What Is Couples Therapy Insurance?
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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. 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.
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.
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.
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
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
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.
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.
Takeaway
Does health insurance cover mental health services such as couples therapy?
Does insurance cover couples therapy? If you’re wondering, can insurance cover couples counseling, know that most insurance plans cover mental health care such as couples and individual therapy. However, not all plans cover therapy, and some plans have high deductibles. Check your plan details and the CPT code for therapy services to see if your plan covers counseling.
How can I find a couples therapist that accepts my insurance?
By looking at your insurance provider’s website, you can find listings of therapists whose services are typically covered by your insurance. Once you contact a therapist, make sure that you ask them if they still accept your insurance before booking a session.
What should I do if my insurance plan doesn’t cover couples therapy?
If your insurance plan doesn’t cover couples therapy, you have a few options for finding lower cost therapy. You can look for a community clinic in your area—such clinics often accept sliding scale fees. You can also look for a counseling organization or faith-based counseling services in your area that may offer free or low-cost counseling. You can also sign up on an online therapy platform such as BetterHelp, which offers therapy at lower costs than individual therapists do.
Are online couples therapy sessions covered by insurance plans?
Insurance covers some types of online therapy platforms, but not others. However, typically couples pay less for online therapy than when seeing a therapist in own practice in an office. Online platforms may also offer payment plans based on patient present financial circumstances, and buying multiple sessions at once includes the reduced rates.
How much is couples therapy without insurance?
The marriage counseling cost can range from $100 to $300 per hour, with some online therapy platforms offering much more affordable options. Know that going to couples counseling is a financial investment in your relationship. Know that insurance equity laws such as the Mental Health Parity and Addiction Equity Act requires that insurance companies can’t make coverage for mental health services more restrictive than for services for physical health conditions.
How can I get free couples counseling?
If you and your partner are seeking therapy, know that low-cost and free relationship counseling are out there. Faith-based organizations and community clinics may offer free or low-cost counseling. Online therapy platforms such as BetterHelp offer therapy at more affordable rates. If you have Medicare coverage, you can optionally purchase Medicare part B, which covers couples counseling.
What percentage of couples break up after couples therapy?
It can be estimated that about 34% of couples break up after couples therapy. Some research claims that 38% of couples break up within a few years of attending therapy, while other data shows that 70% of couples who attend therapy stay together.
What is the success rate of couples counseling?
The American Association for Marriage and Family Therapy reports that three fourths of couples who attend counseling report improvements in their relationships. In the same study, couples also reported improvements in their overall well being, with 90% claiming improvement in their mental health.
Can couples therapy save a toxic relationship?
If a couple has severe relationship issues that include toxic behaviors, it can be difficult, but not impossible, to save a relationship by going to couples counseling. Saving the relationship can be dependent on how willing both partners are to engage in the therapeutic process and how committed they are to the relationship. If toxic behaviors are related to a mental health diagnosis, that person should also get treated for their diagnosable mental health condition. If the entire family is affected by toxic behavior of an identified patient, family psychotherapy can be recommended.
Do couples therapists ever suggest separation?
When couples attend therapy, their therapist or clinical social worker will never recommend divorce. However, they may suggest a therapeutic separation so that both partners can reflect and get a better understanding of the relationship.
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