Does Health Insurance Cover Therapy? Costs And Options

Updated January 26, 2023by BetterHelp Editorial Team

There can be various costs that go into counseling and mental health services. When looking for a service that works for you, you might consider the overall treatment cost per hour, insurance coverage, possible co-pays, and types of treatment needed.

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Does Health Insurance Cover Therapy? 

Each health insurance plan may have different coverage options for mental health treatment. Additionally, some companies may not cover certain services, price points, or pre-existing conditions. Discussing your options with your insurance provider can help you find the most affordable and best-suited therapist for your needs. 

If you have a primary care physician, they may also help refer you to a therapist or specialist that takes your insurance plan. You could face co-pays, session costs, or upfront fees depending on the deductible or plan you signed up with when you first obtained your insurance policy. 

If you have Medicaid or Medicare through the US government, you may have all or most of your treatment costs covered, depending on your need for them and the provider coverage. Some providers offer a selective list of companies they accept, so check with them before signing up for counseling. 

In-Person Counseling 

health insurance may or may not cover your treatment for traditional in-person talk therapy. In personal practice, therapists often have the right to choose which plans to accept, and not every therapist will accept the same plans. Additionally, depending on your policy, you may be limited to seeing counselors in your state or county. 

Some insurance plans will also limit you by cost, the number of sessions, and the names of therapists you can see. If you have a limited list, it may be mailed to you, or you can reach out to your insurance provider through their website or email to ask. 

Many insurance plans have mental health care as a coverage item. However, they might not cover the entire session. In some cases, you might have to pay an upfront cost, such as the entire cost of the session, and your insurance plan may reimburse you afterward. If you have not been diagnosed, an insurance policy could also require you to have a diagnosis and underlying need before seeing a therapist. You might also require a medical doctor’s referral. 

Online Counseling

Many special practice providers have moved to online counseling to offer more accessibility to clients. However, not all online practitioners offer care through insurance plans. If you're searching for individual therapists or therapy companies that offer telehealth therapy, check the insurance page or section of their biography or website. You can also reach out by phone to ask. If they are licensed in your state and can accept your insurance, you may be able to attend online counseling with insurance. 

If you attend counseling through an online platform, you may not be able to use insurance due to the site's terms and conditions or policies. However, many online platforms are hundreds of dollars cheaper than in-person therapy per month, which can benefit those with high co-pays, upfront costs, or barriers to traditional therapy.

Treatment Centers

Insurance may cover treatment centers like rehabilitation centers, psychiatric hospital stays, eating disorder treatment, or outpatient therapy groups. These centers may be costly without insurance, however. Depending on your plan, you may be required to pay an upfront registration fee and the rest through your insurance. For rehabilitation centers in the US, there is an average cost reaching upwards of $30,000.

Psychoanalysis Testing

If you are looking for a mental health evaluation and official psychoanalysis testing from a licensed psychiatrist, you may have to pay the amount out of pocket. Many insurance companies do not offer coverage for official psychological evaluations. These tests may cost around $1,500-$3,000 or more, depending on the area and the provider you select. You might be able to find cheaper testing if you go through a student program at your local university or contact local vocational rehabilitation services for financial support. 

Psychiatry 

Insurance often covers psychiatry as a medical service, as psychiatrists are medical doctors. However, depending on your plan, your medications may or may not be covered. Talk to your local pharmacy to find out if your insurance plan is accepted and how much you might pay in co-pays for your medication if you are prescribed any. Psychiatrist visits can cost between $100-$400 per session. You may pay more for an initial consultation. 

The Costs Of Therapy

Depending on where you live, therapy costs can vary. However, Forbes notes that the national average in the US is $100-$200 per session without insurance. This cost can be around $400-$800 or more per month. 

For those with insurance, your co-pay or upfront service cost can depend on the overall deductible or premium you signed up for with your policy. For example, if you have a high monthly payment on your insurance plan, your insurance policy might cover a significant amount or all of your therapy sessions. 

You may have to pay more out of pocket for your sessions if you have a high deductible and lower monthly cost. For some, that amount might be around $100 per session. If you have a co-pay plan, you might pay around $15-$45 in co-pays. If you are prescribed medication, that could add costs, depending on whether your insurance covers your medication. 

What To Do When You Can't Afford Therapy

People sometimes cannot afford therapy due to insurance coverage limits, co-pays, or other barriers. In these cases, there are a few options. 

Utilize Sliding Scale Providers

Some therapists offer a sliding scale session fee option. Sliding scale means the therapist may consider your case and offer a lower-end fee if you have a financial burden or cannot pay their regular fee. For example, a therapist might offer a sliding scale for sessions at $65-$150 per hour. If you have a lower income and can't afford $150, your therapist might work with you to offer a $65 per-hour rate. 

Although a therapist might not work for free, sliding scales can help those who struggle. You might also find sliding scale providers who offer mental health referrals, such as a primary care physician. 

Apply For A New Insurance Plan 

At times, insurance plans might not cover everything you need them to. In these cases, you can search for a new plan. If you do not have a pre-existing condition, they may offer coverage for therapy within a month or two after signing up. 

If you are low-income, are over 55, or have a disability, Medicaid or Medicare may be available to you and could offer more coverage for therapy, depending on your state. Monthly costs for Medicaid can be under $50 or free in some locations, depending on your financial ability. Talk to your local government health officials to learn more about these plans. 

Talk To Your Doctor 

If you're unsure how to find low-cost services, talk to your primary care physician. They may be able to refer you to a counselor they know of that offers sliding scale or low-cost services under your insurance plan. 

Some primary care physicians can also prescribe certain mental health medications and offer general tips for well-being and care. If you have any mental health symptoms due to physical health concerns, they can also address physical symptoms to reduce stress. 

Try Online Counseling

If you continue to face barriers to treatment or find that the cost of therapy doesn't fit within your budget in your area, you might consider online counseling. Online counseling often ranges from $65 to $90 a session instead of $100 to $200 or higher. Your first session will not cost more than your subsequent sessions. You can also receive some benefits that you might not get from a traditional session, such as the option to attend therapy over the phone, via video chat, or through a live chat feature. If you feel most comfortable at home, online therapy can allow you to attend counseling through a method that feels safe to you.  

Studies on the efficacy of online counseling found that it was more cost-effective and practical overall for conditions such as obsessive-compulsive disorder (OCD). The APA also labels telehealth therapy as a promising new treatment that offers several benefits to clients with any symptoms or mental health conditions. If you're interested in trying an internet-based treatment modality, you can do so through platforms like BetterHelp for individuals or ReGain for couples. 

Takeaway

Although insurance plans may not cover all therapists, therapy sessions, or types of mental healthcare, there are many options for finding low-cost therapy. You can try attending online therapy, visiting a sliding scale therapist, or reconsidering your insurance plan. If you want more information on what your particular plan covers, contact your policy and ask for guidance on finding a provider.

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