Does Insurance Cover Marriage Counseling?

If you’ve decided marriage counseling is for you, that’s a huge step. However, the cost can be a big barrier for many. So, how much does marriage counseling cost? And can you claim it on your health insurance? Let’s take a look.

therapist sean abraham By Sean Abraham, LCSW
Queer women holding hands.

Updated on May 20, 2024

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In 2021, the CDC reported 689,308 divorces in 45 states plus Washington D.C. — that’s 2.5 divorces per every 1,000 of the population. While marriage counseling may not be able to completely transform those statistics, it can provide many couples with the tools they need to improve their relationship and get back to a place where both parties in the marriage are happier.

If you’ve decided marriage counseling is for you, that’s a huge step. However, the cost can be a big barrier for many. So, how much does marriage counseling cost? And can you claim it on your health insurance? We dive into these questions and more here, along with some reasons couples end up in marriage counseling, the different types of marriage counseling, and the key question: Is it worth it?

Reasons to Seek Marriage Counseling

There are many reasons a couple may seek marriage counseling. Kristian Wilson, a licensed mental health counselor with Grow Therapy, shares some common relationship issues that might lead two people to look for outside help.

Communication: Communication breakdowns, frequent conflicts, or difficulty expressing needs or emotions can lead to relationship stress, as well as conflict-resolution challenges, where couples end up stuck in repetitive patterns of disagreement or unresolved issues.

Trust: Infidelity, breaches of trust, or other forms of betrayal can all severely impact a relationship and result in couples seeking professional guidance to rebuild trust and navigate the aftermath.

Family: Family-related concerns such as differences in parenting styles, conflicts about child-rearing, or challenges in blending families can present tension in a partnership.

Money: Financial disagreements or conflicts related to money management, financial goals, or spending habits might cultivate resentment and frustration.

Sex: Issues with sexual intimacy, differing sexual expectations, or a lack of emotional connection can create marriage distress.

Life Changes: Major life changes like parenthood, career changes, relocation, loss of a loved one, health issues, or financial difficulties can strain a marriage.

Dissatisfaction: If one or both partners feel a lack of fulfillment or discontent, it can make couples emotionally disconnected and distant.

Life Goals: When couples don’t share the same goals, values, or aspirations, this can cause tension and conflict.

Additionally, some couples proactively seek marriage counseling to strengthen their relationship, serving to resolve current and potential concerns.

How Much Does Marriage Counseling Cost?

Once a couple has decided on marriage counseling, the next thing to consider is the cost.

The cost of couples or marriage counseling sessions can vary significantly depending on various factors such as location, the credentials and experience of the therapist, the length of each session, and the type of therapy being provided.

Does Insurance Cover Marriage Counseling?

Whether healthcare insurance covers marriage counseling depends on your insurance provider, policy, and coverage. Some health insurance plans may cover this type of therapy, but others might not include it in their list of services covered. Here are a few reasons why, shares Wilson:

Definition of Medical Necessity: Insurance companies typically have specific criteria to determine what they consider medically necessary for coverage. Some insurers may not consider marriage counseling medically necessary unless a diagnosed mental health disorder directly impacts the individual or couple.

Limited Number of Covered Therapy Sessions: Even if marriage counseling is covered, insurance plans may have limitations on the number of sessions covered, may require pre-authorization, or may impose specific treatment-duration restrictions.

The cost of couples or marriage counseling sessions can vary significantly depending on various factors such as location, the credentials and experience of the therapist, the length of each session, and the type of therapy being provided.

Insurance Plan Type: The type of insurance plan, such as an employer-sponsored or individual plan, can also influence coverage. Different plans may have other coverage options and limitations.

Out-of-Network Providers: If specific mental health services aren’t in-network with your insurance provider, the coverage may be limited, resulting in higher out-of-pocket costs for the individual or couple.

Kristina Anzell, a licensed clinical social worker (LCSW) with Grow Therapy, says, “One of the reasons insurance companies pay less for marriage counseling is because it is seen as preventative care rather than treating a problem.”

If you or your partner are interested in marriage counseling, it’s important to check with your health insurance provider whether individual or couples marriage counseling is covered, and if it is, how much you’ll need to pay.

