Does Insurance Cover Mental Health Therapy?

If you’re looking to start working with a mental health therapist, you’ve already taken  the biggest step. Working with a therapist can help grapple with mental health conditions like depression and anxiety. But does insurance cover mental health therapy?

This guide covers  answer that questions and reviews the pros and cons of using insurance for therapy.

So what’s the deal — does health insurance cover mental health therapy or not? The short answer is yes, it does — most of the time.

Read on for details along with answers to other questions you may have about insurance and therapy.

Does Insurance Cover Therapy?

Most insurance policies cover mental health services, such as ADHD therapy, depression therapy, anxiety therapy, and  insomnia therapy, at least to some extent. These services are typically listed as “behavioral health” in insurance plan policies. Therapy may also be included under “outpatient” services.

And the Mental Health Parity and Addiction Equity Act of 2008 dictates that mental health benefits offered under insurance plans are comparable to (or better than) physical health or surgical benefits. 

If your plan offers different coverage for in-network and out-of network therapists, it’s important to know the difference and pick a therapist that is in-network. 

Also know that behavioral health coverage on insurance plans ranges from full coverage to no coverage at all. That means some insurance plans may not cover therapy. And in some cases, insurance plans only cover therapy and other mental health services when deemed “medically necessary.” 

To find out what your plan covers, see your benefits summary or call the number on your health insurance card. Also check to ensure your chosen provider is in-network before your visit. Most providers can tell you if they take your specific insurance.

Types of Health Insurance Plans that Cover Mental Health

The U.S., doesn’t have a centralized form of health insurance. This means that people are insured through many different companies and plans.

You may get  health insurance through:

• Employer-sponsored insurance at a large company: Companies with more than 50 full-time employees are legally required to provide health insurance. Due to the Mental Health Parity Act, the plan must cover therapy and other mental health services.
• Employer-sponsored insurance at a small company: Companies with fewer than 50 full-time employees aren’t legally required to provide health insurance, but behavioral health services must be covered if they do choose to offer insurance. 
• Healthcare Marketplace: People who don’t have insurance through their employer (for example, freelancers and gig workers) can sign up for individual or subsidized health insurance through the Healthcare Marketplace. These plans include private plans as well as federal plans. Due to the Affordable Care Act, all Marketplace insurance options must cover behavioral health services.
• Medicaid: If you meet income eligibility requirements, you may be covered under government-sponsored insurance plans like Medicaid. Medicaid covers mental health services including therapy.
• Medicare: Federally-sponsored Medicare is available to people over 65. Medicare Part A covers inpatient mental health services (hospitalization). Part B covers outpatient behavioral health services, including therapy and an annual depression screening.

What Types of Mental Health Services Are Covered by Insurance?

You might also be wondering what services arecovered by health insurance. Does any type of mental health therapy qualify?

The types of mental health services covered by insurance depend entirely on the insurance plan that you have. You should read the details of your insurance plan or call them directly to find out if the type of therapy you need is covered.

In general, some common mental health services covered under many insurance plans include:

• Diagnosis and assessment; for example to arrive at an ADHD diagnosis.
• Outpatient behavioral health services, like therapy or substance-abuse counseling
• Group therapy
• Emergency psychiatric services, for example hospitalization due to suicidal thoughts
• Psychiatry services or medications, for example, antidepressants
• Online therapy
• Inpatient behavioral health services, like “rehab” for substance use
• Medical detox services for drug and/or alcohol addiction

In some cases, your insurance plan may put an upper limit on the amount of money or time that’s covered. For example, you may have maximum coverage of $5,000 a year or eligible for coverage for  inpatient behavioral health stay for a certain amount of time.

Some  therapy methods may also not be covered under an insurance plans. For example, psilocybin-assisted psychotherapy, art therapy, equine therapy, and others are often not covered. 

Pros and Cons of Using Insurance to See a Therapist

Even if your insurance plan covers behavioral health services, there are some reasons why you might choose not to use insurance to see a therapist. 

Pros

• For most people, cost is the most important reason to use insurance. Your insurance co-pay is less than a therapist’s full fee. For example, you may pay $50 per visit compared to $200. You plan may also have a lower negotiated rate with their in-network providers, so when you’re paying toward a deductible, you pay less as well.
• You may find it more convenient to find a therapist through your insurance plan’s network. You plan includes access to a list of therapists within its network. You simply need to choose from that list, so there’s may be less research involved.
• Unless your insurance provider changes, you know f how much you’ll be charged for therapy.

Cons

• The therapist you want to work with may not accept your insurance plan. More and more therapists don’t accept any insurance at all. This means that your options may be limited if you’re only able to see therapists who are in your insurance company’s network.
• It may go on your health record that you live with a mental illness or require mental health treatment, especially if services are medically necessary. This could be considered a “pre-existing condition” moving forward. However, this is a small concern and doesn’t outweigh the need to get help. HIPPA protects the privacy of your information, and pre-existing conditions may not affect you.  
• Some types of therapy aren’t covered under insurance. Even if these therapy methods are helpful to you, you may not be able to get coverage for under your insurance. 

How Much Does Mental Health Therapy Cost if I’m Not Covered by Insurance?

Most insurance plans do cover therapy and other mental health services if you can’t afford therapy out-of-pocket. If you don’t have any type of health insurance, you’ll need to pay out of pocket. Therapists may charge anywhere from $85 to $300 per session. Some specialists charge even more. 

How Can I Get Therapy without Insurance?

Klaritys marketplace of mental health providers makes it easy for you to access therapy with no insurance. Klarity let’s you bypass insurance companies and get access to qualified mental therapy providers right away.

You can start your therapy journey today with Klarity by taking a free self-assessment.