How Many Therapy Sessions Does Insurance Cover?

There is no universal number of therapy sessions that every insurance plan covers. Some insurance plans may cover a set number of sessions per year, while others may cover therapy as long as it is considered medically necessary. 

Your exact coverage can depend on your plan’s mental health benefits, deductible, copays, provider network, prior authorization rules, and any therapy session limits.

Enacted in 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA), also known as the federal parity law, says that affected health insurance companies can’t restrict mental health coverage more than they restrict medical coverage.

Outside of this, however, legal limits on mental health services like therapy sessions may still exist. Exactly what, when, and how much an insurance company will pay for therapy can vary widely, depending on many factors. 

If your insurance plan covers talk therapy, it’s important to learn the exact parameters, including whether there are therapy session limits. Each plan is different, so understanding how many sessions yours might cover can be a necessary step toward receiving care.

What are therapy session limits?

Therapy session limits are when an insurance company only covers a specific number of mental health treatment sessions for individuals with a particular plan. These limits can look different depending on the insurance company and the specific policy. 

Here are just a few examples of the many forms that therapy session limits may take:

• An insurance company pays 100% of the cost of an individual’s first six sessions with a covered provider, and the client must pay out of pocket for any future sessions in that calendar year.
  
• An insurance company does not cover any of the cost of an individual’s sessions until they reach their deductible. After that, it will pay 50% of session costs for the rest of the year.
  
• An insurance company pays 100% of the cost of 10 therapy sessions if a health care provider has deemed them “medically necessary” for the individual. After those 10, the provider will have to submit a statement to the insurance company outlining why they believe further treatment should be covered, which the company may or may not approve.

How many therapy sessions does insurance cover?

There’s no minimum or universal number of therapy sessions that will be covered by every insurance plan. Coverage can vary widely depending on many factors related to your specific plan.

Even among plans that do cover therapy, each one may handle it differently. For instance, some plans pay all or part of the cost of a set number of sessions per year for every individual with a certain policy. 

What impacts how many therapy sessions are covered by insurance?

Some of the key factors that can impact how many therapy sessions are covered by insurance include your plan’s:

• Deductible, or the amount of money you need to spend on out-of-pocket healthcare costs through your insurance in a year before they start covering certain services.
• Copays, or how much you’ll need to pay out of pocket for each session in order for your insurance plan to cover the rest.
• Annual therapy session limit, if any, which is a fixed number of appointments your plan will cover each year, or certain circumstances under which some sessions will be covered.
• Requirements for medical necessity, if any, which may mean that therapy will only be covered if you have a qualifying diagnosis confirmed by an in-network provider.

Each of these factors can vary depending on your insurance company and your particular insurance plan.

How to check how many therapy sessions your insurance covers

There are a few different ways to find out if your insurance plan has therapy session limits. You can examine your plan’s documents, contact your insurance company, or contact a therapist’s billing office.

Examine your plan’s documents 

First, you can look through the documents your insurance company may have sent via mail or electronically. 

Specifically, you might search for one called “summary of benefits and coverage.” It’s usually several sheets of full-page charts that list:

• Common medical events
• Services you may need in those situations
• What you’ll pay for care from in-network and out-of-network providers
• Any exceptions or limitations (like needing pre-authorization or having a therapy visit limit) 

In this document, you might look for the row(s) that contain information on mental health care, sometimes called “behavioral health services” or "outpatient mental health services.” 

If you do not have this document, you can often find it or similar documents by logging in to your insurance member portal online and navigating to the “documents” or “plan benefits” section. 

Call your insurance company

A second option is to contact your insurance company directly. In most cases, your member card will have a phone number on the back that you can call. You might ask the representative questions like:

• Does my insurance cover therapy? 
• What is my therapy cost with insurance?
• If therapy is covered, are there any session limits?
• If limits exist, is there a way I can request additional sessions?
• Do I need prior authorization for therapy?
• Do I need to see an in-network provider? How can I find one?

Contact your therapist’s billing office

Finally, a third option is to contact the billing office of your current or a prospective therapist. They may be able to verify your plan’s coverage with your insurance company on your behalf.

What happens if insurance stops covering therapy sessions?

In some cases, insurance coverage of therapy sessions may stop or change suddenly. This denial of care could leave you with a bill and unanswered questions. Understanding the reason can help you figure out next steps.

For example:

Options to consider if you’ve reached your therapy visit limit

If you’re not able to get any more sessions covered by your insurance, there may be other ways to find mental health care that fits your budget. For instance, you can explore free or low-cost options such as seeking counseling through community clinics or getting temporary support through crisis hotlines.

Another option is to consider an online therapy platform like BetterHelp. Online therapy may be more affordable than in-person sessions, and BetterHelp also offers financial aid to those who qualify. Plus, some providers on the platform now accept select insurance plans, and you may be able to pay with your FSA/HSA.

Is there a limit to how many therapy sessions insurance covers?

In some cases, yes. Many insurers have limits on mental health insurance coverage, which could look like only covering a set number of sessions or requiring prior authorization or proof of medical necessity. 

Does insurance cover therapy every week?

It depends on your specific policy. Many insurance plans have limits on how many therapy sessions they’ll cover. For example, some may not pay for any sessions until you meet your deductible, while others may only pay for therapy when it’s deemed “medically necessary.” 

Can insurance limit the number of therapy sessions?

Yes. While the Mental Health Parity and Addiction Equity Act requires that most US insurance companies not restrict mental health coverage more than medical coverage, they may still legally be allowed to place certain limits on care. 

For example, some plans will only pay for therapy when it’s deemed “medically necessary,” while others may cover a few sessions and then require you to request their authorization if you want or need to receive more.

What does “medically necessary” mean for therapy?

Some insurance companies will not pay for therapy unless it’s deemed “medically necessary,” which means that current healthcare best practices would recommend it as a treatment for a given illness.

For example, a person who is seeking therapy for PTSD symptoms that are making them unable to sleep or work might qualify for “medically necessary” therapy sessions. That said, the exact manner in which an insurer determines medical necessity can vary.

How do I check how many therapy sessions my insurance covers?

You can reference your plan’s summary of benefits and coverage, which may have been mailed to you or might be available through your insurance company’s member portal. Another option is to call the number on the back of your insurance member card and ask the representative your questions.