If you’re still not clear on what exactly your insurance policy offers, call your health insurance provider and speak to a customer service agent. You can ask them about reimbursement, out-of-pocket costs, copays, and deductibles.

Does Medicare Cover Marriage Counseling?

Medicare has specific guidelines around its coverage of marriage counseling. Medicare Part B covers marriage counseling under the category of family counseling and mental health care.

If the counseling is carried out by a behavioral health care provider, such as a psychiatrist, physician, clinical psychologist, clinical social worker, or a nurse specialist, Medicare Part B covers 80% of the cost, proving especially helpful for couples on low-cost incomes. This makes the cost of marriage counseling, couples therapy, or family therapy through Medicare between $75.00 and $150.00 per session.

However, if the counseling is provided by a licensed marriage and family therapist (LMFT) that isn’t employed at a clinical facility or a staff member at the clinical offices of Medicare-eligible practitioners, Medicare doesn’t provide coverage. If you choose to be treated by an LMFT, you’ll need to pay out of pocket.

Marriage Counseling Without Health Insurance

“Generally, an individual marriage counseling session fee might range from $75-$200 for 45-60 minutes, and a couples counseling session cost might range from $100-$300 for 60-90 minutes,” says Wilson.

“Some therapists offer sliding scale fees based on income or financial need, making counseling more accessible for individuals or couples with limited financial resources. These fees are typically discussed and agreed upon during the initial consultation,” she adds.

Types of Marriage Counseling

The reasons that couples seek marriage counseling are varied and nuanced. Therefore, several methods and therapies are used in sessions to help with treatment and support. Each therapeutic approach is different and often tailored to the needs of every individual and couple.

Cognitive Behavioral Therapy (CBT)

Not only is cognitive behavioral therapy used to treat mental health conditions, but it can help couples work through their marriage issues, too. “CBT helps couples identify and change negative thought patterns and behaviors that contribute to relationship difficulties. It also helps with fostering healthier communication, problem-solving, and conflict-resolution skills,” advises Wilson.

The Gottman Method

Anzell describes the Gottman Method as “one of the gold standards in treating couples.” She says it looks at the relationship as a whole rather than only paying attention to the issues. It includes an in-depth assessment to help point out the strengths and weaknesses of the relationship, and an effective treatment plan is created.

Emotionally Focused Therapy (EFT)

EFT focuses on strengthening emotional bonds between partners, helping couples understand and address underlying emotions and attachment needs to create a secure and fulfilling relationship.

Positive Psychology Therapy

Positive psychology therapy emphasizes identifying and building on strengths, nurturing gratitude, positive emotions, and optimism within the relationship, and promoting overall well-being and resilience.

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Solution-Focused Therapy (SFT)

Solution-focused therapy helps couples explore their goals and strengths, focusing on finding practical solutions and implementing small, achievable changes that lead to positive outcomes in the relationship without too strong of a focus on past experiences..

Family Therapy

Family therapy is a branch of psychotherapy that focuses on interfamilial relationship issues and how to improve them. A family therapist is often an LMFT, but they can also be a psychologist, social worker, or counselor who also treats many kinds of mental illness.

Is Marriage Counseling Worth It?

Whether marriage counseling is effective or valuable depends on the couple involved, the relationship problems being addressed, and the commitment and effort both parties put into the process. “Both partners need to be willing to actively engage in therapy, be open to self-reflection, and actively work on the relationship. Without commitment and active participation, the outcomes may be limited,” points out Wilson.

Here are a few ways marriage counseling can help couples:

Creates a Safe Space

Marriage counseling provides a structured and safe environment where couples can express their concerns, improve communication, gain insights, and receive guidance from a trained therapist. A skilled marriage and family therapist (MFT) can offer perspective, tools, and techniques to help couples navigate challenges effectively and can act as a sort of unbiased mediator in situations that can be highly emotionally charged.

Resolves Issues

Marriage counseling can help couples resolve conflicts, improve communication, and develop healthier relationship patterns. It provides a space to address underlying issues, heal emotional wounds, and rebuild trust.

