Does Health Insurance Cover Therapy?

Therapy and mental health services have various costs that health insurance may or may not cover. When looking for a mental health service that does work for you, you might consider the overall treatment cost per hour, health insurance coverage, possible insurance co-pays, and the types of mental health treatment.

Does health insurance cover therapy for mental health? 

Does health insurance cover mental health therapy? 

Most insurance providers have in-network therapists and other mental health professionals, allowing clients to reach therapists who have experience providing therapy and treating mental illness covered by insurance. If you have a primary care physician, they may refer you to covered, in-network therapists. Working with an in-network therapist, instead of a therapist not covered by your insurance plan, does help you save money. Still, you could face outside factors that affect how much you pay for therapy, depending on the deductible or the insurance plan you signed up with when you first obtained the coverage policy. 

Some outside factors may include these:

• Therapy and insurance co-pays
• Added mental health therapy session costs that are not covered by insurance
• Online or in-person mental health professionals who charge upfront therapy fees you may need to pay
• Online or in-person mental health professionals who require you to submit therapy invoices for insurance reimbursement for therapy

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

You may also learn more about the Mental Health Parity and Addiction Equity Act of 2008, a federal law preventing companies that offer insurance from restricting their mental health coverage options more than physical health. Even though therapy can be expensive, the Mental Health Parity Act helps ensure that the covered mental health benefits are as comprehensive as the physical health benefits. 

In addition to the parity law, the Affordable Care Act is another reform law that deals with insurance for mental health services. The act outlines government policies to provide equal access to coverage, including coverage plans through Medicaid or Medicare. This act may ensure insurance does cover some or all your treatments as a low-income individual. Some government plans will cover online therapy as well as in-person. 

Types of therapy that insurance may help with

Below are some of the most common mental health services sought by clients and information on whether they will be covered by insurance providers. 

In-person counseling

Health insurance may cover your treatment for traditional in-person talk therapy. However, in personal practice, therapists often have the right to choose which insurance plans to accept, and not every therapist will accept the same insurance plans. 

Some health insurance plans may also limit your therapy sessions by:

• Setting a fixed cost for each in-person therapy or online therapy session that it does cover
• Covering a limited number of mental health therapy sessions
• Providing a specific list of mental health therapy professionals whom your insurance provider does cover
• Requiring a mental health diagnosis before insurance covers any therapy sessions
• Lacking insurance coverage for alternative mental health therapy, such as online therapy or CAM therapy
• Including annual limits on mental health and therapy care (though parity law prevents unequal coverage between mental and physical health services) 

Many insurance plans have mental health care, online therapy, or therapy as a coverage item. However, they might not cover the entire therapy session. In some cases, the client might have to pay an upfront cost, such as the entire cost of the session, and the insurance plan may cover you in the form of reimbursement (note, however, that these reimbursement rates can vary). If you have not been diagnosed with a condition needing therapy, the policy could also require you to have a diagnosis and establish the underlying need before covering these therapy sessions. They might also require a medical doctor’s referral for any treatments.

Many special practice therapists have moved to online therapy to offer more therapeutic services and convenience for clients experiencing mental illness concerns. However, not all internet therapists offer therapy services 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. 

If you attend therapy through an online therapy platform, you may not be able to use insurance coverage 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 therapy practice locations. However, many online therapy platforms are hundreds of dollars cheaper than in-person therapy per month, which does benefit those with high co-pays, upfront costs, or coverage barriers to traditional therapy.

Health insurance and therapy treatment centers

Companies, like Blue Cross Blue Shield, may cover therapy treatment centers like substance use disorder rehabilitation centers, psychiatric hospital stays, eating disorder treatment and therapy centers, or outpatient therapy groups. These centers may be costly without insurance coverage, however. Depending on your insurance provider, you may be required to pay an upfront registration fee, and the rest will be covered by your insurance. For rehabilitation centers in the US, there is an average cost reaching upwards of $30,000. However, location can also have an impact on cost. Rehabilitation and therapy centers in the UK typically cost up to £14,000.

Health insurance and psychoanalysis testing

If you are looking for an 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 services. Many companies do not cover official psychological evaluations. These tests may cost around $1,500 to $3,000 or more, depending on the area and the therapist you select.

Insurance and psychiatry

Insurance often covers psychiatry as a behavioral 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 plan does cover it and how much you might pay in co-pays for your medication if you are prescribed any. Psychiatrist office visits can cost between $100 to $400 per therapy session. You may pay more for an initial consultation and diagnosis. 

If you're unsure how to find low-cost medical services, talk to your primary care physician. They may be able to refer you to a mental health professional they know of who offers sliding scale or low-cost services under your insurance plan. They may also recommend outpatient mental health services with mental health classes, or health insurance marketplace plans as a more affordable option.

Some primary care physicians can prescribe certain mental health medications and offer general tips for well-being and care. If you have any mental health symptoms due to physical health concerns, they can also address physical symptoms to reduce stress.