Couples therapy is a powerful tool for resolving relationship problems and fostering well-being. It serves to heal and strengthen the bonds that exist between two individuals. However, the financial aspect of couples therapy can be a hurdle for many who seek therapy.
In this article, we’ll explore the ins and outs of insurance coverage for couples therapy, how to check your benefits, and where to find a couples therapist.
What Is Couples Therapy and Why Is It Important?
Couples therapy is a type of psychotherapy that focuses on improving a couple’s relationship. Couples therapy aims to help couples resolve conflicts, communicate better, deepen their emotional connection, and enhance their overall satisfaction with their relationship.
In 2021, the United States marriage rate was 14.9 per 1,000 women, with the average first marriage length being seven years. Couples therapy has become increasingly crucial in helping couples navigate the complexities of modern-day relationships.
Research has proven that healthy relationships reduce mortality risk by 50%. Conversely, negative relationships, such as constantly receiving criticism from a spouse or partner, can increase older adults’ mortality risk. These findings emphasize the need for interventions to reduce criticism in romantic partnerships and help couples adopt better communication skills.
How Can Couples Counseling Help?
Marriage and couples counseling provides invaluable assistance in navigating partnership challenges. Some of the common scenarios that can benefit from relationship counseling include:
- Addressing communication patterns causing conflict and hindering relationship progress
- Emotional intimacy issues after having a baby
- Adjusting to significant life transitions, such as an “empty nest”
- Dealing with infertility issues
- Coping with changes in intimacy
- Working on overcoming betrayal while rebuilding trust, friendship, and respect
- Making co-parenting work after a divorce
Common Types of Couples Therapy
Many couples therapy approaches provide support and guidance for different relationship issues. One commonly used approach is emotionally focused therapy (EFT), specifically designed for couples in high-stress situations like military couples, parents of chronically ill children, spouses or family members with severe disorders, and veterans with post-traumatic stress syndrome (PTSD).
Another approach is the Gottman Method, which focuses on addressing and overcoming marriage-ending behaviors. Cognitive behavioral therapy (CBT) helps couples improve communication and problem-solving skills. These therapies provide practical tools and strategies to navigate relationship issues and build a stronger bond.
Other Benefits of Couples Therapy
Statistics reveal the benefits of couples therapy. Behavioral and emotional-focused approaches are effective for 60 to 80% of distressed couples. Meanwhile, 90% of couples completing treatment with a trained couples therapist report improved emotional well-being, with 98% reporting an overwhelmingly positive therapy experience. Couples therapy can also benefit families dealing with eating disorders, fostering a more positive co-parenting dynamic.
Cost of Couples Therapy
Couples therapy is an investment that can bring immense value and benefit to your relationship and life. On average, couples therapy costs usually begin at $90 per hour. The price of therapy fluctuates in different states and cities.
Licensed marriage and family therapists (LMFTs) usually recommend couples counseling sessions weekly or biweekly, each lasting about an hour.
Therapy duration varies based on specific concerns and needs. Some couples resolve issues in a few sessions, while ongoing support benefits others. Each journey is unique, but most therapy models recommend three to 12 months.
Understanding Insurance and Couples Therapy
Having a comprehensive understanding of health insurance for mental health services is vital when you embark on couples therapy because coverage differs based on the provider, policy, and specific mental health diagnosis.
Insurance Companies’ General Stance on Couples Therapy
Couples counseling or marriage counseling is generally not covered by insurance companies as they don’t classify “relationship issues” as mental health disorders. However, there may be situations where insurance coverage is available for couples sessions if there are underlying health issues, behavioral health problems, or mental disorders diagnoses, such as depression, anxiety, or adjustment disorder.
In-Network vs. Out-of-Network Therapist
There are two types of providers: in-network and out-of-network. In-network providers have agreements with insurance companies, usually meaning lower costs for you. Out-of-network providers don’t have these agreements, resulting in higher expenses.
In many situations, you may need to pay first and file for a reimbursement from your provider. Always check your out-of-pocket expenses beforehand to avoid any surprise bills.
Find an in-network couples therapist
Does Affordable Care Act (ACA) Insurance Cover Couples Therapy?
While the Affordable Care Act (ACA) recognizes mental health care services as an essential benefit, couples therapy isn’t within its policies. Couples therapy isn’t specifically designed to treat illnesses or mental health conditions. Instead, its main focus is to assist individuals in improving their relationship and communication skills.
For couples therapy to be covered by the ACA, it must be considered medically necessary and directly related to a diagnosis such as depression, anxiety, or PTSD. Healthcare professionals must also prove that couples therapy is necessary as part of the treatment plans and beneficial for the patient and their overall physical and mental health goals.
