Does Insurance Cover Therapy? Considerations For Affordable Mental Health Help
Medically Reviewed By Aaron Horn, LMFTIf you’re interested in going to therapy, one of the concerns you probably have is how you’re going to pay for it. Even if you have health insurance, you may still be confused. Does the health insurance cover mental healthcare? Many may think that law requires insurance companies to provide mental healthcare, but that isn’t necessarily the case.
The cost of a therapist varies greatly based on many things, such as the area you live in and their area of expertise. If you’re looking for affordable mental health help or affordable therapy, you need to understand your insurance company and insurance coverage.
What To Consider When Looking At “Does Insurance Cover Therapy?”
The answers to the questions “does health insurance cover therapy?” or “what exactly does my insurance cover?” aren’t as simple as you might think. There are many different types of health insurance coverage and different insurance plans available, which means that some health insurance plans cover different things than others. Here are some things that you should know regarding insurance plans and mental healthcare.
What Health Insurance Companies Are Required To Offer
There have been some misunderstandings around how the Affordable Care Act impacted health insurance coverage. There is a misconception that law requires insurance or that law requires companies that deal with insurance to cover mental healthcare. However, that’s not entirely true. The ACA does not require insurance companies to offer comprehensive and extensive mental health care.
The ACA indeed made some great changes for those that want coverage for mental wellness services. For example, health insurance companies can’t turn you down because you have a mental health diagnosis, including substance abuse disorders. And, there are some services that you can take advantage of that are covered at no cost.
However, this doesn’t mean that your company that deals with health insurance must offer coverage or mandatory that your insurance pays for mental health. The ACA only requires “parity protection.” This means that the coverage for mental health services needs to be equal to medical or surgical coverage. So, while this sounds good, it doesn’t necessarily mean that you are getting good coverage for mental wellness services. Many people right now are on plans that provide little coverage for any medical service. This means you still aren’t getting mental wellness services covered, and you also aren’t getting many medical services covered either.
There are a lot of details to consider, and you may have lots of questions beyond “does health insurance pay for therapy?” Does my health insurance pay for prescription medications for mental health if I need and am prescribed them?? Does my health insurance pay for psychology? Does health insurance pay for couples therapy? Does health insurance pay for group therapy? Does health insurance pay for other less conventional treatments?
To answer “does my health insurance cover what I need?” you may have to analyze your current policy or keep these questions in mind when looking for insurance. When choosing insurance, it’s important to verify the type of coverage you’ll be receiving. And, if you have any questions, make sure to contact your health insurance provider to find out exactly what is covered and what’s not. You can easily find contact information for your carrier on your insurance card.
It’s important to be aware of what your health insurance covers and what it doesn’t. That way you won’t be surprised by any unexpected bills.
Here are some things to watch out for below:
Limited Necessity
It used to be more common for health insurance companies to limit the number of sessions that someone could use. While this has pretty much been done away with, other limitations still apply. For example, you may have an insurance plan that limits coverage to be “medically necessary.”
The problem with this is that many people can benefit from mental wellness services without an official diagnosis. For example, if you wanted to get counseling for marital problems or anxiety that doesn’t meet the requirements set in the DSM, your health insurance will not be able to cover the services.
Limit On The Dollar Amount Spent
Your health insurance may also include a cap on the amount they will cover in any given year. This means, even if you could use continued services like sessions with your therapist, they will not be covered if you have reached that dollar amount.
Not only could this limit the number of sessions that you do in a year, but it could also influence what professional you choose to work with. Those with higher costs will be harder to work with because you’ll reach your limit faster.
Restricted Options On Who You Can Work With
Another way that coverage with your health insurance is limited when it comes to mental wellness services is that you will work with certain mental health professionals and some that you won’t. Your health insurance company may not work with the provider that you want to work with. This means that you will either have to pay out of pocket for your sessions, or you’ll have to choose a different provider that your insurance will work with.
Why Some Therapist Won’t Accept Your Insurance
You may run into a situation where you wonder, “why doesn’t my therapist accept my insurance?” Sometimes it’s not your health insurance company that is refusing to work with a mental health professional. There are many mental health workers, such as psychologists that will not work with insurance companies. This is because the insurance companies refuse to compensate the professionals for what they consider a fair price.
So, you will want to check with your therapist to see what type of plans with your health insurance they work with, if any. Depending on where you live, you may need to do some looking to find a therapist who will accept your insurance. Contact your insurance provider with any specific questions or to understand what your options are.
