The cost of therapy is often a major barrier to treatment. But, many people don’t realize that their health insurance covers mental health services, making the path to improved mental wellness more affordable.
Every health insurance company and plan is different, but generally speaking, your insurance likely does cover mental health, reducing your out-of-pocket costs for therapy services. Understanding your insurance benefits is key. Keep reading to learn all about using insurance for therapy and mental health.
Does insurance cover therapy?
In most cases, yes, insurance covers therapy services through your health insurance plan’s mental health benefits. However, the exact coverage will vary based on your insurance company.
Sometimes, you may just pay a low copay (also known copayment), which is a fixed fee per visit. Or, you might have to pay a coinsurance amount: a percentage of the cost of services. Some health plans may have a deductible you must meet — meaning an amount of money you have to spend before it starts paying for services.
If you use insurance for therapy, your provider must diagnose you with a mental health condition, which becomes part of your medical record. Some people prefer to pay out-of-pocket for therapy to maintain privacy and avoid potential insurance restrictions
Want to know exactly what therapy will cost?Check your coverage on Grow
In the US, certain mental health coverage is mandated by law. The Mental Health Parity and Addiction Equity Act of 2008 ensures that if an insurance plan covers mental health care, it must do so at the same level as medical or surgical care. However, not all plans are required to offer mental health benefits, and certain employer-funded plans may have exemptions.
Additionally, the Affordable Care Act (ACA), enacted in 2010, deemed mental health and substance abuse services “essential health benefits.” This means that all government marketplace plans cover behavioral health and mental health services. Medicaid and Medicare must also cover mental health.
Did you know?
Under the Mental Health Parity and Addiction Equity Act, insurance plans that cover mental health must do so on comparable terms to physical health care — meaning your therapy coverage can’t have stricter limits or higher cost-sharing than comparable medical services.
Does insurance cover online therapy?
Most insurance companies cover telehealth appointments, including online therapy. The COVID-19 pandemic led to the rise of telehealth and insurance coverage of virtual services. The benefits of online therapy are numerous, including increased accessibility to more mental health professionals and no commute to a provider’s office. To make sure that your insurance plan covers services through an online therapy platform, contact your insurer directly.
Does insurance cover couples therapy?
Couples therapy is often not covered by insurance unless at least one partner has a mental health diagnosis and the therapy is aimed at treating that condition. Some insurance plans may offer partial coverage, so it’s best to check with your provider about specific benefits.
When it comes to therapy, a diagnosis is typically required to determine medical necessity, which then prompts the insurance company to cover the treatment. Since couples therapy tends to focus on relationship problems, not mental health conditions, it’s usually not covered.
However, if there is an underlying mental health condition that is contributing to the relationship issues, you might be able to get some coverage. Still, it depends on your insurance. You can read more about couple’s therapy insurance coverage here.
What are the pros and cons of using insurance for therapy?
There are various pros and cons of using insurance for therapy, including:
Pros:
More affordable mental health care
Potential low-cost — or even no-cost — treatment, depending on your plan
Therapy costs might apply toward your overall deductible
Cons:
It limits your selection of therapists to ones who are in-network (if you don’t have out-of-network benefits)
Some highly experienced therapists or therapists who specialize in less common treatment modalities do not take insurance
Copays, coinsurance, and deductibles may be high for some plans
Mental health professionals who accept insurance might have longer waiting times/waiting lists to start treatment
Want to use insurance?See which therapists are covered by your plan
How can I check whether my insurance covers therapy?
There are a few ways to check whether your insurance covers mental health treatment.
Check your plan’s website or documentation
If you have a hard copy of your plan documents, check those. If not, check your insurance carrier’s website for the Summary of Benefits and Coverage (SBC). The SBC will clearly outline what’s covered.
Call your health insurance company
Check your insurance card to find the Member Services phone number. Once connected, ask the following questions.
Does my plan cover therapy?
How much is my copay or coinsurance for therapy?
Do I have to reach a deductible?
Do I need a referral for therapy?
Is there a limit on the number of sessions insurance will cover?
Does my plan offer out-of-network benefits? If so, what are they?
Use a provider like Grow Therapy
Grow Therapy can help you find a skilled therapist who’s covered by your health insurance.
Once you find a provider you’re interested in, we can verify insurance for you. We will ask for your plan information and then check if your insurance is accepted and give you a cost estimate.
