Key Highlights
- Is marriage counselling covered by insurance
- When is marriage therapy covered by insurance
- Do marriage counsellors take insurance
- Other affordable options to explore
- Is marriage counselling covered by health insurance plans like HMOs or PPOs
In my career as a psychologist, I’ve often encountered this question: Is marriage counselling covered by insurance?
Most insurance companies don’t categorize couples therapy as a medically necessary treatment. It’s more of a relationship-focused service. If you're someone who's considering couples therapy, asking, "Is marriage counselling covered by health insurance?" is one of the first questions that comes to mind. Seeking help is a good start to solving marital problems. About 75% of couples respond positively to couples counselling.
But the answer to the main question isn’t that simple. Let me walk you through what I tell my clients about marriage counselling. The understanding is important before you book a therapy session.
Is Marriage Counselling Covered by Insurance?
The answer is no in most cases. Insurance equity laws don't normally extend to cover marriage counselling costs. Insurance plans cover therapy sessions that are medically necessary, usually concerning the diagnosis of a mental health condition. But the first step is finding out if couples therapy is right for you.
If you or your partner are having communication issues, struggling with trust, or growing apart, but neither of you has been diagnosed with a mental health condition, your insurance company likely will not pay for therapy. The presence of a mental health diagnosis might offer some form of therapy coverage, but it usually does not include couples therapy unless the sessions are necessary for the individual's treatment.
Understanding what “does medical cover couples therapy” can save you time navigating your insurance coverage possibilities.
When is Marriage Therapy Covered?
There are very few situations where insurance companies and policies might cover marriage therapy. Here's when insurance might help:
A marriage suffers for many reasons, and one reason is when one of you is diagnosed with a mental health condition. Depression, anxiety, PTSD, or substance abuse disorders are some of the conditions your health insurance might cover. If your therapist includes the partner in treatment, there is a chance that insurance may cover the sessions.
- One partner needs to be an identified patient.
- The bills of the session depend on the person's diagnosis.
- That participation of the partner is considered part of the treatment plan.
Here’s how I can put it into easier words. There’s no insurance coverage for couples therapy, but if your partner is diagnosed with a mental health condition and you need to be included in the treatment plan, your sessions might get covered by the insurance.
Do Marriage Counsellors Take Insurance?
I get asked this often, and the answer is that some do and some don't. Many licensed marriage and family therapists (LMFTs) and psychologists accept insurance. But even if they do, they may only bill for individual therapy and not couples counselling. You need to ask your healthcare practitioner directly if they take insurance or not. Try to get more details on how couples therapy will be billed under individual diagnosis. Discuss any additional concerns you may have with them. Even if the counsellor does not work directly with your insurance, there's a chance you might get partial reimbursement.
Other Legitimate Ways to Get Couples Counselling
Does medical cover couples therapy? Well, we've discussed that, and the answer is no. It can only be covered if one of you is a mental health patient.
But gladly, I can help you explore some other legitimate options to get couples counselling if money is your concern. Here are some ways you can get help:
Employee Assistance Programs
I advise you to check with your human resources department for EAPs. Several of them offer couples counselling services. They are designed to provide confidential, short-term support to employees and their family members. These programs cover a wide range of services, including couples counselling. It might be hard to get a spot, though, because sessions are limited in number.
University or Community Clinics
You could explore the option of getting in touch with your local community colleges or university clinics. Many offer low-cost marriage services through student-led clinics and training programs. In this case, therapy is usually offered by graduate student therapists under the supervision of licensed professionals. They use several therapy strategies to heal wounded couples. Even though this is an affordable option, availability and waiting lists may be a concern.
Sexual Dysfunction
Not all plans cover sexual disorders, but if you or your partner are diagnosed with sexual dysfunction, your insurance might cover couples therapy as a legitimate part of treatment. Sex therapy has been found effective in changing approaches and beliefs inside and outside of the bedroom. Get in touch with your insurance provider to find out if your insurance covers sex therapy.
Other Options Include
- Some churches offer free couples counselling.
- Research affordable online platforms.
- Ask your therapist for multiple session discounts.
- Ask your therapist if they have a payment plan.
- Ask about discounted rates or sliding fees that might be available.
- Ask for a referral from your family doctor.
Is Marriage Counselling Covered by Health Insurance Plans Like HMOs or PPOs?
The type of plan you have makes a significant difference in your insurance coverage.
- HMO plans are restrictive. You'll have fewer choices when it comes to therapy, you'll need to stay in-network, and you might need a referral.
- PPO plans are different and more flexible. You can visit therapists without a referral and have many coverage options, especially for mental health services. Even with PPO, couples therapy needs to be billed under a diagnosis of one person.
Get the Help You and Your Partner Deserve
I hope you have a better understanding of "Is marriage counselling covered by insurance?" As I explained earlier, most insurance plans don't cover couples and marriage counselling. You or your partner needs to be diagnosed with a specific mental health problem. But that shouldn't stop you from getting the help you need. There are several affordable options for couples therapy you can explore. These alternative options give you access to the help you need to strengthen your relationship without money being a concern.
Don't let the question, "Does insurance cover couples therapy?" be the reason not to mend your relationship. Take the first step and get the help you and your partner deserve.
Comments