Alternative Options For Therapy
If you don’t have coverage with health insurance or are interested in alternative options, there are several that you can choose from.
Things You Can Do At Home
You can do some things at home on your own to improve your mental health challenges, depending on what it is you’re facing. Some of the things below have proven beneficial for people with anxiety and depression and can also help treat other mental health disorders.
Self-care – Practicing self-care includes eating right, exercising, meditation, rest, journaling, etc. It’s pretty much any activity that helps you to take care of yourself in a healthy way. Everyone needs to focus on self-care each day, and if you have a mental health challenge, doing so becomes even more important. This can help you reduce anxiety and improve your chance of overcoming depression.
Aromatherapy – Aromatherapy with the right essential oils can help to reduce anxiety and boost your mood. This can be a great alternative treatment to try in addition to other more traditional forms of treatment.
Pet therapy – Some people find support from emotional support dogs, and others enjoy horse therapy. If there’s an animal that you enjoy that helps you to relax, it can be good to spend time with it. It can help you to relieve stress and anxiety and calm down.
Free Or Low-Cost Alternatives
If you’re looking for free alternatives to affordable mental wellness services, there are some options that you can look into. For example, some churches provide free counseling services. While these services can be helpful, you will want to ask questions about the person's credentials that are providing the therapy. Likely, they will not have the same experience as a mental health professional such as licensed therapists or counselors.
You can also try looking to see if there are any free clinics in your area. Many health centers offer free screenings or therapy for those that qualify for services.
There are also online forums that you can join. You can find one full of others working through the same challenges that you are. This can be helpful because it lets you know that you’re not alone. And, you can receive tips and advice from others that know exactly what you’re going through because they have been through it too.
If you attend a university or are a student in school, you may have access to free counseling through your school. Schools understand that students face a wide array of challenges and often provide free or very affordable counseling options.
One final option for finding affordable mental wellness services is finding a therapist that offers a sliding scale fee. This means that the price you pay for your session will be dependent on how much money you make. That means if you don’t make a lot, you’ll be able to have a smaller session fee. This is something that therapists do to help make therapy sessions more affordable for everyone.
Online Therapy
Another option for affordable mental wellness services is online therapy. These sessions have several benefits over traditional therapy sessions. They can be more affordable, for starters. But they can also be more convenient. You don’t have to take the time out of your day to travel to another location to talk with a therapist. You have access to your therapist from anywhere that you have access to the internet or your phone.
Online therapy is also a great option if you are worried about sharing personal details about your life, actions, and thoughts. Being able to meet not face-to-face helps some people open up and share more without feeling judged.
FAQs (Frequently Asked Questions)
How do I know if my insurance covers therapy?
If you’re wondering, “does my insurance pay for mental healthcare?” or “how do I find out what my insurance covers?” you aren’t alone. Today, more and more plans cover mental wellness services. Look into what details and providers are covered by your current health insurance policy or insurance plan if you have one and look into what coverage looks like for potential plans. You may also want to consider what other services may apply to your treatment or needs, like psychiatrist visits, children’s health insurance, life insurance, or other ways that health insurance and mental health can overlap.
As discussed earlier, the law does not require companies that deal with insurance to cover all mental wellness services. In fact, the law doesn’t explicitly require insurance companies to cover basic mental wellness services. It’s crucial to understand your health insurance policy. You may also want to understand how to ask your insurance company for reimbursement for mental wellness services.
You also may have questions or doubts regarding how to pay for mental health services for others, particularly children. You may have heard of the health insurance program CHIP or Children’s Health Insurance Program. The insurance program CHIP is specifically a children’s health care program that covers various important medical services, like doctor visits, prescription medications, vaccines, and others. This coverage can extend to parents and pregnant women, so it is an important option.
The best way to find out in specific detail what services and providers are covered in your situation is to reach out to the insurance company you receive your coverage from. Call your insurance company before making any final decisions about scheduling treatment sessions.
How can I get my insurance to pay for therapy?
If your insurance policy does not cover mental health services or the services you seek out, there may not be a way to make your insurance payments. Different health insurances cover different things. You may be limited to the amount or type of coverage outlined in your plan if you want the costs of therapy to fall under the insurance.
If your health insurance doesn’t work for you, you may want to consider what options are available online or for reduced prices that may be more manageable out of pocket. Sometimes we are unable to switch insurance policies or health insurance. If your employer provides your insurance, it might not be realistic to expect that you can purchase a separate, private plan.
