Are you considering therapy but worried about the cost of paying for sessions with a therapist? How do you know if your insurance covers therapy or not?
Well, whether or not insurance covers therapy is dependent on so many factors. Most health insurance policies cover mental health treatments like therapy, emergency care, substance abuse, and impatient hospitalization.
However, for these services to be rendered, the policyholder has to undergo a standard diagnosis that necessitates these services.
Perhaps, you are wondering if your health insurance covers therapy or you seek answers to other questions related to this subject matter, this is the best place to get all the information you need.
In this article, we would provide insights on health insurance and therapy; ensure you read to the end.
Does Insurance Cover Therapy?
According to the Affordable Care Act (ACA), health insurance policies are required to include coverage for mental health, which includes provision for therapy to policyholders if the need arises.
Aside from this mandate gotten from ACA, there are laws that assist people who seek mental health care. For example, the Mental Health Parity and Addiction Equity Act (MHPAEA).
This law was passed in 2008, and it required insurance companies to offer mental health services to policyholders who seek to need help in improving their mental wellbeing.
How to Know If Your Health Insurance Covers Therapy
In order to confirm your health insurance, there are steps you need to take. This would enable you to know if you have mental health treatment coverage or not.
Firstly, reach out to your insurance company and request a copy of the summary of benefits and your health insurance policy documents. This document will enable you to review what’s covered under your policy and how much you should prepare towards your care. You can also contact your HR department if you have group health insurance you are benefiting from at work.
For those who are on Medicare, you can contact centers for Medicare and Medicaid services to get more details on mental health coverage. You can also contact your insurance company if you have a Medicare Advantage plan to get more details about mental health services available for you.
What Type Of Treatment Does Health Insurance Cover?
Typically, health insurance covers a wide range of health-related issues. This type of insurance helps to cover the cost of medical treatment and other expenses of the policyholder.
However, for a mental health-related treatment to be covered under a health insurance plan, there has to be a diagnosis that necessitates the medical treatment. Your health insurance may cover emergency care, medications, impatient hospitalization, substance abuse treatment, psychotherapy, and partial hospitalization.
What Mental Health Treatment Does Health Insurance Plan Not Cover?
Although health plans can include coverage for a wide range of mental health treatments, you may not be offered mental health services for:
- Long-term mental health and addiction treatment.
- Addiction/mental health treatment that is medically unnecessary
- Experimental therapies
- Educational programs for mental health or addiction.
- Mental health treatment requested by a third party.
It is important to note that health insurance will not cover most mental health treatments. While you can receive coverage for other types of mental health issues, there are some that are not medically superfluous.
How Much Does Therapy Cost?
The amount your therapist bills for a mental health session is dependent on whether you have health insurance and the specific health plan you have.
The majority of mental health plans include health insurance deductibles that must be paid before the coverage starts.
Once you’ve paid your health insurance deductibles, you may also be required to pay a percentage of the cost of services.
To get a better understanding of how you will be billed for a therapy session, you can reach out to your insurance company for detailed and comprehensive information.
They are in the best position to explain what your health insurance plan covers and how much you will be required to pay out-of-pocket for therapy.
Does insurance cover couples therapy?
Couples therapy is usually not covered by health insurance policies since relationship problems are not regarded as mental health disorders. Most insurance policies provide coverage for couples therapy; however, it might be accessible in some circumstances if there are underlying medical conditions such as depression or anxiety.
If your health insurance policy does not cover couple therapy, you can check if your workplace has an Employee Assistance Program that offers mental health services for couples.
