Does Insurance Cover Therapy? Understanding Your Mental Health Coverage
Yes, most insurance plans cover therapy in the United States. Federal law requires many health insurance plans to include mental health benefits, which means therapy sessions may be at least partially covered under your plan. However, the specifics of that coverage can vary widely depending on your insurance type, your chosen provider, and the kind of therapy you're seeking.
Navigating insurance can feel overwhelming, particularly when you're already considering taking the step to prioritize your mental health. Below, explore the types of insurance that may cover therapy, how to verify your coverage, what costs to expect, and what alternatives exist if your plan doesn't fully meet your needs.
BetterHelp now accepts insurance in
select states and plans
Types of insurance plans that may cover therapy
Several types of health insurance may provide coverage for mental health services, including therapy. The Mental Health Parity and Addiction Equity Act requires many insurance plans to offer mental health coverage that is comparable to coverage for physical health conditions. Understanding which type of plan you have can help you determine what therapy benefits may be available to you.
- Employer-sponsored health insurance
- Marketplace and ACA plans
- Medicaid
- Medicare
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. These plans frequently include outpatient mental health services, prescription medication, and counseling, though the extent of coverage varies by plan.
Certain employers might also offer employee assistance programs (EAPs), which are separate from insurance benefits and can provide additional support for those seeking mental health resources. EAPs may provide access to short-term counseling, health coaching, or other mental health resources for employees and their family members.
Marketplace and ACA plans
For those whose employers do not offer health coverage, who are self-employed, or who would prefer to find health insurance coverage on their own, Marketplace plans offer an alternative. These plans are available through the Affordable Care Act (ACA) and can be purchased via your state's health exchange, which may be accessed through HealthCare.gov.
Marketplace plans are required to cover mental health coverage as an essential health benefit. This means that if you purchase insurance through the ACA marketplace, your plan must include some level of coverage for mental health services, including therapy. The extent of this coverage, including copays and deductibles, may vary depending on the specific plan you choose.
Medicaid coverage for therapy
Medicaid provides health coverage to eligible low-income individuals and families. Mental health services, including therapy, are typically covered under Medicaid, though the specifics can vary by state. Some states offer comprehensive mental health benefits, while others may have more limited coverage or smaller provider networks. Eligibility is based on income and other factors, so checking with your state's Medicaid program can help clarify what services may be available to you.
Medicare coverage for therapy
Medicare Part B covers outpatient mental health services, including therapy sessions with licensed professionals. For most services, Medicare beneficiaries pay 20% coinsurance after meeting their annual deductible. This means that while therapy is covered, there may still be out-of-pocket costs to consider. If you have Medicare, reviewing your specific plan details can help you understand what mental health services are included.
How to check if your insurance covers therapy
Before scheduling your first therapy session, it can be helpful to verify what your insurance plan covers. Taking a few steps to understand your benefits may help you avoid unexpected costs and find a provider who works with your plan.
Locate your insurance card and find the member services phone number on the back.
Call your insurance company and ask specific questions about your mental health benefits.
Review your benefits summary document, which outlines covered services and cost-sharing details.
Search your insurance company's online provider directory to find in-network therapists.
Contact potential therapists directly to confirm that they accept your specific plan.
Questions to ask your insurance provider
When you call the number on your insurance card, having a list of specific questions ready can help you get the information you need. The following questions may help clarify your coverage:
[call_out_content]
- Does my plan cover outpatient mental health services?
- What is my copay or coinsurance for therapy sessions?
- Do I need prior authorization before starting therapy?
- Is there a limit on the number of sessions covered per year?
- Do I need a referral from my primary care doctor to see a therapist?
[/call_out_content]
Finding in-network therapists
Most insurance companies maintain an online provider directory where you can search for therapists who are in-network with your plan. Using this directory can be a helpful starting point, though it's often a good idea to call therapists directly to confirm they are currently accepting new patients and that they accept your specific insurance plan. Provider directories are not always up to date, so verification can help prevent billing surprises.
Understanding in-network vs. out-of-network coverage
One of the most important factors affecting your therapy costs is whether your therapist is considered in-network or out-of-network with your insurance plan. Understanding this distinction can help you make informed decisions about your care and budget accordingly.
What in-network coverage means for therapy costs
When you see an in-network provider, your insurance company has already negotiated rates with that therapist. This typically means lower out-of-pocket costs for you, including reduced copays and coinsurance. Your insurance pays a larger portion of the session cost, making therapy more affordable. In-network coverage also tends to offer more predictable costs, since the rates are pre-established.
