help stems from a mental health condition think: sex addiction, schizophrenia, alcoholism, mood disorders, etc.

Because the above are categorized as mental health conditions, therapy can be considered medically necessary. There are a few other situations where you might be able to get your marital counseling covered by your insurance. Well cover some of the big ones here.

The Risk Of Attempting To Pay For Couples Counseling With Insurance

If you call a therapist to inquire about couples’ therapy, and that person, or their staff, tells you that your insurance can pay for your couples counseling, your insurance company would falsely believe it is individual counseling as described above.

The only way to have your insurance plan pay for your couples’ counseling is to misinform your insurance company. They cannot know the truth about the true nature of the work that you and your partner are doing together, or they would not and could not pay for it.

If a counselor engages in misinforming your insurance company, and your insurer discovers that you have been doing marriage therapy rather than treatment of mental illness as individual therapy, they are likely to deny payment. In that case, you would owe the counselor ‘s firm.

The unexpected bill could be quite large. You may have had quite a few sessions before your insurance company figures out that the counseling was not treating diagnosed mental illness, and you learn that they had denied the claim.

Even though you must pay on your own, counseling to help your romantic relationship is probably worth it for you and your mate. Marriage counseling is still much less costly than ending your relationship.

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Read Your Contract Carefully

Health insurance contracts are often wordy and difficult to understand.

This is where determination and perseverance are required on your part as the policyholder in order to find out exactly what your benefits are and to understand how does couples therapy work with insurance.

Bear in mind that there have been cases where a verbal or even written assurance has been given by the insurance company to go ahead and receive treatment, but then later, when the claim has been made, the company has declined and refused to pay.

What Therapists Have To Say

How To Verify If Marriage Counseling Is Covered By Your Insurance

Kate McNulty, LCSW: Your insurance may cover some of the cost of therapy if family therapy is a benefit on your plan. Billing for therapy sessions beyond one-on-one treatment can be a source of confusion for some therapists. Billing advice from experts in the field indicates that it is entirely legitimate to bill for family therapy if the people in therapy identify as a family unit. Nevertheless, this does require that billing is in the name of one person as the identified patient.

Health insurance coverage is intended to address costs associated with managing the symptoms of a condition, illness, or disorder, so one person must meet criteria for a diagnosis in the DSM, the Diagnostic and Statistical Manual of Mental Disorders used by all credentialed mental health practitioners.

Some insurance companies are beginning to cover family therapy only for situations involving treatment of a child with a diagnosis, and will not cover therapy unless a child is present at the treatment session.

If youre considering using insurance to pay for therapy as a couple, you may want to call your insurer yourself and make sure you understand your benefits. Have your insurance card ready and all numbers the representative may need to locate your plan details. Ask about a deductible, co-pay, and exclusions you can inquire specifically about CPT code 90847, which is used for family therapy.

Jonathan Bartlett, MA, MFT

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What Are The Benefits Of Paying Out Of Pocket Instead Of Using Insurance For Couples Therapy

Pros of paying for couples counseling sessions out of pocket:

  • No diagnosis is required. Since youre not going through your health insurance, the therapist does not need to assign a diagnosis to help cover the cost.
  • Counseling is private, since theres no chance of an insurance company asking for case notes.
  • Larger pool of therapists to choose from
  • Your therapist can use different approaches and modalities in treatment, since they are not limited to those approved by the insurance company.

And so there you have it. The reason why I chose to make The Relationship Center a full-fee practice that accepts limited insurance for couples therapy. If you still have questions, we would love to answer them, because choosing a couples therapist is one of the most important decisions you can make!!

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