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Insurance Coverage for Therapy: How Do I Pay for Therapy?

Westside Behavioral Care / Insurance Coverage for Therapy: How Do I Pay for Therapy?
Insurance Coverage for Therapy: How Do I Pay for Therapy?

If you have private health insurance, Medicaid, military coverage, or Medicare, it may cover mental health services such as therapy. Before you start therapy, you should check with your insurance plan to see what is covered.

Insurance companies vary in terms of which mental health conditions they cover. That means some insurance policies may not cover certain mental health disorders.

Your employer may also offer an employee assistance program. These programs typically offer one to eight sessions of mental health treatment for free or at a very low cost. Your spouse or partner may also be eligible for these benefits.

Government-sponsored health care programs are another potential source of mental health services. These include Medicare for people age 65 and older and people with disabilities, as well as health insurance plans for military personnel and their dependents. In some states, including Colorado, Medicaid programs also cover mental health services.

Look on the back of your insurance card for a phone number for mental or behavioral health or call your insurance company’s customer service number. Before your first psychotherapy appointment, ask your insurer the following questions:

Does my plan cover mental health services?

Do I have a choice about what kind of mental health professionals I can see?

What kinds of treatments are covered and excluded.

Is there a deductible? In some plans, you have to pay a certain amount yourself before your benefits start paying. Also ask how much the deductible is, what services count toward your deductible and when your deductible amount starts over again. Some deductibles re-set at the first of the year, for example, while others re-set at the beginning of your employer’s fiscal year.

What is my co-payment? Your plan probably requires you to pay for part of treatment yourself by paying either a set amount or a percentage of the fee directly to your therapist for each treatment session.

Is there a limit to the number of sessions? This article was paraphrased from a publication by the American Psychological Association.