Insurance Often Includes Mental Health Coverage: Check Policy for Details
Updated March 17, 2025
Accessible Online Therapy Through Insurance
Empower your mental health journey by taking advantage of insurance coverage for online therapy with licensed providers for copay-only fees.
Navigating the Cost of Mental Health Care Simplified
Securing the right mental health care often appears challenging, especially when considering the financial aspect. Common concerns revolve around the presumed high cost of therapy. However, reality may present a more hopeful outlook.
Through insurance coverage, therapy might be more accessible and affordable than expected. In many cases, insurance plans may cover a substantial portion, if not the entirety, of therapy expenses. For those lacking health insurance, various avenues exist to secure the mental health care required.
Unsure if your insurance covers online therapy? We walk you through the intricacies of navigating insurance-covered in-person and online therapy. Equipped with this knowledge, you can prioritize your well-being effectively.
Is Your Insurance Therapy-Friendly?
Typically, health insurance offers some degree of mental health support due to laws advocating equal treatment for mental and physical health. However, insurance coverage for therapy hinges on an existing mental health diagnosis.
Additionally, coverage varies significantly depending on individually tailored health plans. Certain plans offer comprehensive coverage for multiple therapies and therapists, while others may impose more restrictions or require patients to contribute some costs.
Support for Mental Health Coverage
The Mental Health Parity Act of 2008
The Mental Health Parity and Addiction Equity Act (MHPAEA) is a federal law that mandates group health plans to provide equal mental health benefits compared to medical or surgical benefits.
The intent behind MHPAEA and the Affordable Care Act (ACA) was to build a system offering equal coverage for treatment of mental health disorders and addiction. Prior to MHPAEA's enactment, 49 million Americans did not have insurance, 2% had plans lacking any mental health benefits, and 7% had no substance use benefits.
Affordable Care Act (ACA)
The ACA, passed in 2010, aimed to reduce health insurance costs for those seeking coverage. It offers tax credits and cost-sharing reductions to make insurance affordable for low-income households.
Among other provisions, ACA established the Health Insurance Marketplace and mandates plans to provide specific essential health benefits, including mental health and substance use disorder services. Plans obtained through the Health Insurance Marketplace are required to cover mental health services, as well as substance use disorder treatments.
For mental health, Health Insurance Marketplace plans must offer:
- Inpatient and outpatient mental health services
- Behavioral health treatments (such as counseling and psychotherapy)
- Coverage for pre-existing conditions
- Parity protections ensuring reasonable cost-sharing (coinsurance, co-pays, and deductibles) are either the same or almost equal to those for medical and surgical benefits offered
Options for Insurance-Covered Therapy
Individual Insurance Plans
Individual insurance plans often include coverage for therapy and mental health services, making them a vital resource for those in search of support. These plans, purchased independently rather than through an employer, provide varying degrees of mental health coverage unique to each policy. Understanding the nuances of your individual plan is essential to access and utilize therapy services effectively. Some factors to consider include:
- Plan type (e.g., HMO, PPO, or EPO)
- Coverage limits and restrictions
- Out-of-pocket costs (e.g., deductible, co-pays, and coinsurance)
- In-network vs. out-of-network providers
- Coverage for different therapy modalities
- Telehealth options (possibly including online therapy)
Insurance Through Employer
Employer-provided health insurance (also known as group insurance) often incorporates mental health services, including therapy, for employees. However, the extent and nature of this coverage can vary, particularly between small businesses and large corporations.
Small Businesses (50 employees or fewer)
Small companies may offer more limited plans with a smaller network of therapists. Nevertheless, they are required by law (Affordable Care Act) to supply mental health coverage if they offer health insurance.
Larger Corporations (51 employees or more)
Larger employers, unlike small businesses, are not obligated to comply with ACA. Nevertheless, they usually provide more comprehensive health plans. These plans often boast a broader network of therapists, offering more options for employees to find suitable mental health care.
In addition, larger corporations may possess more resources to negotiate favorable deals with insurance providers, translating to better therapy session coverage for employees. Employees in these settings should explore the mental health benefits offered, including various therapy options ranging from traditional in-person sessions to innovative telehealth services, such as our site.
Employee Assistance Programs (EAPs)
Some companies extend further support to employee mental health via Employee Assistance Programs (EAPs). These programs offer immediate, short-term counseling at no cost to the employee, separate from standard health insurance benefits.
The Children's Health Insurance Program (CHIP)
CHIP, a state-based program, offers low-cost health insurance for low-income families with children. Coverage of therapy and related mental health services differs between states, but most plans usually include therapy, counseling, medication management, peer support, social work services, and substance use disorder treatments.
Medicaid
Medicaid, a collaborative federal-state program, supports individuals and families with low income and limited resources. The extent of therapy coverage under Medicaid varies significantly by state, as each state has its own program rules and coverage limits. Generally, Medicaid must cover any essential health benefit, which includes mental health services and substance abuse services. Similar to CHIP, Medicaid plans will vary from state to state, but they must still adhere to MHPAEA requirements.
Medicare
Medicare, primarily serving individuals aged 65 or older as well as some younger individuals with disabilities, offers mental health coverage through various parts of its program:
- Medicare Part A: Covers inpatient behavioral healthcare and substance use services, but may require deductible and coinsurance costs for hospitalization.
- Medicare Part B: Offers coverage for outpatient mental health services, including individual and group therapy sessions, as well as psychiatric evaluations and preventive services like depression screenings.
- Medicare Advantage (Part C): Covers therapeutic services at least at the level of the original Medicare plan or better.
- Medicare Part D: Includes coverage for prescribed medications necessary alongside therapy.
