Is Therapy Covered By Insurance Or Do I Have To Pay?
By Toni Hoy
Updated December 10, 2018
One of the first things people think about when they are trying to make a decision about attending therapy is how much it costs and how they will pay for it. Insurance laws and programs have changed drastically since the Affordable Health Care Act came into existence. You may be asking yourself, "Is therapy covered by insurance?" You may also be wondering if there are other ways to pay for it rather than filing a claim with your health insurance provider.
Is Therapy Covered by Insurance and Should I Use It as a Source of Funding?
Unfortunately, there are no fast and easy answers to whether your health insurance plan will cover your therapy sessions. Your health insurance provider will tell you whether they cover therapy and under what conditions they will cover it.
The law doesn't require them to pay for the total cost of therapy, if it's covered at all. They may cover a portion of the payments. They may also have a limit on the number of sessions that they will pay for or a total cap on the amount that they will pay. You may also need to pay a co-pay or satisfy a deductible before the insurance company pays their portion.
Many health insurance companies require that you first schedule an appointment with your primary care provider before they will approve costs for sub-specialties, which can include therapy.
You'll want to take into consideration that many counseling sessions aren't terribly expensive. It may be more cost-effective to just pay out-of-pocket. You'll find that the costs at BetterHelp.com are quite reasonable.
Another option to pay for therapy is a health savings account or flexible spending account. A health savings account is a savings account that allows users to save money tax-free to pay medical expenses ONLY. Needing counseling or therapy sessions is a good reason to dip into this account, and you get to use it at your own discretion.This information may have led you to understand that it doesn't make sense for you to request that your health insurance provider cover your therapy sessions; however, that is a personal decision and each individual should do what works best for their own financial stability.
Is Therapy Covered by Insurance Under the Parity Laws?
The parity laws have some effect on the benefits for therapy, but the laws don't require insurance companies to cover therapy in all situations. The parity laws require health insurance providers to cover mental health conditions on equal terms as physical health. This means they can bill you for co-pays and deductibles on equal terms with other illnesses.
Is There a Downside to Claiming Therapy Costs Using My Health Insurance?
There are some negative reasons for using health insurance to pay for therapy. Health insurance companies often need to have a diagnosis before they will pay your claims. This gives them the opportunity to ask your health provider any questions about your health and well-being. Anything that they learn goes into your health file, and you have little or no control over who can access it from there.
The reasons that led you to counseling may not be something that you want stored in your personal health file. You may not want to risk letting information out that could cause new problems in your employment or other personal matters.
Cost should never be a reason that you avoid getting help that you need. Claiming it under your health insurance is a personal decision. It's wise to learn all the pros and cons before making a final decision on how to pay for therapy sessions.