Does Health Insurance Cover Therapy For Mental Health Or Do I Have To Pay?

By: Sarah Fader

Updated July 13, 2021

Medically Reviewed By: Dawn Brown

"Does health insurance cover therapy?” One of the first things people usually think about when it comes to therapy is how much it costs with or without health insurance and how they will pay for it. The healthcare system and insurance marketplaces can be confusing, but people seek mental health treatment every day, and we’re here to walk you through mental health benefits.

This article will cover what is:

  • mental health therapy coverage, mental health plans

  • mental health insurance coverage, health insurance marketplace

Does Insurance Cover Mental Health? What Kind Of Coverages Are There?

There are many ways to pay for mental health treatment. What is covered by health insurance and what isn’t can be confusing at first. The Mental Health Parity Act is a component of the Affordable Care Act that requires large health insurance providers and health plans to provide equal coverage for mental illness (including substance abuse coverage and treatment). Contact your insurance provider for more information. 

does insurance cover therapy, what insurances policies will cover

Get Fast, Affordable Counseling With BetterHelp
Sign Up To Be Personally Matched To A Licensed Counselor
This website is owned and operated by BetterHelp, who receives all fees associated with the platform.

Source: pxhere.com

What Insurance Policies Will Cover? Therapy Coverage, etc.

Unfortunately, there are no fast and easy answers to the question of whether your health insurance plan will cover your therapy sessions or mental health services. The law doesn't mandate small health insurance companies with fewer than fifty employees to have health insurance cover the cost of therapy. A therapist's office can also help with these questions and you can always check with your health insurance benefits department or insurance company to verify what level of mental health coverage you have.

Common Coverage Concerns - What Won't Insurance Cover

Many companies that aren't governed by the Affordable Care Act or the Mental Health Parity Act choose to provide mental health coverage for their employees. Mental health benefits can be confusing, so we’ll outline a few things to look for. 

Before seeing a therapist, it's important to see if the provider takes your health insurance. One way to find out is to give your provider the details shown on your insurance policy. 

For family members, it may be useful to look into a Children’s Health Insurance Program, CHIP. People with diagnosed mental illnesses, substance use disorder, or other mental illness can find their essential health benefits may seek more information with the Consumer Assistance Program. 

Medicaid programs are a good option for family members, especially those with a diagnosable disorder, mental health condition, pre-existing condition, or those looking for a children’s health insurance program/CHIP. Learn more about these programs at Healthcare.gov. 

If you’re interested in minimizing costs, you may seek in-office talk therapy that is covered by your insurance. However, many online therapy options (which may not be included in some marketplace plans) can be much cheaper than even in-network options. 

When exploring your options, here are some questions to ask your health insurance company when you have them on the phone:

  • Are there specific mental health services/therapists that my health insurance plan doesn't cover?
  • Am I covered for therapy/therapists if I have a pre-existing condition?
  • What is the privacy policy/terms of service for these mental health services/therapists?
  • What is the number of therapy sessions my health plan covers per year?
  • Do I have a deductible to pay before my health plans cover services under my health insurance plan?
  • Is there a copay required by individual or group health insurance plans?
  • Do I need a referral from my primary care doctor for a therapist?

Health Insurance Network Providers - Does Insurance Cover Therapy

  • A network provider is a provider who accepts health insurance as a form of payment. In this case, that health insurance partially pays for mental health care. Although they may accept insurance for mental health coverage, a network provider is "inside" your health plan’s network. 

Coverage & Deductibles - How Does Insurance Coverage Work

  • It is important to pay attention to what your mental health care health plans cover (before and after the deductible). You can talk to your insurance company to get a good idea of what your deductible is, along with hearing the terms of service and privacy policy. 
  • Even though your therapist takes your insurance plan, you may have to pay for each session out-of-pocket until your health plans reach a certain balance before insurance will pay. That's why many people prefer to pay for more affordable licensed online therapy.