If you are shopping for insurance to cover mental health expenses, it may be helpful to determine what exactly you need your insurance to cover. You might have additional expenses, like psychiatric care, to consider that you want to ensure your health insurance can pay for. You might look at insurance reviews from other customers to help you make your decision.
As always, be sure to reach out to your provider with specific questions and concerns about any insurance program. Some health insurances cover more than you may expect, or expenses may differ.
How do you file a claim to your insurance for mental healthcare? How does the rate for psychologists or the reimbursement rate for psychologists differ from the rate for therapists? To understand specific details like an insurance claim, insurance exchange, how much you might have to pay out-of-pocket before your insurance can step in, and more might only be answerable if you reach out to the carrier of your health insurance plan.
Does Blue Cross Blue Shield cover therapy?
Blue Cross Blue Shield is an example of an insurance provider that offers members coverage for therapy and behavioral health services. Blue Cross Blue Shield’s coverage also extends to services related to health online with certified providers. Members can receive online therapy support for various mental illnesses, including anxiety, depression, bipolar disorder, post-traumatic stress disorder, and more.
More and more insurance providers are beginning to cover mental wellness services. As with any health insurance provider and/or policy, it’s important to review the specific details of what you’re paying for and what you’re receiving. Always check with your provider before scheduling sessions and treatment to ensure that your coverage will work for you and your plans.
How much does a therapist cost without insurance?
You may assume that mental healthcare requires insurance. This isn’t necessarily the case, though insurance does often significantly reduce the cost.
Without insurance assistance, you should expect to pay the rate set by your therapist or practitioner per session out of pocket. The national average cost for the United States is about $90 per hour or session, but this rate can vary anywhere from $50 to over $250-300, depending on the therapist.
Where can I get a free therapist?
Perhaps you feel like you cannot afford therapy based on the given information so far, or perhaps all of the therapists in your area who accept your insurance are booked. There are many reasons you may seek out free or reduced therapy even you can get your health insurance to cover some expenses.
Established therapists or practitioners sometimes offer free or reduced-cost therapy options. Completely free therapy may be hard to come by, especially if you’re looking to work with a good, certified, and practicing therapist. However, some options can still work for those looking to spend as little as possible.
Consider online therapy as an option – it may be easier to find and utilize affordable services for you. It’s also possible that there are free or low-cost options available to you in your local community. It’s always a good idea to look around to understand what options exist already for you before making a decision.
How much is therapy out of pocket?
How much you pay out of pocket for therapy services depends on a couple of factors. Your insurance policy or insurance plan may help cover the costs of therapy, or they may not. The cost of therapy out of pocket can be much more without the assistance of health insurance.
If you are paying out of pocket completely, or if your insurance plan doesn’t cover the services in question, the cost can vary. Therapists usually charge per session or hour, and the price can range anywhere from $50 to-200. Online therapy can generally be a more affordable option both with and without insurance.
What are therapists covered by my insurance?
If my health insurance plan covers therapy costs, how do I determine which practitioners to go to? Who do insurance plans cover? Depending on the insurance plan you have and your provider, you may be limited to a specific network of therapists or practitioners in your area for covered care. Some plans may be more flexible than others when picking a specific practitioner, and some plans will handle online therapy services differently than others.
Both in-person and online mental wellness services can accept insurance. If you’re unsure which services are covered or want to know more details, it’s always a good idea to reach out to or call your insurance provider for specific information.
Is therapy worth the money?
Therapy can feel like an expense that is less than necessary, especially if you’re struggling to manage finances in other parts of your life as well. But, with all of the options and types of therapy accessible today, there are plenty of ways to make therapy work for you and your budget.
The value of therapy can extend to everyone, but it’s especially important for those struggling with or who have a mental illness. Without proper care and treatment, these illnesses and conditions can worsen over time and more intensely affect day-to-day life. Severe consequences like feelings of hopelessness, missing out on important work or family events, poor physical health, and more can arise without mental health care.
According to the American Psychological Association, signs you could benefit from therapy include finding it difficult to concentrate on work, worrying excessively, feeling an overwhelming and prolonged sense of hopelessness or sadness. The American Psychological Association stresses that psychotherapy can help people of all ages live happier, healthier, and more productive lives.
Therapy is meant to help you address mental health problems and send you on a path toward stability. If therapy costs feel like an obstacle to you, you may find it helpful to reach out to professionals online or in your area to discuss these concerns.