Strengthens a Relationship

Marriage counseling can help enhance communication skills, deepen emotional connections, and encourage greater understanding and empathy. It can also be an opportunity for personal growth and developing stronger bonds.

Prevents Future Challenges

Marriage counseling can equip couples with tools and strategies to navigate future challenges, improve problem-solving skills, and foster resilience within the relationship. It can help prevent minor concerns from escalating into more significant issues.

Ultimately, if your marriage and its longevity are important to you, “it’s definitely worth it to reach out for support at the first signs of dissatisfaction of your relationship—it might save you a ton of heartache,” notes Anzell.

Maybe you’re about to get married and think some pre-marital counseling might benefit you and your partner — it’s always better to be over-prepared than under-prepared.

What Is the Success Rate of Marriage Counseling?

What works for some couples may not work for others. Marriage counseling might not be successful at fixing relationship issues in all partnerships.

However, National Institutes of Health research showed that couples undergoing emotionally focused therapy (EFT) reported an 86% marital satisfaction rate. This may be due to the effectiveness of this type of therapy, where couples work on strengthening emotional bonds to create a secure relationship.

Wilson emphasizes, “Overall, the success of marriage counseling is a nuanced and individualized outcome. It’s advisable to work with a skilled and experienced therapist who can tailor the approach to your specific situation and provide guidance and support throughout the process.”

Is Marriage Counseling for Everyone?

Factors such as timing, a willingness to engage, and therapist compatibility will all affect how well couples take to marriage counseling. Ultimately, it may not be for everyone. Here are a few elements that might affect whether marriage counseling is right for a couple.

Individual Needs

Sometimes, a person may need individual therapy before or alongside marriage counseling to address any specific needs or mental health concerns. This could be of great help if personal challenges are affecting one or both people in the relationship.


Whether marriage counseling is sought as a preventative measure or for prolonged issues that have started to take their toll, the timing of counseling for couples can affect whether it’s a good fit or not. Ultimately, both parties need to be ready.


“In situations where there is domestic violence, abuse, or any other form of harmful behavior, it’s crucial to prioritize the safety of individuals involved. In such cases, other interventions and support systems may be more appropriate before engaging in marriage counseling,” advises Wilson.

It may be helpful to have a consultation with a mental health professional before you commit to marriage counseling to make sure it’s the right course of action for the relationship and both partners.

If you or someone you know is experiencing domestic violence, contact the National Domestic Violence Hotline at 800-799-7233 for immediate help.

Licensed Marriage Counselors Covered by Insurance

Whatever you and your partner decide, it’s important that the course of action you take suits both of you. Relationship distress, when left for too long, can be harmful to a person’s physical and mental well-being.

Anzel adds, “If you’re committed to staying [in the relationship] to work things out, your marriage can transform.”

Regarding using insurance to cover marriage counseling, it’s important to contact your insurance provider first to check what you are covered for. Also, click here for our excellent guide on understanding health insurance.

Grow Therapy is home to many excellent, qualified therapists who specialize in marriage counseling services, couples therapy, and relationships, as well as family therapy and individual therapy. Simply filter by the specialty you’re looking for and the insurance type, and find the right therapist for you and your loved ones.


  • A good marriage counselor possesses several key qualities: excellent communication and active listening skills, empathy, neutrality, and the ability to create a safe and non-judgmental environment. A skilled counselor should have expertise in couples therapy approaches, experience in addressing relationship issues, and a commitment to ongoing professional development.

  • A therapist should never tell you to end a relationship. That’s your decision and your decision only. If there is active abuse happening, the therapist will support you in getting to safety, but should not tell you what to do with your relationship status.

  • The diagnosis code for marriage counseling is Z63.0 — Problems in relationship with spouse or partner.

  • With hard work and dedication to look at yourself and what you bring to the relationship, your relationship has the potential to be better than you could have imagined.

About the author
therapist sean abraham Sean Abraham, LCSW

Sean Abraham is a licensed clinical social worker who works with those who have struggled with substance use, depression, anxiety, loss, communication problems, student life, as well as other mental health concerns.

This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.

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