Does Insurance Cover Therapy? Considerations For Affordable Mental Health Help

Updated October 22, 2024by Regain Editorial Team

If you’re interested in going to therapy, one of the concerns you probably have is how you’re going to pay for it. Even if you have health insurance, you may still be confused. Does your health insurance cover mental healthcare? Is therapy covered by insurance? Many may think that the law requires insurance companies to provide mental healthcare, but that isn’t necessarily the case.

The cost of a therapist can vary greatly based on many things, such as the area you live in and the therapist’s area of expertise. If you’re looking for affordable mental health help, you may need to understand your insurance company and insurance coverage, and the best way to do so is often to contact your insurance provider directly. If you find you don’t have sufficient coverage for traditional in-office therapy, online therapy may be an affordable alternative.

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Considerations when wondering whether insurance covers therapy

The answers to the questions, “Does health insurance cover therapy?” and “What exactly does my insurance cover?” may not be as simple as you might think. There can be many different types of health insurance coverage and different insurance plans available, which often means that some health insurance plans cover different things than others. Here are some things that you may need to know regarding insurance plans and mental health care.

What health insurance companies are required to offer

There have been some misunderstandings about how the Affordable Care Act impacted health insurance coverage. For instance, there is often a misconception that the law requires insurance or companies that deal with insurance to cover mental health care. However, that’s not entirely true. The ACA does not generally require insurance companies to offer comprehensive and extensive mental health care.

The ACA indeed made some notable changes for those that want coverage for mental wellness services. For example, this act states that health insurance companies can’t turn you down due to a mental health diagnosis, including substance use disorders. In addition, there may be some services you can take advantage of that are covered at no cost.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

However, this doesn’t necessarily mean that the company that manages your health insurance must offer coverage or that it’s mandatory for your insurance to pay for mental health services. The ACA typically only requires “parity.” This usually means that the coverage for mental health services needs to be equal to medical or surgical coverage. This doesn’t necessarily mean that you are getting good coverage for mental wellness services. Many people right now are on plans that provide little coverage for any medical service. This can mean you do not receive much coverage for mental health or medical services in general.

To answer the question, “Does my health insurance cover what I need?” you may have to analyze your current policy or keep these questions in mind when looking for insurance. When choosing insurance, it can be important to verify the type of coverage you’ll be receiving. And, if you have any questions, please make sure to contact your health insurance provider to find out exactly what is covered and what’s not. You can easily find contact information for your carrier on your insurance card.

It can be crucial to be aware of what your health insurance covers and what it doesn’t. That way, you’re less likely to be surprised by any unexpected bills.

Here are some things you might watch out for:

Limited necessity

In general, it used to be more common for health insurance companies to limit the number of therapy sessions that would be covered under insurance. While this isn’t always the case anymore, other limitations often still apply. For example, you may have an insurance plan that limits coverage to be “medically necessary.”

The potential problem with this is that many people can benefit from mental wellness services without an official diagnosis. For example, if you wanted to get counseling for marital problems or anxiety that doesn’t meet the requirements set in the DSM, your health insurance may not be able to cover the services.

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Limit on the dollar amount spent

Your health insurance may also include a cap on the amount it will cover in any given year. This usually means, even if you could benefit from continued services like sessions with your therapist, they typically won’t be covered if you have reached that dollar amount. Not only could this limit the number of therapy sessions that you finish in a year, but it could also influence which professional you choose to work with. Those with higher costs will likely be harder to work with because you’ll reach your spending limit faster.

Restricted options on who you can work with

Another way that coverage with your health insurance can be limited when it comes to mental wellness services is that you may only be allowed to work with certain mental health professionals. Your health insurance company may not work with the provider that you want to work with. This can mean that you will have to pay out of pocket for your sessions, or you may have to choose a different provider that your insurance will work with.

Why some therapists won’t accept insurance

You may run into a situation where you wonder, “Why doesn’t my therapist accept my insurance?” Sometimes, it may not be your health insurance company that is refusing to work with a mental health professional. There are many mental health workers, such as psychologists, that choose not to work with insurance companies. This is usually because the insurance companies refuse to compensate the professionals for what they consider a fair price.

Therefore, it’s often best to check with your therapist to see what types of plans with your health insurance they work with, if any. Depending on where you live, you may need to do some searching to find a therapist who will accept your insurance. Please contact your insurance provider with any specific questions or to understand what your options are.

Alternative options for therapy

If you don’t have coverage with health insurance or are interested in alternative therapy options, there may be several that you can choose from.

Things you can do at home

You may be able to do some things at home on your own to improve your mental health challenges, depending on what it is you’re facing. Some of the things below have proven beneficial for people with anxiety and depression and can also help treat other mental health disorders.

Self-Care – Practicing self-care can include eating right, exercising, meditating, getting sufficient rest, journaling, and more. Self-care can be nearly any activity that helps you take care of yourself in a healthy way. In general, everyone should focus on self-care each day, and if you have a mental health challenge, doing so often becomes even more important. 

Aromatherapy – Aromatherapy with essential oils can help reduce anxiety and boost your mood. This can be a great alternative treatment to try in addition to other more traditional forms of treatment.

Pet Therapy – Some people find support from emotional support dogs improves their mental health, and others enjoy horse therapy. You might choose to spend time with a pet if you have one, or you might visit a local animal shelter.

Free or low-cost alternatives to therapy 

If you’re looking for free alternatives to affordable mental wellness services, there may be some options that you can look into. For example, some churches provide free counseling services. While these services can be helpful, you may want to ask questions about the provider’s credentials. They may not have the same experience as a licensed mental health professional.

You can also try looking to see if there are any free clinics in your area. Many health centers offer free screenings or therapy for those that qualify for services.

There are also online forums that you may join. You can find one full of others working through the same challenges that you are. This can be helpful because it lets you know that you’re not alone. You may also receive tips and advice from others that know exactly what you’re going through because they have been through it too.

If you attend a university or are a student in school, you may have free counseling through your school. Schools often understand that students can face a wide array of challenges and usually provide free or very affordable counseling options.

A final option for affordable mental wellness services may be finding a therapist that offers a sliding scale fee. This typically means that the price you pay for your session will be dependent on how much money you make. If you don’t have much income, it’s likely you’ll be able to have a smaller session fee. This is something that many therapists do to make therapy sessions more affordable for everyone.

Online therapy

Another option for affordable mental wellness services may be online therapy. These sessions often have several benefits over traditional therapy sessions. They can be more affordable, for starters. But they can also be more convenient. You typically don’t have to take the time out of your day to travel to another location to talk with a therapist. You can connect with your therapist from anywhere that you have the internet or your phone.

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Online therapy can also be a great option if you are worried about divulging personal details about your life, actions, and thoughts. Meeting virtually rather than face-to-face helps some people feel more comfortable opening up.

As this study explains, online therapy can be as effective as traditional face-to-face therapy for treating a wide variety of conditions and concerns. Please don’t hesitate to reach out for professional support if you feel you’d benefit from it.

Takeaway

Insurance may cover therapy in some situations, depending on your healthcare plan and its specifications. You may find that only a certain dollar amount of mental health care services is covered, or that only specific mental health professionals are covered by your provider. It is generally best to contact your insurance provider directly to learn about all the details of your mental health coverage. In the case that you don’t feel your provider offers enough coverage for you to get the help you deserve, you might consider online therapy instead.

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