Finding Marriage Counseling That Accepts Insurance Company Coverage
If you are experiencing challenges in your marriage or intimate partnership, you may be considering marriage counseling. Studies show marriage counseling can be an effective way to address relationship issues. Over 70% of couples receiving therapy experience positive outcomes after treatment concludes. Still, concerns about the cost of couples therapy sessions might motivate you to search for therapy options that are covered by your health insurance plan. Below, we’re answering the question Does insurance cover couples counseling services? We’re outlining ways you can find a therapist covered by your insurance plan, discussing strategies for finding couples therapy services through Medicare Part B, and examining the benefits of online therapy compared to in-person therapy.
How can I find marriage counseling that accepts insurance?
It can be a complicated process to find therapy that is covered by your insurance company, and coverage may hinge on whether you or your partner has a mental health diagnosis (e.g., depression, anxiety). For example, Blue Cross Blue Shield offers coverage for behavioral health services. For someone living with a mental health condition, Blue Cross Blue Shield may cover the costs of a treatment plan, including medication management, testing, and, in most cases, therapy. If family therapy or a similar modality is suggested to address the individual’s concerns, Blue Cross Blue Shield might cover these sessions.
Exploring your options for marriage counseling that accepts insurance
However, this approach to therapy could only focus on relationship challenges to the extent that they’re connected to the individual’s mental health condition. If you have coverage through a company like Blue Cross Blue Shield, finding a counselor who accepts insurance and offers couples counseling may be more difficult.
However, there may be options outside of your insurance coverage that fit your needs and budget. For example, online therapy services are effective, affordable options for spouses seeking couples counseling. While even the best online therapy platforms typically do not accept insurance, the cost of membership can be lower than that of copays for regular in-person sessions. Utilizing mental health services through online therapy platforms, you can address conflict in your relationship without going through your insurance provider.
Most insurance companies (e.g., Blue Cross Blue Shield) have databases of in-network providers, including therapists, available on their websites. If you are already seeing a couples therapist and want to ensure their practice is covered by your insurance, it might be worthwhile to call your insurance company and speak to a representative about your options.
What about Medicare?
Potential limitations of Medicare for marriage therapy sessions
- Licensed clinical social workers
- Clinical psychologist
- Clinical nurse specialists
- Physician assistants
- Nurse practitioners
- Psychiatrists and other people with medical degrees (doctors and physicians)
What do I do if my insurance plan does not cover couples counseling?
Most health insurance plans do not provide coverage for couples therapy sessions. If your health insurer does not cover the costs of couples therapy, you may need to go directly to some licensed counselors and ask about your options. They may offer need-based assistance to some couples.
Do your due diligence with your insurance company and therapist
You may want to explore your options if you are in a situation where couples therapy may not be covered, but individual therapy might be. A therapist may be able to work with you or your partner on an individual basis to understand each one's role in the relationship and offer suggestions to improve the dynamic in your relationship.
If you and your partner have found a good therapist but discover they are not covered by your insurance provider, you may still be able to find a way to reduce costs. You could ask your insurance company about benefits for out-of-network providers, for instance. You could also work with your therapist directly to find a way to address expenses. For example, you might be able to come up with a payment plan or receive a discount if you schedule a bulk number of appointments in advance.
Look into an employee assistance program
It may be worth looking into both your and your partner’s employee benefits to see if either of your employers offers an Employee Assistance Program (EAP). While employer-sponsored health care does not usually cover couples therapy outside of the context of treatment for diagnosed mental health conditions (e.g., eating disorders), an EAP may provide mental health care which could include couples therapy.
Typically, an Employee Assistance Program involves an employer contracting with an external mental health services provider to grant their employees to avail of individual therapy, couples therapy, and other mental health care services. You do not usually need to have a diagnosed mental health condition to have this care, and since it is subsidized by your employer, you rarely have to pay out of pocket. There may be limits on the types of care provided or a cap on the total number of couples therapy sessions you can participate in over a certain time, though.
Explore local mental health care for those with a mental health diagnosis
If you can’t devise a plan with your insurance or therapist, and neither you nor your spouse can get Employee Assistance Program, that doesn’t mean that you are out of options. The following local and community resources may offer affordable marriage therapy:
- City, county, and state mental health services offices
- Local nonprofits
- College and university counseling clinics, which may be recipients of grants from the National Institute of Mental Health to provide free therapy services to some clients
- Churches, which may offer premarital counseling or couples therapy for free, even to people who are not part of the religion or regular attendees of the church (note: This form of marriage therapy may be provided by a pastor or priest who may not be a licensed mental health professional.)
- Your family doctor, who may have connections to lower-cost mental health care providers or those that provide services on a sliding scale based on their income level
You may want to consider couples therapy sessions
Some online mental health platforms may offer low-cost online therapy if they cannot accept insurance. For example, some online couples counselors and online therapy platforms may offer sliding scale fees or other discounts for those who need support. Aside from affordability, some people simply prefer the ease and convenience of working with an online therapist from the comfort of their own homes and on their own schedules. One of the essential benefits of relationship therapy is that it can be conducted completely online, which may be helpful if you and your partner are in separate locations due to busy work schedules.