Out-of-network coverage and reimbursement
If you choose to see a therapist who is out-of-network, your costs may be higher. Some insurance plans offer partial reimbursement for out-of-network providers, but you may need to pay the full session cost upfront and then submit claims to your insurance company for reimbursement. Many plans also have a separate, higher deductible for out-of-network services, which means you may need to pay more before your insurance begins covering any portion of the cost.
Therapy costs with and without insurance
Understanding what therapy may cost can help you plan for this investment in your mental health. Costs vary widely depending on whether you have insurance, what type of plan you have, and whether you see an in-network or out-of-network provider.
Understanding deductibles and copays
A deductible is the amount you pay out of pocket before your insurance begins covering services. Once you meet your deductible, you typically pay a copay (a fixed amount per visit) or coinsurance (a percentage of the session cost). Understanding these terms can help you estimate your total therapy costs for the year.
Typical therapy costs with insurance coverage
With insurance coverage, a person typically pays an average copay of about $23 per session for in-network therapy. However, if you haven't met your deductible, you may need to pay the full negotiated rate until you do. Costs also depend on your specific plan type and whether the therapist is in-network.
Scenario | Typical Cost Per Session |
|---|---|
In-network with insurance (after deductible) | About $23 copay |
Out-of-network with insurance | $75-$150+ (partial reimbursement possible) |
Without insurance | $100-$200+ |
Online therapy platforms | $70-$100 per week |
Therapy with insurance, $23 average co-pay*
Many providers on BetterHelp now accept major insurance carriers so you can access therapy affordably. Insured members pay an average co-pay of around $23 per session.
Find a covered therapist*Average co-pay based on insured BetterHelp members. Actual costs vary by plan, provider, and therapist availability.
Therapy costs without insurance
Without insurance, therapy sessions in independent practice settings can cost $100 to $200 or more per session. Costs vary based on factors like geographic location, therapist credentials and experience, and session length. For many people, these costs can create a barrier to care, which is why exploring alternatives may be helpful.
Using HSAs and FSAs for therapy
Those enrolled in high-deductible health insurance plans may be able to use health savings accounts (HSAs) to help cover mental health care, including therapy. Flexible spending accounts (FSAs) may also be used for therapy expenses. While using these accounts does mean paying for therapy with your own money, these funds are not taxed like the rest of your income, which can provide savings.
Therapy is typically considered an eligible expense for both HSAs and FSAs, though it may be helpful to confirm with your account administrator. However, these accounts may not cover therapy if it's not considered necessary for a medical or mental health purpose, or if it falls outside the scope of eligible expenses.
It's easy to pay with your FSA/HSA!
Simply enter your FSA or HSA card on the Payment page. We accept both FSA and HSA cards and therapy is an eligible expense for most providers!
What to do if insurance doesn't cover therapy
If your insurance doesn't cover therapy or your out-of-pocket costs remain too high, several affordable alternatives may help make mental health care more accessible. Exploring these options can help you find support that fits your budget.
Sliding scale fees
Many therapists offer sliding scale fees, which means they adjust their rates based on your income and ability to pay. If cost is a barrier, it can be worth asking potential therapists whether they offer this option. Some therapists reserve a portion of their caseload specifically for clients who need reduced rates.
Community mental health centers
Federally qualified health centers and community mental health centers often provide low-cost mental health services to individuals regardless of their ability to pay. These centers may offer therapy to address specific challenges like attention seeking behavior, along with psychiatric services and other support on a sliding scale basis. Searching for community mental health resources in your area may help you find affordable options.
Online therapy as an affordable alternative
Online therapy platforms may offer a more affordable alternative to traditional in-person therapy, with services like BetterHelp priced around $70-$100 per week compared to $100-$350 per session for in-person care. In some cases, eligible members may find that some providers on BetterHelp are in-network with certain health plans, and co-pays may average about $23 per session or about $23 per week when covered, depending on the plan, provider, and therapist availability.
BetterHelp also now offers psychiatry services through Uplift as an additional care option alongside therapy. For individuals with limited insurance coverage or high out-of-pocket costs, online therapy platforms may provide an affordable path to working with a licensed therapist. Some people may also choose to explore psychiatric support through Uplift based on provider evaluation and clinical needs.
Does insurance cover online therapy?
Many insurance plans now cover telehealth services, including online therapy. Coverage for virtual mental health services has expanded, particularly since 2020. However, whether your specific plan covers online therapy may depend on your insurance company, the platform you use, and whether the therapist is in-network with your plan. Checking with your insurance provider can help clarify what telehealth services are included in your benefits.