Therapy costs can vary significantly depending on your coverage, but the average cost of therapy for people who use Grow Therapy is $0-$50 per session. Your individual cost will vary depending on your plan’s deductible, copay, and provider network.
Find a therapist covered by your insurance
Grow Therapy accepts over 125+ plans, with thousands of therapists and prescribers across all 50 states. Find your therapist match on your terms and budget.
What’s the difference between in-network and out-of-network?
There are two different types of providers: in-network and out-of-network. An in-network provider has a contract with your insurance company. This means your insurance will cover the services of an in-network provider, and you will just have to pay any applicable copay or coinsurance rate.
Out-of-network providers are not contracted with your insurance company. They might not accept any insurance plans at all, or they just may not accept your specific plan. You can still visit an out-of-network provider, but it will be more expensive. You might have to pay full price out-of-pocket to see them. In some cases, your insurance may offer out-of-network benefits to help you pay for out-of-network providers. Check with your insurance to ask if they offer out-of-network benefits and if so, any guidelines.
Do I need a referral to see a therapist with my insurance?
Whether or not you need a referral depends on your insurance. Many insurance plans, especially PPO (preferred provider organization) plans, do not require a referral to see a therapist. However, other insurance plans might require you to get a referral from your primary care physician for insurance to cover your therapy. Check your Summary of Benefits and Coverage or call Member Services to see if your plan requires a referral.
What should I do if my insurance denies coverage for therapy?
Request a written explanation of the denial, then contact your insurer to ask about the appeals process. Common reasons for denial include missing referrals, out-of-network providers, or lack of prior authorization — most are fixable. You have the right to appeal, and your therapist’s office can often help with documentation.
Will insurance reimburse me for therapy?
If you have out-of-network benefits, your insurance may reimburse you for some of your therapy costs if you see an out-of-network provider. Always check with your insurance beforehand to clarify guidelines around out-of-network benefits and reimbursements.
Therapists can provide you with a “superbill” to submit to your insurance. Some therapists do this automatically, but you may have to ask for one. The superbill will include your provider’s details, dates of service, service codes, diagnostic codes, and fees. Your insurance will review this superbill and reimburse you accordingly.
Keep in mind that you may not get reimbursed the full amount, and it’s possible that your insurance might deny a claim altogether. Often, out-of-network reimbursements are for an “allowable amount,” which is what your insurance carrier deems an appropriate fee for the service — and this may be less than what your therapist charges. Reimbursement rates vary by insurance provider and plan.
Does my therapist file insurance for me?
Generally, your in-network therapist should bill insurance for you. When you first start seeing them, they will ask for a photo of your insurance ID card so they have all the necessary plan information. Your provider will file the claim with insurance, and you will pay the copay or coinsurance for your therapy sessions directly to your therapist.
Final thoughts
Using insurance for therapy is one of the most effective ways to reduce out-of-pocket costs — but it does require a bit of upfront research. The most important steps are confirming your plan covers mental health services, understanding whether you need a referral, and verifying that your therapist is in-network before your first session. Grow Therapy handles insurance verification and billing for you, so you can focus on finding the right therapist rather than navigating paperwork.
Find a therapist covered by your insurance.
Enter your plan details to see in-network therapists with availability — and get a cost estimate before you book.
Covered by Medicaid?Read our guide to Medicaid therapy coverage
Frequently asked questions
What is a superbill and do I need one?
A superbill is an itemized receipt from your therapist that includes your provider’s details, session dates, service codes, and diagnosis codes. You submit it to your insurance for potential reimbursement if you see an out-of-network provider.
Can I use my HSA or FSA to pay for therapy?
Yes. Therapy is generally an eligible expense under both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This can be a useful option if you haven’t met your deductible or prefer not to use insurance.
What if my preferred therapist doesn’t take insurance?
If the therapist you want to see is out-of-network, you have a few options. First, check whether your plan offers out-of-network benefits — if it does, your insurance may reimburse part of the cost after you submit a superbill. Second, ask the therapist directly whether they offer a sliding scale fee. Third, consider whether HSA or FSA funds could offset the cost. Some people choose to see an out-of-network therapist for a limited time while continuing to search for an in-network provider who is a better long-term fit.
About Grow Therapy
Grow Therapy is an online therapy platform that meets you where you are. With thousands of providers, therapy and medication support, and insurance-covered care, starting therapy is faster, easier, and more affordable.
