Mental Health: Does Insurance Cover Therapy Appointments?

What is mental health coverage? When it comes to counseling, people almost always wonder how much therapy costs with or without a health plan and how to pay for therapy, be it online therapy or in-person. Healthcare professionals, systems, and marketplaces can be confusing, but people seek mental health treatment every day, and we’re here to walk you through the many mental health and therapy benefits available. To learn more about what's covered in your policy and what steps to follow, read below.

Therapy Covered With Insurance

What Kind Of Insurance Plans Are There For Therapy?

There are many ways and different purposes in paying for mental health treatment. While most of us are familiar with auto insurance and what coverages come with our plans, mental health treatment is definitely more nuanced. Many ask themselves, "does insurance cover therapy?" What is covered by health insurance and what isn’t can be confusing at first?

For example, the Mental Health Parity and Addiction Equity Act is a component of the Affordable Care Act that says it is within your rights for large health insurance providers and health plans to provide equal coverage and protection for mental health for Americans (including substance abuse disorder services and treatment). In other words, insurers are not allowed to offer undesirable options when it comes to mental health services or substance use disorder services, versus the coverage for aspects such as physical health or surgical benefits. It likely doesn’t matter if you have Blue Cross Blue Shield or some other insurance plan, since this is a federal law. Contact your insurance provider for more information.

What Different Types Of Therapies Does Insurance Cover?

Unfortunately, there are no fast and easy answers to the question of whether your health insurance plan will cover your therapy sessions or provide coverage for mental health provider services. The rules might not be as clear-cut when it comes to looking into benefits related to mental illness as opposed to something like surgical benefits. Some plans may not consider mental health to be an essential health benefit, despite the law.

The health care reform law doesn't mandate small health insurance companies with fewer than fifty employees in their business to have health insurance cover mental health and the cost of therapy even when you submit a claim or even multiple claims. A therapist's office can also help with these questions and you can always check with your health insurance benefits department or insurance company agent to verify what level of mental health coverage you have. Furthermore, you might be able to look into the specifics of your insurance account online, to determine what services are covered by insurance.

Does Health Insurance Cover Therapy?

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. This may provide them with a way to tell if your insurance company covers behavioral health services.

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

Medicaid programs are a good option for family members who lack access to other options, especially for individuals with a diagnosable disorder, mental health condition diagnosis, pre-existing condition, or those looking for a children’s health insurance program/CHIP. Learn more about these programs at healthcare.gov. 

You might want to talk with your primary care physician for more information and to find out if they have additional information on finding a clinic or plan that will cover therapy for you or a loved one.

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

Questions To Ask Your Health Insurance

• Are mental health services included in my insurance coverage? 
• Are there specific mental health services/mental health professionals or therapists that my health insurance plan doesn't cover?
• Am I covered for therapy/therapists if I have a pre-existing condition?
• Will I be covered by insurance if I have had a mental health diagnosis?
• What if I want to take mental health classes to help loved ones?
• Does my plan cover emergency mental healthcare?  
• 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?
• Will there be any additional out of pocket costs to consider?
• Do I need a referral from my primary care doctor for a therapist?
• Does my state I live in versus that of my provider make a difference in coverage?
• Can you help me get an fmla for mental health? 

Insurance Network Providers

A network provider is a provider who accepts health insurance as a form of payment. In this case, health insurance partially pays for its clients' mental health conditions care. Although they may accept insurance for mental health coverage, a network provider is "inside" your health plan’s network. You may understand this process if you have incurred other medical costs in the past.

Insurance Coverage And Deductibles

How Insurance And Deductibles 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. They are probably the same ones you contact when you want to know more about medical services you can take advantage of as well.
• Even though your therapist takes your insurance plan, you may have to pay for each session out of pocket costs 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 Fees

• Some people find a behavioral health 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.

Low-Cost And Free Clinics

• 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). They generally offer outpatient mental health services to consider. Some universities 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. If these options are applicable to you, look into which behavior health and other mental health services they offer which could provide you assistance.

FSA And HSA Insured Coverage

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? Will It Affect What Insurance Plans Can Provide?

• Mental health parity laws don't always require insurance companies to cover therapy in all situations. The parity law stipulates that large group health insurance covers therapy, 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. An insurance plan must cover mental health services as well as medical and surgical benefits in the same ratio.
• If you have questions about what your health insurance company 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. On the other hand, if you are looking for a new plan, you may want to check out the health insurance marketplace to see options that are offered.

