Does Insurance Cover Psychotherapy? Here’s How To Tell

A medical professional might well suggest that psychotherapy would be a good thing to consider as part of your plan to get your health profile back on track.

It can often be the case that residential treatment proves beneficial as part of the recovery process but one obvious question that might immediately come to mind is who is going to pay for that?

Does insurance cover services such as psychotherapy?

Here are some pointers on how to find out what help you might be able to get from your insurance provider with psychotherapy.

Mental health is a financial conundrum for many

Although some insurance cover does allow you to claim for psychotherapy there is often a bit of a dilemma for some patients to consider even when coverage is available.

The difficulty arises from the fact that a lot of insurance providers will provide an option where you can claim for therapy services. The general view is that they tend to only pay for what they deem to be medically necessary services.

In other words, you have to have a mental health diagnosis to confirm you require access to a treatment such as psychotherapy before they will pay.

Some patients are not entirely comfortable with having to go through this assessment procedure. There are so many recognized mental health conditions from stress to phobias, and mental illness, that insurance companies have a range of codes to apply to an insurance claim.

This shows that it is considered a regular aspect of insurance coverage to cover for treatment in relation to a mental health issue. It should not be a deterrent to making a claim, as long as you understand and are comfortable with undergoing a mental health diagnosis if this is required by your insurer.

Psychotherapy is a recognized treatment option and there is no reason why you should be worried about claiming if your insurer provides coverage.

What about if you have a company insurance scheme?

Legally-mandated health insurance provided by employers with more than 50 workers does not usually include mental health services as one of the benefits.

Even so, it is well worth checking as a good number of large companies recognize the benefits and do include the ability to claim for some therapeutic services.

Health benefits under the Affordable Care Act

If you are not part of a company scheme you may well have purchased a plan through the Healthcare Insurance Marketplace.

These plans have to cover essential health benefits, including mental health services and substance use disorder services.

All of these types of plans include a provision to cover mental health services.

Medicare and Medicaid also cover mental health services.

Your first port of call should be to contact your insurance provider and confirm what coverage they offer. They will be able to guide you in relation to what you are covered for and go through the claims procedure with you.

If it is considered that you would benefit from psychotherapy, for instance, there is a good chance that you have some level of insurance coverage for this option.