Is Therapy Covered by Insurance?

    Millions of American adults of all ages and backgrounds take part in therapy, counseling and other forms of mental health treatment regularly.

    In fact, data from the 2019 National Health Interview Survey shows that close to 10 percent of American adults reported receiving counseling or therapy during the last 12 months.

    If you’ve considered taking part in therapy, you may have concerns about whether or not you’ll be covered by your health insurance provider.

    Most health insurance providers provide coverage for therapy. In fact, many insurance plans, such as those purchased through the Health Insurance Marketplace, must offer coverage for mental health services by law. 

    Below, we’ve dug into the details about therapy and insurance, covering everything from what certain plans cover to what your options are if you’re not fully covered for therapy.

    We’ve also listed mental healthcare coverage information for several popular health insurance providers, including Kaiser Permanente, Blue Cross Blue Shield and UnitedHealthcare.

    Therapy and Health Insurance: The Basics

    • Most insurance providers, including employer-sponsored plans and state-run insurance services such as Medicaid, offer some level of coverage for mental health services.

    • If you have insurance through the Health Insurance Marketplace, you’re covered. The law requires that all plans offered through the ACA Marketplace offer coverage for mental health and substance use disorder services.

    • You can check your health insurance provider’s mental health coverage by contacting them directly, visiting your insurance provider’s website or, if you use employer-sponsored health insurance, talking to your company’s human resources (HR) department.

    • Some insurance providers may require you to be diagnosed with a mental health condition, such as depression or an anxiety disorder, to receive coverage for therapy or other mental health services.

    • Even if you’re not covered, affordable mental healthcare options, such as telepsychiatry and online therapy, can give you access to the professional help and support you need.

    Employer-Sponsored Health Insurance & Therapy

    If you have health insurance through an employer-sponsored policy, you may also be covered for mental health services such as therapy.

    Under the Affordable Care Act, “applicable large employers” (defined as employers with 50 or more full-time employees or their part-time equivalents) are required to offer insurance to their full-time staff members.

    While the law doesn’t require that mental health coverage is included in employer-sponsored health insurance, most employer-sponsored plans include mental health coverage.

    If you’re an employee of a company with 50+ employees, you can check your level of mental health care coverage by calling your insurance provider or reaching out to your company’s HR services department. 

    Under the Mental Health Parity and Addiction Equity Act (MHPAEA), health insurance policies that include mental health or substance use disorder services need to provide coverage that’s comparable to that provided for physical health issues.

    This means that if your plan is subject to federal parity laws, it needs to offer an equal level of coverage for mental health. 

    The National Alliance on Mental Illness provides more information on how mental health parity laws work, as well as what to watch for if you face issues accessing mental healthcare through your insurance provider.

    The Affordable Care Act and Therapy

    Under the Affordable Care Act, all health insurance plans purchased using the Health Insurance Marketplace need to provide mental health coverage as an essential benefit.

    If you purchased your health insurance plan through the marketplace, it must provide coverage for the following:

    • Behavioral health treatment, such as psychotherapy and counseling
    • Mental and behavioral inpatient services
    • Substance use disorder (substance abuse) treatment

    Marketplace plans are also required to provide certain “parity” protections for mental health and substance abuse services.

    This means that your health insurance can’t charge higher deductibles, copays or out-of-pocket limits for mental health services than for physical health services, or offer more restrictive terms for things like care management or the number of visits for which you’re covered.

    The precise benefits of your insurance plan may vary based on your state and the specific plan you select. 

    You can check what is and isn’t included in your plan when you compare insurance options using the marketplace.

    By law, marketplace insurance plans can’t deny or charge you more for mental health coverage based on pre-existing conditions. 

    They also can’t place annual or lifetime limits on the amount of coverage you receive for mental health and/or substance use disorder services.

    Medicaid and Therapy

    Mental health services, including therapy, are provided under Medicaid. In fact, Medicaid is the single-largest payer for mental health services in the United States.

    Like other health insurance plans, Medicaid plans are subject to the MHPAEA. This means that the level of coverage that’s provided for mental health and substance abuse services must be equal to that for physical health services. 

    Medicaid plans vary by state. The official Medicaid website provides state profiles that allow you to view key information about your state’s Medicaid program and eligibility.

    Not all therapists and mental health professionals accept Medicaid. You can find local therapists that accept Medicaid by contacting your local Medicaid office, or by searching using terms such as “Medicaid therapist in [location]” on Google.

    Medicare and Therapy

    Medicare Part B (medical insurance) provides coverage for many mental and behavioral health services, including screenings for mental health conditions and, if required, therapy.

    These include:

    • An annual depression screening
    • Individual and/or group psychotherapy
    • Famous counseling
    • Psychiatric evaluation
    • Medication management
    • Certain practitioner-administered medications and diagnostic tests
    • Partial hospitalization for psychiatric care
    • An annual “wellness” visit

    The amount of coverage provided by Medicare can vary depending on the specific service you need and the healthcare provider you visit.

