What Is Couples Therapy Insurance?

Couples counseling can benefit many couples navigating relationship challenges. Intimacy and sex, previous relationships, finances, infidelity, and trust are some topics that may be addressed with a couples therapist. Along with facilitating the discussion of these challenges, couples therapy may help relieve tension that’s affecting the mental health of the individuals in the relationship. As an impartial party, the therapist can introduce a safe space to discuss sensitive topics and offer valuable management skills to relieve stress between you and your partner. 

However, many people find that they are not covered by insurance for this purpose alone, as health insurance coverage may only pay for certain kinds of therapy. Read on to find out whether your health insurance may cover couples counseling and learn ways to get free or affordable therapy.

The ins and outs of couples therapy insurance

When billing the insurance company, therapists who take insurance usually must list a primary patient with a diagnosed mental health condition. This means one of the partners in couples therapy must be diagnosed with a mental health disorder. 

Unless their therapy is connected to a mental health condition, such as anxiety, depression, or substance use disorder, many insurance companies may not cover couples counseling. It's important to understand that some insurance plans may not cover couples counseling unless there's a diagnosed mental health condition involved. However, as many individuals' mental health conditions are affected by their relationship, a family and marriage therapist working in-network with an insurance company may bill under the mental health condition diagnosis. 

For example, if one of the partners is experiencing depression, the therapist may use the insurance code corresponding to that diagnosis. 

The Affordable Care Act

Under the Affordable Care Act, mental health services are considered an "essential benefit." Those who work for a company with more than 50 employees are usually entitled to health insurance (including mental health) that covers 60% of medical expenses. The remaining part for which the employee is responsible should be, at most, 9.5% of their family’s income.

Those who aren't eligible to receive insurance through an employer but qualify for state or federal programs such as Medicare may also receive coverage for mental health expenses with an in-network therapist. However, it's important to note that not all mental health services, such as counseling for couples, are covered by every insurance plan.

Short-term health insurance may also cover couples therapy in connection with a diagnosed mental health condition. However, not all marriage and family therapists operate within the same framework, so it's advisable to ask whether the therapist you are considering accepts couples therapy insurance. Health insurance coverage may also accept family therapy as a treatment option.

Since every insurance plan is different, you may need to check with your insurance company to determine the number of sessions you're entitled to and whether the therapist must be a network provider, especially for counseling services.

Employee assistance programs for couples and mental health

Intended to address mental health conditions that can impact job performance, some employee assistance programs (EAPs) offer a limited number of family and couples counseling to their employees as part of the benefits package. 

Those who partake in the company's EAP may be offered a free assessment, short-term counseling, and referral to an outside therapist. However, employee assistance programs differ in scope, and some may prioritize certain issues, such as substance use disorders. Depending on the company's EAP structure, some may offer in-house or external programs for family therapy. Member assistance programs like those provided by unions may also offer family counseling. 

Benefits manager and insurance

Your company's benefits manager may be able to clarify what you are entitled to for couples therapy, the number of sessions, and other applicable details. If you are planning on receiving counseling through an employee assistance program, you may inquire whether the therapist you plan to see is part of the network for counseling services.

If your former employer offered an EAP but you are no longer part of the company, Continuation of Health Coverage (COBRA) plans may also offer couples counseling. 

Alternatives to insurance plans for couples counseling

These might include:

• Local colleges or mental health centers offering couples therapy
• Faith-based programs offered by a church, congregation, or other organization
• Sliding-scale payment options from therapists in an in-person practice
• Online therapy sessions with licensed therapists
• Community-based programs offering couples counseling
• Couples therapy through employee assistance programs
• Nonprofit organizations specializing in couples therapy and counseling
• Therapist referral networks or directories offering discounted couples counseling
• Couples support groups or workshops
• Government-funded services or clinics providing couples therapy and counseling

Mental health conditions therapy may address

According to the American Psychological Association, couples and family psychology (CFP) is defined as a specialty in which the couple, family, and society are viewed holistically and in relation to one another. It focuses on the emotions, thoughts, and behaviors of the individuals in the relationship as a unit and in relation to their environment in "systemic relational systems." 

Common topics for couples counseling:

• Sexual, physical, or verbal abuse*
• Intimacy and trust issues 
• Dissatisfaction with the relationship
• Infidelity
• Family relationships
• Mental health conditions, such as bipolar disorder and depression
• Alcohol and drug use
• Caring for elders or a child with a chronic illness
• Financial stress or disagreements among couples
• Communication problems
• Couples navigating life transitions (e.g., marriage, parenthood, empty nest)
• Couples coping with loss or grief
• Couples with differing life goals or values

A marriage and family therapist (MFT) may diagnose and address mental health conditions concerning the family unit. Conditions commonly addressed by a marriage and family therapist may include:

• Eating disorders
• Conduct disorder 
• Sexuality and sexual or intimate wellness
• Personality disorders

Marriage and family therapists can practice in various settings, including in-person practice, inpatient facilities, community mental health centers, research centers, and employee assistance programs. 

Potential benefits of couples therapy for individuals

According to the American Association of Family and Couples Therapy, the relational approach to treating mental disorders in association with the person's relationship and family unit may, in some cases, be equally or even more effective than therapy that addresses the individual's condition alone. 

Research findings support using marriage and family therapy in addressing substance use disorders, for example. The approach has been found to help reduce family and marital conflict, improve communication, and lower the severity of underlying substance use disorders.

Here are more potential benefits of couples therapy:

• Couples counseling can help partners develop healthier communication skills, allowing them to express their needs, resolve conflicts, and understand each other more effectively, not just as individuals but as a team.

• Counseling provides couples with the tools to rebuild trust, especially after breaches such as infidelity, creating a foundation for a stronger, more secure relationship that is not based on past mistakes.

• Through counseling and therapy, couples can provide each other with emotional support, fostering a deeper sense of connection and empathy, which can improve overall well-being, not just for one partner but for both.

• Couples counseling can help partners navigate external stresses (e.g., work, family issues) together, strengthening their bond and increasing resilience, not only as individuals but as a united team.

• Couples counseling provides a structured space for addressing long-standing issues and unresolved conflicts, offering solutions that can enhance harmony and satisfaction in the relationship, not just temporarily but in the long term.

Online couples therapy

You may want to consider online therapy if you are looking for options other than insurance-covered therapy. An online couples therapist can facilitate communication between you and your partner and help you address the challenges you may be experiencing as a couple or individually, regardless of whether it's in relation to a diagnosed mental health condition. 

Many people find it helpful to discuss their feelings with a counselor, as the therapist may help mediate the discussion of sensitive topics. An online therapy platform may allow you to meet with your couples therapist via video call, phone, or online chat, which is often more convenient than in-person therapy for many people.

Research shows that online couples therapy may be as effective as in-person therapy. A large majority of therapists (74%) in one study considered online therapy useful, and an even bigger portion of couples (95 %) found it helpful in their relationships. The correlations among mental health, self-esteem, and healthy romantic relationships are also well-documented.