Can I use my insurance for couple therapy?

Most often, couple therapy is not covered by health insurance plans. Because relational problems (couple and family) are not considered a medical illness, insurance companies do not include them in their covered services.

When is couple therapy covered by insurance?

In order for a couple therapy session to be covered by insurance, one partner must be diagnosed with a mental health disorder, AND the session must focus on alleviating the symptoms of that disorder.

Do therapists at CityCouples™ accept insurance?

Because insurance requirements do not allow couple therapists to address relationship problems and dynamics in an equitable manner, we do not participate as in-network providers with any insurance companies.

If I meet the insurance company’s criteria, how can I use my insurance benefits?

If you would like to participate in couple therapy, and your situation meets the criteria for insurance to cover your services, the next step is to contact your insurance and inquire about your out-of-network benefits. Ask:

• Do I have out-of-network benefits?

• At what percentage rate do you reimburse for out-of-network services?

• Do I have an out-of-network deductible?

• Do you only reimburse for specific diagnoses?

If your insurance company offers out-of-network reimbursement, you will receive a percentage of your up-front costs, once you have met your deductible.

Please note: Only fully licensed therapists may act as out-of-network providers. If your CityCouples™ therapist is fully licensed, they will provide you with the necessary paperwork to submit to your insurance company for reimbursement.

Why have I not heard about the limitations of using insurance for couple therapy before?

Sometimes, therapists do not fully disclose what is required for couple therapy to be reimbursed—especially if they are accustomed to billing insurance for their services.

Whether or not you choose CityCouples™ as your couple therapy provider, make sure to ask your chosen therapist whether they are issuing a diagnosis for you or your partner in order to bill your insurance. A mental health diagnosis will remain on your health insurance record, and you therefore should understand all information being submitted to your insurance company.

In addition, if you contact your insurance company and ask if they cover couple therapy, they will simply say, “yes.” In order to understand the requirements for insurance companies to pay for sessions, you must ask more specific questions (which we provided above.)

Please contact us with any questions about insurance coverage.

If you’re ready to get started with therapy, request an appointment.