Sliding Scale Coverage

  • Some people find a therapist they like who doesn't take their insurance, but who will work with them and see them on a sliding scale. Sliding-scale therapists may charge a lower fee than another psychologist who has a private practice, allowing you to bypass the deductible problem. The sliding scale offers lower rates to those with less financial flexibility.

therapists will sometimes accept insurance depending on what insurances policies will cover

Source: canva.com One Design Use License

Low-Cost Clinic Coverage

  • Another option for finding affordable mental health care is to find a low-cost clinic. Under the Affordable Care Act, some mental health care facilities are designed for people who have lower incomes (where you can pay a sliding scale fee for therapy sessions and mental health benefits). There are also universities that have programs where graduate students are training in psychology under the American Psychological Association (APA) guidelines, and provide low-cost services under the Affordable Care Act. 

FSA & HSA - What Is Covered

  • Another option to pay for therapy is a health savings account (HSA) or flexible spending account (FSA). A health savings account is a savings account that allows users to save money tax-free to pay medical expenses ONLY. You can learn more about flexible spending at Healthcare.gov.

What Are Parity Laws? How Does It Affect Insurance Coverage?

  • Mental health parity laws don't always require insurance companies to cover therapy in all situations. Parity laws stipulate that large group health insurance covers mental health care services and medical health care services equally. What this means is that there can be no differing amounts in what your medical and mental health plans cover.
  • If you have questions about what your health insurance or mental health insurance plan covers under the Affordable Care Act or MHPA, review the terms outlined in your insurance policy, or contact your insurance provider directly.

Online Counseling 

If you are worried about paying for online counseling, it might be more affordable than you think. Public health specialists have increasingly seen it as a cost-saving solution that can reach a large portion of the population. A recent study found online therapy not only delivers successful treatment, but also costs significantly less than face-to-face options over the course of a year.

BetterHelp is an option to consider for those who think they can’t afford therapy. Prices are billed at affordable out-of-pocket rates, so it is cheaper for people who do not have insurance, or for people who have insurance but also have a high deductible. BetterHelp counselors can receive access to your permanent medical record, allowing them to treat mental health and substance use disorders. Read below about what others have to say about their experiences with BetterHelp.

insurance does sometimes provide therapy coverage

Get Fast, Affordable Counseling With BetterHelp
Sign Up To Be Personally Matched To A Licensed Counselor

Source: pexels.com

Counselor Reviews - Therapy, Mental Health Services, And Mental Health Care Can Help

"I've always struggled with going to appointments. Although I don't have to pay in Germany for mental health care, I choose to use BetterHelp because it's easier for me to have counseling sessions and I can be in the comfort of my own home! I am very happy with Daniel Merchant's help so far, I feel very understood, and for the first time in my life I don't feel like i'm incurable. I don't get treated as if something is wrong with me [but like] I have challenges I face that can get solved with methods that I am comfortable with. I can totally recommend it, it's totally worth the money!"

does insurance cover therapy

"I had some trauma when I was younger that was severely affecting my life and my relationships in a negative way. I also didn't have even the kind of money to afford this service for a long period of time. But Danny took the time and discussed treatment options for PTSD that I did not know much about before. I had tried different forms of therapy with limited success, but being able to write out my feelings, thoughts, and experiences allowed me to express myself in a way that I would not feel comfortable doing while sitting one on one with someone in the same room with me. Maybe that's a sign of me being on the older side of the texting/dm/instant message generation, but the messenger discussion was a game changer for me. Danny and BetterHelp helped me so much in a short amount of time, and they didn't dismiss me or treat me as less important just because of my adverse financial situation. Because of Danny, I found a local EMDR therapist that I can see, and it has been so helpful. Thank you so much."

does insurance cover therapy

Conclusion - Can Insurance Cover Therapy?

The process of looking for a therapist and juggling insurance can be complicated with the many factors involved. We hope that this article has given you the tools to reach out to your insurance provider. If you find that your insurance does not pay for therapy, or there is a deductible that's too high, try taking the first step with BetterHelp. You can cancel at any time, no hassle, no questions asked.


Previous Article

Is Trauma Informed Therapy Right For Me?

Next Article

Play Therapy Activities To Make Healing Fun
For Additional Help & Support With Your Concerns
Speak with a Licensed Counselor Today
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.