Effectiveness of online couples therapy on improved mental health
Most online therapy services offer a diverse array of mental health professionals, including licensed professional counselors, licensed clinical social workers, LMFTs, and psychologists. Research indicates that online couples therapy may lead to just as much relationship improvement as with traditional in-person therapy. One study found that couples who completed an online relationship therapy program showed marked gains in relationship satisfaction and relationship confidence, a decrease in individual levels of depression and anxiety, and improvements in quality of life. Another study found that online therapy was also effective for adjustment disorder, phobias, panic disorders, substance use disorder, OCD, and bipolar disorder.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
Takeaway
In some situations, marital counseling may not be covered by insurance unless you or your partner has a diagnosed mental illness and marriage counseling could be considered treatment for that condition. However, it may be worth asking if your insurance covers marriage counseling or other types of therapy. If you can’t get couples therapy covered by insurance, it may help to look into online therapy, which tends to be more affordable than in-person counseling without insurance. With an online therapy platform, you can be matched with a professional with training in marriage and family therapy and methods such as emotionally focused therapy.
You may also benefit from individual therapy, whether in person or online. With BetterHelp, you can choose from more than 25,000 licensed therapists to find someone with experience in your areas of concern. Take the first step toward getting support and reach out to BetterHelp today.
Is marriage therapy covered by my insurance company?
Whether marriage therapy is covered by your insurance company depends on your health insurance provider and policy details. Check that your policy includes mental health treatment as part of its benefits under the Affordable Care Act.
Many health insurance providers cover counseling if it’s linked to diagnosed mental health issues. Other policies may only cover therapy if it is provided by a licensed therapist or clinical social worker. If your insurance comes through Medicaid services, your policy may cover therapy and certain behavioral health services, depending on what state you live in.
What are the pros and cons of premarital therapy?
Pros:
- Helps couples learn and employ conflict-resolution skills.
- Creates a relationship dynamic that allows for a deeper understanding of each partner’s values and expectations.
- Guides the identification and mapping of life goals.
- Helps establish relationship values.
- Helps partners allocate housework and other household needs.
- Allocates a defined time to nurture the relationship.
Cons:
- May not be covered by traditional health insurance plans, making marriage counseling costs a potential barrier.
- May be challenging or uncomfortable to discuss sensitive issues, giving rise to disagreements and conflict.
- Limited availability of licensed couples therapists in some areas may make it difficult to find the right licensed professional counselor.
What is the success rate of premarital counseling?
Over a decade of research has shown that attending premarital counseling significantly decreases the likelihood of divorce and increases rates of marriage satisfaction and stability over time. One study found that premarital counseling reduced the risk of marriage failure by 31%.
Do most counseling and mental health care services accept health insurance plans?
Clinical psychologists, licensed professional counselors, and clinical social workers who provide couples therapy may be covered by health insurance plans, but not all do. It is important to verify your coverage with your service provider.
How many relationships survive after couples therapy?
In the United States, 40% to 50% of marriages end in divorce. Research indicates that couples therapy often works to reduce relationship stress. According to one study, “The average person receiving [couples] therapy is better off at termination than 70% to 80% of individuals not receiving treatment—an improvement rate that rivals or exceeds the most effective psychosocial and pharmacological interventions for individual mental health disorders.” However, individual results may vary based on the therapist’s skill level, the couple’s needs, and how willing the individuals in the couple are to communicate openly. Sessions conducted by a licensed therapist who has knowledge about mental and physical health issues tend to have better outcomes.
What type of therapist is best for marriage counseling?
Marriage and family counseling is a specialized subsection of therapy. For this reason, marriage and family therapists will be best equipped to work with interpersonal relationships and family dynamics. Clinical psychologists, social workers, or licensed professional counselors who have experience with marriage issues may also be suitable partners.
What is the difference between couples therapy and marriage counseling?
According to the American Psychiatric Association, couples therapy is “therapy in which both partners in a committed relationship are treated at the same time by the same therapist or therapists.” Couples therapy typically focuses specifically on the needs of a romantic relationship as both partners discuss their individual concerns and how they affect the couple.
Marriage and family counseling, as the name suggests, addresses a broader range of issues that may involve additional family members like children. According to the American Association for Marriage and Family Therapy, a marriage and family therapist “broadens the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family.”
What is the insurance code for couples therapy?
Insurance billing for couples therapy often uses CPT code 90847 or 90846, depending on the session type. The specific code used can vary based on the therapist or clinic and the policies of the insurance provider involved. Verifying with your insurance company or checking with Medicaid services can clarify whether the session is covered.
What should you not say in marriage counseling?
- It may be best to avoid accusatory or absolute statements such as “You always …” or “You never …,” as they can set up the session to be less productive.
- Allow your therapist to guide discussions; they are trained to find a constructive path forward.
- Comments that dismiss mental health concerns that may be impacting the relationship dynamic should be said only when necessary and with tact.
- If there’s a topic that you’re not emotionally ready to discuss, consider saving it for a time when you’re in a more positive headspace.
What is the downside of couples therapy?
Since couples and marriage and family therapies are not typically covered by health insurance, out-of-pocket costs may become a deterrent. Once in couples therapy, discussing such deeply personal topics can come with a lot of emotion and, sometimes, disagreement. Perhaps the individuals of a particular couple misalign in their beliefs regarding religious beliefs or values, for example. Couples therapy aims to work through those differences. Being honest in sessions can help prevent a buildup of conflict down the road.
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