    Make sure to contact the mental health professional before scheduling an appointment to check that they provide services under Medicare.

    The official Medicare website provides more information about outpatient mental health services and their costs.

    Health Insurance and Therapy FAQs

    Does Kaiser Permanente Cover Therapy?

    Kaiser Permanente offers personalized treatment for mental health conditions, including issues such as depression, anxiety disorders, personality disorders, bipolar disorder, problems related to sleep, eating disorders and substance use disorders and addiction. 

    You can view more information about Kaiser Permanente’s mental health coverage and services online.

    Does Blue Cross Blue Shield Cover Therapy?

    Most Blue Cross Blue Shield health insurance plans offer coverage for therapy and other mental services. 

    You can check your level of mental health coverage by viewing the “Outpatient Mental Health'' line of your policy’s Summary of Benefits and Coverage (SBC).

    Although rare, some Blue Cross Blue Shield plans may not provide coverage for therapy or place restrictions on your level of mental health coverage. 

    Does UnitedHealthcare Cover Therapy?

    Many UnitedHealthcare plans include coverage for therapy. If you have a health insurance plan with UnitedHealthcare, you can sign in to your health plan online or call UnitedHealthcare using the number on your member ID card to find out more about your level of coverage.

    How Much Does Therapy Cost With Insurance?

    The amount you’ll need to pay for therapy varies based on the level of coverage provided under your plan. 

    While some insurance plans may provide total coverage, others may require that you pay a copay at each therapy session. 

    If you’re concerned about the cost of therapy, it’s important to contact your insurance company before scheduling your first appointment with a therapist or other mental health provider.

    How Can I Check My Insurance Plan’s Coverage?

    Details of your plan’s mental health services should be included in its benefits description. If you can’t find this information, you can contact your insurance company or speak to your company’s human resources department for personalized information on your plan’s coverage. 

    How Much Does Therapy Cost Without Insurance?

    The cost of therapy can vary hugely based on where you’re located, your specific needs and the therapist you choose to visit. 

    In general, you can expect to pay $100 per hour or more for cognitive-behavioral therapy (CBT) if you don’t have insurance that covers mental healthcare services, or if you opt not to use your insurance coverage.

    If you don’t have insurance, online mental health treatment can help you to access therapy at a more affordable price. 

    How to Find the Right Therapist for You

    Whether you’re insured or not, there are several steps that you can take to find a therapist that can meet your personal mental health needs. 

    Use Your Insurance Provider’s In-Network List

    If your health insurance plan covers therapy, start by using your insurance provider’s in-network list to check for providers close to you. 

    Choosing a network provider (a mental health provider in your provider network) is usually the most cost-effective way to access therapy. 

    Search for Supported Providers Online

    Many therapists and mental health professionals advertise based on their support for Medicare, Medicaid and other programs. 

    You can find these providers by searching for “Medicaid” and the type of service, followed by the name of your city or region. 

    Visit a Therapist With Sliding Scale Pricing

    If you have a limited income, working with a therapist that offers sliding scale pricing can make therapy more affordable.

    Sliding-scale pricing involves adjusting the cost of therapy based on a person’s income. If your income is low, you’ll pay a reduced amount for each therapy session.

    Not all therapists offer sliding scale pricing. To find sliding scale therapists close to you, you can search for “sliding scale therapy” or “sliding fee therapy” using Google, followed by the name of your city or region.

    Use an Online Therapist Database

    Several online databases list mental health professionals, including therapists, and allow you to search directly for mental health providers in your area. These include:

    Get Help Through Your Campus

    If you’re a student and don’t have health insurance that covers therapy, try getting in touch with your college or university’s health services office. 

    Many campuses offer on-site mental health services for students, including therapy. If services aren’t available on-campus, your health services office may be able to refer you to a therapist in your area that offers their services to students.

    Talk to a Therapist Online

    Finally, one of the easiest ways to access therapy without insurance is by taking part in online individual therapy.

    Just like offline therapy, online therapy allows you to talk to a licensed therapist in a private and comfortable setting. 

    Instead of needing to travel to your appointment, you can schedule therapy when it’s convenient for you and take part from the privacy of your own home.

    Starting Therapy

    Most health insurance providers offer at least some level of coverage for mental health services such as therapy. 

    By law, coverage for mental health care is included in all plans sold through the Health Insurance Marketplace, as well as programs such as Medicare and Medicaid.

    Since coverage varies from one plan to another, it’s best to check with your insurance provider before you schedule an appointment with a therapist if you plan to use insurance. 

    If you don’t have insurance, options like sliding scale therapy, online therapy or online support groups can help you to the mental healthcare you need at a more affordable price. 

    Considering therapy? Our mental health resources share effective, science-based techniques from licensed therapists and mental health professionals that you can apply to make progress on your mental health journey. 

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.