From Cosmopolitan · Syeda Khaula Saad · · 1m 20s
Does Insurance Cover Couples Therapy?
How to navigate couples therapy costs with insurance
In brief
How to navigate couples therapy costs with insurance Insurance covers couples therapy only if at least one partner has a diagnosed mental health condition and therapy is medically necessary Originally reported by Cosmopolitan.
Insurance Basics
Health insurance typically covers couples therapy only if at least one partner has a diagnosed mental health condition and therapy is deemed medically necessary.
Verify Coverage
Ask your insurance company directly about out-of-pocket costs using your NPI number and tax ID to ensure the therapist is in network.
Deductible and Co-pay
A deductible is the amount you pay before insurance kicks in. A co-pay is a fixed fee per session, like $25 for therapy.
Coinsurance
Coinsurance is the percentage of the therapist’s fee you pay after meeting your deductible, such as 20% of $200 equals $40 per session.
Out-of-Network
Out-of-network therapy requires upfront payment and reimbursement via a superbill or out-of-network claim.
Sliding Scale Options
Therapists offering sliding scale services adjust fees based on income, helping couples with limited budgets.
Pro-Bono Therapy
Some therapists provide free sessions while they work toward full licensure or as part of their internship program.
Biggest Mistake
Assuming health insurance covers couples therapy without verifying with your specific plan.
The key point
Insurance covers couples therapy only if at least one partner has a diagnosed mental health condition and therapy is medically necessary
