Is Marriage Counseling Covered By Insurance?

Do marriage counselors take insurance?
on October 05, 2023
Read time: 10 mins
by Moraya Seeger DeGeare

Marriage counseling is a big step in any relationship — that naturally comes with a lot of questions about your relationship. 

While there’s a lot to consider, the cost of marriage counseling is a big factor in your decision. So, is marriage counseling covered by insurance? How do you know if your insurance provider is willing to cover the costs? 

With so many details to sort out, it’s important that you consider marriage counseling as a positive step in your relationship and try to work out the fine print as a team! 

What is marriage counseling? 

Marriage counseling is a form of psychotherapy and is seen as one of the best ways to deal with relationship issues, whereby a clinical psychologist helps the couple see things in a new way. 

These therapy sessions aim to give couples the tools to fix their relationship problems in a mature and healthy manner. Based on these counseling sessions, therapists can advise couples on whether they can move forward as a team, or if it could be time to break apart for the sake of their mental health and emotional well-being. 

If couples decide they need couples counseling, there are a number of factors to consider including what therapist to trust, the cost of couples therapy, and if your insurance covers these costs! 

How much does marriage counseling cost? 

The cost of marriage counseling varies depending on a number of factors, including the number of sessions, the treatment plan discussed, and the experience of the health professional in question. 

While similar in structure, couples therapy costs can also vary based on these conditions. 

Even though the costs can be off-putting, you should always choose a licensed professional. However, your choice of relationship counseling will directly affect if you can use insurance to cover the costs — making it an even more important choice! 

While this is a big factor, choosing your therapist is something you should consider as a team and ideally, you should prioritize finding the connection you need with your clinician. 

Is marriage counseling covered by insurance? 

The cost of marriage counseling can be offputting for many couples, as they’re worried they’ll be out-of-pocket if their chosen counseling services don’t work. 

In some cases, your insurance company will cover marriage counseling costs if they fit with certain requirements. Depending on your health insurance plan and your chosen network provider, you could be required to at least partial reimbursement — making family counseling more of a low-cost option.  

How can your insurance cover marriage counseling costs

1
In-network therapists: If a therapist is in-network, they have a contract with health care or health insurance companies to accept a set fee for each session. The cost of these sessions will vary on your deductible and copay amounts, which can vary depending on your agreed insurance benefits.
2
Individual health insurance: If you or your partner are given a mental health diagnosis, you can claim family therapy or individual therapy under your insurance as part of your treatment plan. This means that your out-of-pocket costs are much lower, and since you’re claiming under one person it can be easier to keep track of everything! However, it’s important to be aware that insurance coverage may not extend to the therapist that you require, and it’s less private due to the involvement of the insurance company.
3
Dual health insurance: If you’re both covered by insurance, and one or both of you have been given a mental health diagnosis, you can claim it on both of your insurance plans. By utilizing your insurance in this way, both parties are financially responsible for the marriage counseling sessions.
4
Use of out-of-network benefits: If your insurance provider offers out-of-network benefits, this expands the number of family therapists available to you — making it easier to find the right fit! However this scheme usually only warrants partial reimbursement, so these referrals won’t save you as much money as in-network options.
5
Affordable Care Act (ACA) insurance: This kind of insurance will only cover your marriage counseling if there is a genuine mental health condition identified. Although your relationship health is important, these are not classified as health issues under this scheme.
6
Employee Assistance Program (EAP): While standard insurance provided by your employer likely will not cover counseling sessions, they will be covered if your employer offers EAP.
7
Medicare: Family counseling is generally covered by Medicare Part B. For this to apply, the therapy sessions need to be directly related to the treatment and covered by a clinical social worker, a clinical psychologist, or a psychiatrist. If you’re being treated by a licensed marriage and family therapist (LMFT), this plan will not cover your therapy sessions as they may not be deemed medically necessary or as part of mental health treatment.

How do I tell if marriage counseling is covered by insurance? 

While there are a number of insurance plans that can cover your marriage counseling, it’s best to conduct proper research before committing to any therapy sessions. 

Since insurance companies are quite strict on the requirements, it’s best to speak to your provider to see what they will and won’t cover — making your decision with all the facts in hand! 

If your insurance won’t cover your therapy sessions, there are other avenues to explore, with some therapists offering a sliding scale of costs depending on your needs. 

Even though marriage counseling can seem expensive, remember that you can’t put a price on a healthy and fulfilling relationship with your spouse! 

Frequently Asked Questions

  • How do I know if a therapist takes my insurance?

    Reach out to the therapist or clinic directly through email to inquire about their acceptance of your specific insurance. It's important to note that their website may not provide a comprehensive list of all the insurances they cover. By contacting them directly, you can ensure that you have accurate and up-to-date information regarding your insurance coverage.
  • What if I find a therapist I like and they don’t take my insurance?

    It’s still worth reaching out to them to find out more information. "If you find a therapist who feels like a good fit but doesn't take insurance, or if you don't have insurance and still want to work with them, send an email anyway explaining what you want to work on and why their experience seems like it might be a good match,” says Seeger DeGeare. It is common for people to reach out and inquire about availability, but it does not speak to why they could be a good fit to work together.”
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