BetterHelp and insurance coverage
Some providers on BetterHelp may be in-network with certain health plans in select states, including Arkansas, Colorado, Connecticut, New Jersey, Florida, Illinois, Indiana, Kentucky, Maryland, Michigan, Ohio, Nevada, Missouri, Montana, North Carolina, New York, Oklahoma, Pennsylvania, Texas, Virginia, Washington, DC. Coverage varies by plan, provider, and therapist availability, so it's important to check your eligibility and in-network status. For eligible members, co-pays may average about $23 per session or about $23 per week when covered. BetterHelp also accepts HSA/FSA cards, and for those not using insurance, the platform's flexible subscription model remains an option. BetterHelp also offers psychiatry services through Uplift, which may be covered by insurance depending on the provider, plan, and location. Psychiatry services may include medication management when clinically appropriate, following a full evaluation by a licensed psychiatric provider.
Benefits of online therapy
Online therapy may offer benefits for those navigating insurance barriers or seeking more accessible care. Without the need to travel to an office, online therapy may fit more easily into busy schedules and can be accessed from the comfort of home, allowing you to navigate personal challenges like needing reassurance in relationships.
How effective online therapy may be
Experts say online therapy is just as effective as traditional therapy, only with better retention rates. That aligns with findings from the BetterHelp outcomes report, in which therapists earned a 4.9 out of 5 average rating for a live session, from over 1.7 million client ratings. For people comparing insurance options, copays, or paying on their own, this may help frame online therapy as a practical form of ongoing support.
Takeaway
Is therapy 100% covered by insurance?
Most insurance plans require some out-of-pocket costs like copays or coinsurance, though the amount varies by plan. Full coverage without any cost-sharing is uncommon, so checking your specific benefits can help you understand what to expect.
How do I find a therapist my insurance will cover?
You can check your insurance company's website and search their provider directory for in-network therapists. Calling potential therapists directly to confirm they accept your specific plan can also help ensure your sessions will be covered.
How much does a therapist cost if you have insurance?
If you have insurance coverage, therapy session costs usually depend on your insurance company and plan details. Most in-network providers are covered, and a person typically pays an average copay of about $23 per therapy session.
Does insurance cover online therapy?
Yes, many major insurance plans now provide coverage for virtual therapy or online psychotherapy, following expanded telehealth policies. Coverage depends on your specific plan and whether the online therapist is in-network, so checking with your insurance provider can help clarify your benefits.
Does BetterHelp accept insurance?
Some providers on BetterHelp may be in-network with certain health plans in select states. Coverage varies by plan, provider, and therapist availability, so checking your eligibility and in-network status is important. For eligible members, co-pays may average about $23 per session or about $23 per week when covered. BetterHelp also accepts HSA/FSA cards as payment. BetterHelp also offers psychiatry services through Uplift, which may be covered by insurance depending on the provider, plan, and location.
What if my insurance denies coverage for therapy?
You may be able to appeal the decision or explore alternatives like sliding scale fees, community mental health centers, or online therapy platforms. Contacting your insurance company to understand the reason for denial can also help you determine next steps.
Do I need a referral from my primary doctor for therapy?
Some insurance plans require a referral for mental health services, so checking with your insurance provider before scheduling can help avoid unexpected costs. Many plans allow you to see a therapist directly without a referral, but this varies by plan type.
Can I get reimbursed if I see an out-of-network therapist?
Many insurance plans offer partial reimbursement for out-of-network providers, though you may need to pay upfront and submit claims yourself. Checking with your insurance company about out-of-network benefits can help you understand what portion of costs may be reimbursed.
How do I know if my therapist is in-network?
You can check your insurance company's online provider directory or call the number on your insurance card to verify a therapist's network status. Calling the therapist's office directly to confirm they accept your specific plan could also be a helpful step.
Can I get a mental health diagnosis online?
In some cases, licensed mental health or psychiatric providers may assess symptoms online and determine whether a diagnosis is appropriate based on a full clinical evaluation. BetterHelp now offers psychiatry services through Uplift, which can provide access to licensed psychiatric providers for evaluation and ongoing care when appropriate. Diagnosis and treatment recommendations, including whether medication management may be considered, depend on the provider's assessment. Medication availability and coverage may vary by member location, clinical appropriateness, and individual pharmacy/insurance benefits. Prescribing decisions are made by the treating clinicians. We do not guarantee that any specific medication will be prescribed or covered by a member's insurance plan.
- Previous Article
- Next Article