Factors That Influence Coverage
As you may know, getting coverage for couples therapy can be a challenging undertaking. Understanding the factors influencing coverage is crucial in helping you navigate this process. Let’s dive deeper into some key factors that can impact coverage for couples therapy.
Therapy Type
The type of therapy you choose can impact your insurance coverage for couples therapy. Coverage may vary for marriage counseling, family counseling, or couples therapy. Reach out to your insurance provider to discuss your plan details and determine which types of treatment are covered. Remember, they’re there to support you in navigating this process.
Role of Diagnosis Codes
Diagnosis codes can play a critical role when seeking coverage for couples therapy. Mental health issues such as depression, bipolar disorders, and anxiety disorders may be more likely to receive coverage by insurance.
Billing Codes for Couples Counseling
You may be able to lower the cost of marriage counseling or extend the amount of covered sessions by using insurance billing codes under different family and couples counseling categories. You can submit your individual sessions under different codes. This method allows both you and your spouse to benefit from more visits.
Consider using codes 90832, 90834, or 90837 for individual therapy sessions without guests. In cases where your significant other is absent, the billing code 90846 is specifically for family and couples therapy. By closely collaborating with your LMFT, clinical social worker, or marriage counselor, you can maximize the mental health benefits you receive and minimize any unexpected out-of-pocket charges.
Alternative Insurance Options
Insurance coverage for couples therapy isn’t always guaranteed, but there are alternative options to help offset treatment costs. Consider these options:
- Employer-Sponsored Group Insurance: Many employers offer employee assistance programs (EAPs) that cover counseling, including couples therapy. Contact your benefits manager for your health insurance benefits details.
- COBRA: If your previous employer’s insurance or EAP covered couples counseling, it’ll continue under COBRA. Contact your former employer or insurance provider for more information.
- Medicare: Medicare Part B covers family counseling that aids in treatment and recovery and is provided by a behavioral healthcare provider. While couples counseling with a licensed marriage and family therapist may not receive coverage, exceptions exist.
- College Counseling Center: If you or your partner is still in school, you may be able to take advantage of the campus mental health system.
Remember, exploring these options can make couples therapy more accessible and affordable.
Tips to Mitigate Financial Burden
Couples therapy can be a wonderful way to strengthen your relationship, but it can also be quite expensive and insurance coverage may not always be available. The good news is there are strategies to help ease counseling costs. Here are some practical tips:
Talk to Your Insurance Provider
Before the initial session, reach out to your insurance provider to understand the specifics of their coverage for couples, relationships, or family therapy. They’ll give you a clear idea of copayments, session frequency, and any associated fees. It’s crucial to gather accurate information to avoid surprises.
Explore Sliding Scale Options
Many therapists offer sliding fee scales, adjusting their fees based on your income. Finding a therapist who’s willing to work with you and create a plan that fits your budget is essential. Don’t hesitate to ask therapists about sliding scales or other reduced-price therapy options.
Consider Using a Health Savings Account (HSA) or Flexible Spending Account (FSA)
HSAs and FSAs allow you to set aside pre-tax dollars for healthcare expenses. If your employer offers these options, you can use the funds in your account to cover couples therapy sessions. You may also explore using your spouse or partner’s HSA or FSA.
Look Into Employee Assistance Programs (EAP)
Many employers provide Employee Assistance Programs, confidential services designed to support employees with personal or work-related challenges. While EAP coverage may not cover all your therapy sessions, it can still be a valuable resource for those facing financial difficulties.
Explore Online Therapy Platforms
Online therapy platforms offer a more affordable option compared to traditional therapy sessions. You have flexible options to connect with licensed therapists via video calls. It’s important to choose a platform that aligns with your budget and thoroughly research the provider before making any payments.
Consider using Grow Therapy to find a couples therapist who fits your budget and your needs.
Remember, taking care of your relationship is important, and there are practical ways to make couples therapy more accessible and affordable.
Takeaways
Therapy isn’t just about mitigating problems. It’s also an excellent tool for understanding, personal growth, and self-awareness. With or without insurance, investing in couples counseling is essentially investing in the health and future of your relationship.
Therapy is a valuable resource, and understanding your insurance options will help make it more accessible. But even if insurance doesn’t provide the coverage you hoped for, remember there are alternative avenues and resources available. Grow Therapy understands the struggle to find help that fits all your criteria, and we strive to connect you with the best mental health professionals across the country.
In the grand scheme of things, your relationship’s health is priceless. When your relationship thrives, both partners also benefit from a wealth of mental, emotional, and physical health benefits. So, while numbers and policies play a role, the real essence lies in the commitment you and your partner are making toward a brighter, more understanding future together.
