Marriage Counseling That Accepts Insurance for Mental Health

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?

How can I find marriage counseling that accepts insurance?

It can be a complicated process to find couples 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 online therapy platforms vary in whether insurance options are available, some people may find that subscription pricing can be a practical alternative depending on their situation. Utilizing mental health services through online therapy platforms, you can address conflict in your relationship without always 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 couple's therapist and want to understand whether 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?

Some government-funded health plans may have their own rules about mental health and family therapy benefits. Because plan details can differ, it may help to contact the plan directly to ask about covered services, approved provider types, and any requirements for medically necessary care.

Potential limitations of government health plan coverage for marriage therapy sessions

Some plans have limitations on what kinds of providers are covered for therapy and mental health care, so you may have fewer options in terms of therapist choices. The following types of providers are commonly covered under many health plans for mental health services:

• Licensed clinical social workers
• Clinical psychologists
• Clinical nurse specialists
• Physician assistants
• Nurse practitioners
• Psychiatrists and other physicians

It may be helpful to call your plan representative and ask whether your therapy may be covered. You may want to keep in mind that many couples and family therapists may not be included under every plan unless they also fall into one of the above categories or are employed at the office of a covered practitioner.

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 large 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 allow their employees to access 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.

EAPs are becoming increasingly more common, especially with larger employers. More employers are beginning to provide Employee Assistance Programs because they recognize the benefits of offering holistic wellness options to their employees.

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 an 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, 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 for those without insurance coverage. 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.