Our site offers Medicare-covered therapy in certain states, with more states coming soon (Medicare Advantage does not cover our site at this time).
Therapy Costs: Insurance vs. Self-Payment
The average cost of therapy with insurance typically ranges from $20 to $50 per session, depending on your insurance plan. Without insurance, therapy sessions can cost significantly more, usually between $100 and $200 per session. These costs vary based on the therapist's location and expertise. For uninsured individuals, options such as sliding scale therapy fees, community health centers, or online therapy platforms can provide more affordable therapy services.
Types of Therapy Covered by Insurance
Insurance coverage for mental health services and treatments can change based on the insurance company and specific health plan:
- Treatment for co-occurring behavioral health and medical conditions (e.g., dual diagnoses, like depression combined with addiction)
- Psychiatric emergency care
- Talk therapy (e.g., cognitive behavioral therapy and psychotherapy)
- Telemedicine or online therapy
- Outpatient therapy sessions
- Addiction treatment
- Detox services
Marriage counseling and couples therapy are typically excluded from insurance coverage, but affordable couples therapy options are available through online platforms like our site.
"Behavioral health therapy and support for substance abuse disorders are usually covered by most insurance plans and should be comparable to medical care coverage, depending on your plan type. Familiarize yourself with the specific terms of your health insurance plan to better understand what providers and services are available to you."
Discovering if Your Insurance Covers Therapy
To determine if your health insurance covers therapy within your specific health insurance plan, follow these simple steps:
1. Check Your Online Insurance Account
If you haven't already, register your account online with your insurance company. Most plans have websites offering information about coverage and related costs. To ensure accuracy, be sure you're viewing information for your exact insurance plan.
Consider the necessity of finding a therapist or provider within your plan's network, as using an out-of-network provider may lead to additional fees.
2. Contact Your Insurance Provider
You can also call the provider directly. Look for a toll-free number on the back of your insurance card. Ask about the mental health benefits offered by your plan, as well as out-of-pocket costs you should be aware of.
3. Inquire with Your Employer's HR
If you have insurance through your company, contact your Human Resources (HR) department with any questions.
4. Consult Your Therapist
Before seeking mental health support, feel free to ask a prospective therapist if they accept your insurance. Always verify with both the therapist and your insurance company to be certain they are in-network.
"Finding the right, licensed therapist might take time, depending on your specific needs and preferences. Exploring the reimbursement rates and session limits can help streamline the search for a suitable therapist. Our site offers access to licensed therapists and prescribers, with options for self-pay and plans through your employer or school."
What to Do if Therapy Isn't Covered
If your insurance does not cover therapy, alternative options can be found:
- Employer Benefits: Check if your workplace offers an Employee Assistance Program (EAP), which may provide free, short-term counseling.
- Sliding Scale Therapy: Many therapists offer fee adjustments based on income, providing sessions at reduced rates.
- Community Health Centers & University Clinics: These often offer low-cost or free therapy sessions, including services from supervised graduate students.
- State & Federal Assistance: Programs like Medicaid and local mental health initiatives may offer low-cost or free services.
- Support Groups & Hotlines: Resources like NAMI and SAMHSA provide emotional support and advice.
While insurance makes therapy more accessible, these options can help you find support without coverage.
Online Therapy: A Digital Mental Health Revolution
Online therapy offers convenience and greater privacy, making it appealing for those hesitant to seek mental health support or those leading busy lives. Online therapy sessions can be as straightforward as logging onto a platform or application.
Wondering if your insurance covers online therapy? Our site is supported by various mental health providers and insurance companies, including Cigna, Anthem, Optum, and TRICARE, among others[5][6]. To find out if your employer or health plan will cover your therapy, reach out to your specific insurance provider and plan. If therapy is covered by your insurance, learn how to find a therapist online with us.
References
[1] American Psychological Association (APA). (2021). Parity for mental health and addiction. https://www.apa.org/ptsd-guidelines/
[2] Centers for Medicare & Medicaid Services (CMS). (2021). Comparing insurance coverage in Medicare Advantage and Original Medicare - parity protections for mental health and substance use disorder services (fact sheet). https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet
[3] Frank, R. M., Beronio, K. M., & Glied, S. A. (2014). Behavioral health parity and the Affordable Care Act. Journal of Social Work Disability and Rehabilitation, 13(1-2), 31-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334111/
[4] Murray, C. (2023, May 5). The average cost of therapy in 2023. Bankrate. https://www.bankrate.com/finance/credit-cards/average-cost-of-therapy/
[5] BetterHelp Contributors. (n.d.). Online therapy for individuals and couples - how to find a therapist online. BetterHelp. https://www.betterhelp.com/advice/therapy/types-of-therapy/online-therapy-for-individuals-and-couples-how-to-find-a-therapist-online/
[6] Carbonell, A., Leffert, D., & Dryden, A. (2019). The benefits of online therapy: Review and meta-analysis of its effectiveness. Journal of Medical Internet Research, 21(6), e12358. https://www.jmir.org/2019/6/e12358
- Insurance coverage for online therapy can enable more accessible and affordable mental health care, as some plans may cover a substantial portion or the entirety of therapy costs.
- To determine if your insurance covers online therapy, you can check your online insurance account, contact your insurance provider, inquire with your employer's HR department, or consult your therapist to verify their acceptance of your insurance.
- Some insurance plans and providers that cover online therapy include Cigna, Anthem, Optum, and TRICARE, among others.
- Online therapy can offer convenience and greater privacy and is appealing for those hesitant to seek mental health support or those leading busy lives.
- It can be essential to familiarize yourself with the specific terms of your health insurance plan, including out-of-pocket costs and what therapists and services are covered, to better understand what options are available to you.