If you’re unsure about what your plan covers and what your insurance plan doesn’t cover, it’s always a good idea to contact your insurance company for details and limitations. You can also contact practitioners to see who accepts your insurance and to what extent.
How much does therapy cost with insurance?
Many people interested in mental health treatment wonder how much it costs and whether health insurance covers part of the payment. It’s a difficult question to answer, given that mental health care changes drastically based on various factors.
Your health plan and health benefits depend on where you live, how old you are, and what type of mental health care you are looking for, among other factors. Despite the confusing nature of health plans and mental health care, keeping in mind some vital information may help you find mental health treatment more easily.
It is a common misconception that the Affordable Care Act (ACA) requires that health plans require coverage of mental health treatment. Although the Affordable Care Act did improve access to mental health and substance abuse therapies, it is not across the board - it is more nuanced than that.
Instead, the Affordable Care Act requires health plans to ensure “parity protection,” which is essentially the concept that health plans cover mental health treatments to the same level that insurance covers medical or surgical needs. The downside is that people on a health plan that doesn’t include many health benefits won’t get much coverage for mental health care.
The most crucial point to take home is that your insurance covers different amounts of mental health care depending on your coverage and location.
There are still general prices for therapy with health insurance that you can use as a ballpark with all of that said. Mental and behavioral health therapies generally cost about $60-$120 per session, but with health plans covering mental health, the cost can fall to around $20-$50 per session.
It’s essential to understand what health benefits your health plan provides. Don’t hesitate to contact your health coverage company better understand your insurance covers regarding mental and behavioral health.
Is it bad to use insurance for therapy?
It is not a bad thing to use insurance to help cover the costs of mental health care.
First of all, the reason to get health plans is to have reduced out-of-pocket costs for health care needs such as therapy or surgery. Secondly, mental health care is incredibly important - mental health, behavioral health, and physical health are crucial elements to an overall healthy lifestyle. A health treatment that focuses on mental health care, like therapy, can be essential to your wellbeing.
If possible, try to learn more about your health plan and the health benefits provided by your insurer. Through a better understanding of your health coverage, you can learn what your insurance covers and what may need to be out-of-pocket costs.
A comprehensive understanding of the health benefits provided by your health plan allows you to make informed and prudent decisions about your mental health care in the future.
Is mental illness covered by health insurance?
The question of whether mental illness is covered in health plans is tricky. The unfortunate answer is: it depends.
It mainly depends on the type of health care plan that you have. Many health plans include mental health care (such as therapy, psychiatric care, etc.) as part of the health benefits package. However, some have a minimal budget allocated to cover mental health or include overly restrictive qualifications for received mental health and substance abuse treatments.
For example, some health plans will only offer a limited selection of professionals that will be covered. Other times, there is a dollar limit on how many mental health benefits can be provided.
It can be very informative to contact your insurance provider to learn more about your specific health plan. A better understanding of the health benefits provided by your health plan will allow you to make informed decisions about what sort of specific and tailored mental and behavioral health treatments are available to you.
How does insurance work for therapy?
Insurance for therapy works on the same principles that insurance for surgery or other similar medical expenses relies on.
In the broadest terms, you pay an insurance company a set amount for a health plan - this health plan then provides health benefits that include reduced costs of medical procedures. The idea is to limit your downside risk of how much money you need to pay in a worst-case scenario.
Say you get in a car accident - instead of paying $300,000 for your surgeries, you only need to pay $30,000 because you’ve been paying into a health treatment plan.
In therapy, many good health plans provide adequate coverage and reduce the cost of therapy. However, mental health care is not included in the health benefits of all plans.
Be sure to take some time to contact your health insurance provider to learn more about what your plan covers types of mental health treatment. And don’t forget to bring your insurance card with you whenever you receive health care of any kind.
What do I do if I can’t afford therapy?
Unfortunately, many people find themselves in a situation where they can’t afford therapy or other mental health treatments. In these cases, there are some options for free or reduced-cost therapies.
You can do things at home by yourself that could help improve your mental health, such as self-care, aromatherapy, mindfulness exercises, or pet therapy. However, these aren’t perfect solutions. Talking to a trained medical professional is always the preferred route for diagnosing and treating mental illness, even if you can’t commit to therapy.
Some professional therapies are free - take some time to research in your specific area. Often, churches, colleges, and schools provide some level of free mental health service. When in doubt, contacting your general healthcare provider for recommendations is another great idea.