Online Therapy 

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 research that online therapy not only delivers successful treatment but also costs significantly less than face-to-face options over a year.

BetterHelp is an option to consider for those who think they can’t afford therapy or therapy copays. 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 psychologists, counselors, and licensed clinical social workers can receive access to your permanent medical record, allowing them to treat mental health and support substance use disorders with substance use disorder services. Online therapy may be the best way to get the mental health help that you want. Read below or our additional articles about what others have to say about their experiences with BetterHelp.

BetterHelp Therapy And Therapist Reviews

Daniel Merchant, LPC

"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 recommend it, it's worth the money!"

Danny Drew, LPCC

"I had some trauma when I was younger that was severely affecting my life and my relationships negatively. I also didn't have even the kind of money to afford this service for a long period. 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."

Frequently Asked Questions (FAQs) About Counseling

Can insurance be used for therapy?

This depends on a few factors and varies among insurance plans, whether Blue Cross, Blue Shield, Aetna, Kaiser Permanente, Medicare, or any other plan. BetterHelp does not officially accept insurance or partner with any health insurance providers and partners. However, the Mental Health Parity Act currently requires that employers and others who provide access to group health plans must offer equal benefits for medical and mental health-related services. As a result, some major health insurance providers now cover online behavioral health and mental health services; all of which are covered by insurance. 

How do I know if my insurance covers a therapist?

The best way to find out if you can have therapy covered by your health insurance is to ask your provider by either calling a human resources department or human resources representative or by reviewing your health insurance coverage plan online.

How much does therapy cost?

In-person therapy prices will vary by therapist, location, and insurance plans. The cost of therapy through BetterHelp app subscription options ranges from $60 to $90 per week (billed every 4 weeks as a subscription plan) and it is based on your location, preferences, budget, and therapist availability. You can cancel your membership at any time, for any reason. 

Is getting a therapist worth it?

Whether you'd like to see a therapist for everyday life management and well-being or would like to tackle complex mental health concerns, literally everybody can benefit from therapy. Remember, there are many different types of therapy available and it may take time to find a therapist who is a good fit for you. Therapy is as beneficial as you make it, so it's absolutely worth giving a shot.

How do I find the right therapist?

When choosing a therapist, it's good to consider what their licensing and specialties are, and how those things align with your therapeutic needs. It may take time to find a therapist who feels like a good match. Even if they seem perfect on paper, you may find in your gut that they just aren't the right fit. With BetterHelp, if the therapist you are initially matched with isn’t a good fit, you can change therapists at any time right from your profile, no questions asked. This allows you more time to get started on your own betterment rather than having to go through your insurance or calling multiple therapist offices in your area which often have long wait times.

How often should you go to therapy?

Most people who see a therapist whether in-person or online have a session once a week. This allows a steady pace of communication with healthy reflection between sessions. BetterHelp subscription plans include one live session per week along with unlimited messaging with your therapist. If you would like more than one session a week, you can let your therapist know and reach out to the member advocate team to make an adjustment to your subscription plan. Ultimately, it's up to you how much you want to use the service. The best way to make use of your BetterHelp subscription is to have weekly live sessions with messages, journal writing, and group session communities in between.

How long does the average person stay in therapy?

The answer to this depends on a number of factors, including what you are seeking therapy for. If you just need advice or someone to talk to about a specific situation, one or two sessions may be all you need. However, many people will stay with a therapist for months or even years to work on more deeply rooted issues such as childhood trauma and negative thought patterns. After meeting your therapist, you can set up a general timeline for how long you may benefit from therapy. Remember that this can always change, you may decide to leave then come back, or you may add sessions over time as you see fit.

How long is a therapy session?

An in-person therapy session may range from 30-60 minutes, or even longer for special circumstances. On our platform, our therapists offer one 30-50 minute live therapy session per week, although other platforms like Talkspace or Amwell might differ. If you would like longer or more frequent appointments with your online counselor, please reach out to your therapist as well as the member advocate team to see if this is something we can accommodate. 

Conclusion: Accessing Therapy

In summary, the process of looking for a therapist and juggling insurance can be complicated with the many factors involved. Of course, the hope is that this article has given you the tips and tools to reach out to your insurers or insurance provider or even the health insurance marketplace to learn more. 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.

Don't hesitate - reach out with any therapy questions today via email or on our site.