Do you need insurance for online therapy?

If you are exploring the possibility of beginning therapy, you may have found yourself wondering about the cost of therapy and whether insurance plans cover this type of mental health service. In this article, we aim to provide information that may be useful for navigating insurance as it relates to therapy, online therapy, and other forms of mental health care. 

Therapy and insurance: Exploring different forms of coverage

To better understand how insurance may be able to help you pay for therapy, we'll first explore types of medical insurance available and what they cover. In the United States, individuals seeking medical coverage often have a few options available to them. These might include:

Employer-sponsored health insurance: Employers in the United States often sponsor health insurance coverage for eligible full-time employees and their spouses, children, and other dependents. Employer-sponsored health plans are those purchased by an employer on behalf of employees. Employers may also offer other forms of coverage, such as health reimbursement arrangements (HRAs), health savings accounts (HSAs), or other health and wellness benefits. 

Individual plans: For those individuals whose employers do not offer health coverage, who are self-employed, or who would prefer to find health insurance coverage on their own, other options are available. Health insurance marketplace plans are one such alternative. These plans are available through the Affordable Care Act (ACA) and can be purchased via the individual’s state health exchange, which may be accessed through HealthCare.gov. Individuals can also explore the possibility of buying coverage directly from their chosen insurance company.  

Medicaid and Medicare plans: Those with incomes that fall below a certain threshold or who are 65 years old or older may qualify for medical benefits via Medicaid or Medicare, respectively. State Medicaid agencies and the United States Social Security Administration can provide further information about qualifications and coverage, as well as details on how to apply for and enroll in a plan. The Children’s Health Insurance Program may also be an option for obtaining coverage for children.  

Does insurance cover mental health care?

Whether a health insurance plan covers mental health care, including online therapy, may depend on a variety of factors. For those enrolled in plans through their state’s health insurance marketplace, insurance providers are required to cover mental health services. The extent of this coverage may vary, though. 

An employer-sponsored insurance provider may also cover outpatient mental health services, prescription medication, and counseling. Certain employers might also offer employee assistance programs (EAPs), which are separate from insurance benefits. EAPs may provide access to short-term counseling, health coaching, or other mental health resources for employees and their family members.

Those enrolled in high-deductible health insurance plans may also be able to use health savings accounts (HSAs) to help cover mental health care, including therapy. While using an HSA does mean paying for therapy with one's own money, these funds are not taxed like the rest of a person's income, which saves money. However, an HSA may not cover therapy if it’s not considered necessary for a medical or mental health purpose.

Traditional, in-person therapy may not always be easily accessible. Costs associated with this type of therapy can be priced as high as $200 or more per session. Varying levels of coverage, provider networks, copays, and deductibles may complicate things further. These barriers can make it challenging to receive therapy in an in-person setting. For this reason, some individuals may opt for counseling via an online therapy platform, like BetterHelp, instead. Online therapy platforms may offer a more affordable alternative to traditional therapy. In some cases, the full cost of online therapy is equivalent to an insurance co-pay for traditional therapy. 

Does online therapy require insurance?

Insurance is not typically required in order to start online therapy. Moreover, health insurance plans may not always cover online therapy. Still, it could be worth considering the reduced costs associated with online therapy. Online therapy also gives a person the ability to speak to a mental health professional from the comfort of home. A person with an HSA may be able to apply those funds to online therapy. Consider contacting your account administrator to confirm. 

A variety of studies have found online therapy to be an effective and cost-efficient alternative to in-person therapy. For example, one study determined that internet-based cognitive behavioral therapy (CBT) is a useful mental health treatment, including for post-traumatic stress disorder, chronic pain, panic disorder, generalized anxiety disorder, depression, bipolar disorder, and adjustment disorder.