How to Check if Your Insurance Covers Therapy

You may check whether your health insurance covers therapy by reviewing your policy details, logging into your insurer's provider portal, or calling the number on the back of your insurance card. It usually only takes a few minutes to find out what's covered and what you might need to pay. 

Knowing what to expect may make accessing mental health care feel less intimidating. Here's how to check if your insurance covers therapy so you may get started without any surprise costs.

What does insurance coverage for therapy typically look like?

It's natural to feel a bit overwhelmed by insurance jargon and benefits charts. However, what insurance covers is often more straightforward than it seems. 

Thanks to parity legislation, many insurance plans are required to cover some mental health services in addition to physical health care. The exact details vary, though. Two plans might have very different coverage amounts, session limits, and copay charges. 

Insurance companies usually have provider networks, which are groups of therapists who have agreed to work with them. Whether your therapist is in-network or out-of-network may affect what's covered. 

An in-network therapist has a contract with the insurance company that often includes pre-negotiated rates. For example, they may have agreed to charge $75 less for a therapy session than their standard rate. That typically means you have lower out-of-pocket costs. 

On the other hand, an out-of-network therapist doesn't have an agreement with the insurance provider for a set rate. You may also need to pay for sessions upfront and ask your insurance company for reimbursement. However, your health plan could still cover a portion of the cost. 

No matter which type of therapist you choose, many insurance plans have a copay. This is a set amount that you'll need to pay out of pocket for certain mental health services. For instance, you may have a $40 copay for each therapy session, while your insurance covers the rest. 

Health insurance plans typically have a deductible, too. This is an amount of money that you might need to pay out of pocket before your health plan starts covering its share. If you have a $1,000 deductible, you may need to pay the first $1,000 yourself, before your plan kicks in at $1,001 and beyond. 

Some plans count copays toward deductibles, while others treat them as separate. 

How can you check if your insurance covers therapy?

Figuring out whether your insurance plan covers therapy and if there are any limitations doesn't take long. Follow these simple steps to check your mental health coverage. 

Call the number on your insurance card

Locate your member ID and group number on your insurance card. The company usually needs this information to look up your coverage details. 

The card should also include a customer service number that you may call with questions. Ask the insurance company's support team whether your plan includes mental health benefits, such as talk therapy sessions and medication management, or psychiatric services. If a service is covered, ask how much your copay is and whether your deductible applies. 

You should also inquire about whether you need a referral to a mental health care provider. For instance, your primary care physician might refer you to a therapist if you're experiencing symptoms of depression. 

Log in to your insurance provider portal

Many health insurance plans have self-service portals where members may search for in-network mental health providers. 

Start by looking for therapists in your area, or see if your plan covers telehealth services. If so, you may be able to attend online therapy sessions from home. This may be more convenient than traveling to a therapist's office, especially if you have a hectic schedule or no nearby providers. 

You may also use the portal to view a summary of benefits and coverage. This document outlines covered benefits, exceptions, copays, and other details in plain language. 

Ask your HR department

According to BetterHelp research, 25% of Americans fear that seeking mental health care could affect their job. However, you shouldn't feel afraid to ask about your health insurance benefits. 

If you have an employer-sponsored plan, reach out to your human resources department with questions. They may help you understand your mental health coverage or point you to a benefits summary. That's useful if you have practical questions, like "When does my deductible reset?" or "Is it possible to change my coverage?"

You don't have to reveal anything about your mental health to ask these questions. Stick to the plan details. 

Contact a mental health care provider directly

Mental health professionals are another valuable resource for insurance-related questions. Often, a therapist's office or a platform may verify your insurance details on your behalf before the first session. That way, you don't have to guess what your insurance covers before you take the next step on your mental health journey. 

What questions should you ask when confirming your mental health benefits?

Insurance plans may be complex, so don't make assumptions about your benefits and out-of-pocket costs. These questions will help you understand what your plan covers before starting therapy: 

• Does my plan cover mental health treatment? Take the time to confirm your basic eligibility before you book a therapy session. Some plans have restrictions, such as only providing coverage for certain mental health disorders. For example, your plan might pay for individual therapy for anxiety but not couples counseling. 
• What is my copay or coinsurance for a therapy session? Make sure you understand your out-of-pocket expenses before you make an appointment. 
• Is there a session limit? Some plans will cap the number of covered visits per year.
• Do I need a referral or preauthorization? In some cases, you may need to complete an extra step before your health insurance will cover therapy. 
• Which mental health care providers are in network? This helps you narrow your search to therapists who already accept your plan. 
• Is any treatment covered beyond therapy? Some health plans may cover behavioral health services, substance use treatment, and other types of mental health care. This may be helpful if therapy doesn't meet all your needs. 

If you are struggling with substance use, contact the SAMHSA National Helpline at 1-800-662-HELP (4357) to receive support and resources. Support is available 24/7.

What if your insurance doesn't cover therapy?

Don't feel discouraged if your health plan won't cover therapy. Many people receive mental health care without insurance coverage and find a way that works for their budget. 

An online platform may help you access affordable care. BetterHelp accepts over 125 insurance plans, with eligible members paying an average copay of $23 per session. If you don't have mental health coverage, BetterHelp's subscription plan costs around $70 to $100 per week. 

Pricing is based on factors such as location, referral source, preferences, therapist availability and any applicable discounts or promotions that might apply.

This option gives you flexibility to access care when and where you need it, including live sessions and messaging with your therapist. BetterHelp insurance availability, coverage, and cost may vary by state, plan, provider network, therapist availability, and deductible status.

You may also be able to use funds from a health savings account (HSA) or a flexible spending account (FSA) to help offset the cost. 

Online therapy can also make it easier to fit support into a busy schedule. Sessions happen wherever you have an internet connection, so you're not adding a commute on top of everything else, and you can message your therapist between sessions if something comes up before your next appointment.