If you are considering having couples therapy, we can help you. Heal Your Roots Wellness has a team of telehealth therapists with experience helping couples with their relationship. Founded in Philadelphia, Heal Your Roots Wellness therapists will examine communication styles, and behavior patterns so she can understand how you work together. Please note, your relationship does not need to be on the verge of a break up for you to attend couples therapy. You can simply have the therapy should you wish to have a little help.
Many people ask how does couples therapy work with insurance? We can help you to understand this and so you know where you stand.
How Much Does Couples Therapy Cost?
Without any insurance, couples therapy can cost between $80-$250 an hour. However, costs can differ depending on who your therapist is, how experienced they are, how busy the therapist is, and where they are located.
Couples counseling can be quite demanding work, and the therapist needs to ensure that both parties are looked after. This is one of the reasons why couples therapy costs more than individual therapy.
When you enter couples therapy, you will have an intake session together. This session will help our therapist to explore the way you behave as a couple, gather relationship history and determine the goals for couples therapy. After the intake session together, you will be asked to see Kira individually. This will give you the opportunity to talk about what is concerning you, explore family upbringing, and better understand who you are as an individual outside of the relationship. Finally, you will be seen as a couple again and for subsequent sessions. The couple sessions will help you to both talk about communication styles, past wounds, repetitive patterns along with what you’ve learned, the progress you have made, and much more.
As you can see, there is a lot of work involved. This is why couples therapy tends to be a lot more expensive than individual therapy.
Does Health Insurance Cover Couples Therapy?
Insurance is not always required if you would like to have couples therapy. This is because there are federal laws, the Mental Health Parity and Addiction Equity Act as well as the Affordable Care Act that can be taken into consideration. A person’s insurers must provide coverage for some mental health conditions. In other words, they are required to treat mental health concerns in the same way that they treat physical health concerns. In addition to this, the insurance company must also refrain from excluding people from insurance coverage and refrain from charging high co-pays.
However, many insurance equity laws do not tend to apply when it comes to couples therapy. This is because mental health parity laws always treat mental health conditions as a medical condition. What this means is that couples therapy is not considered to be a requirement as part of a medical diagnosis. In other words, it cannot be compared to any physical health condition.
Some health insurance providers might need to cover couples therapy if the therapy is required as a direct result of a mental health concern. For example, if an individual’s mental health causes them to refuse to communicate with their partner, it can affect their marriage. Unfortunately, it can prove to be hard to get any insurance coverage. Please make sure that you always read and understand the terms and conditions of your insurance coverage.
If current insurance does not cover couples therapy, is there a way for you to add it to your plan? Your insurance provider may have a few options for you to consider.
Some insurance plans can cover couples therapy, and it can be an additional benefit. Please make sure that you always read your insurance documents so you know what you are covered for. There is always a chance that you might need to reach a deductible before the insurance coverage can be used. Alternatively, you might need to ask to be reimbursed rather than paying a copay. It makes sense for you to understand whether you will need to wait to be reimbursed for your couples therapy.
Please make sure that you know whether you are likely to be reimbursed before you book your first therapy session. This is because couples therapy can be expensive, and the cost can run into thousands of dollars.
Requirements For Covering Couples Therapy With Insurance
At the time of writing, Heal Your Roots Wellness accepted Highmark Blue Shield plans. Please note, Heal Your Roots Wellness cannot guarantee that any claim you may make for out-of-network reimbursement will be met.
Using individual insurance for couples therapy
You will need to make sure that you or your partner’s health insurance covers your sessions. This can help you if you or your partner has a mental health diagnosis. You or your partner could use the individual insurance to cover the counseling as part of your treatment. You will have to be sure that you or your partner has the right type of insurance first. This is to ensure that you know you’re going to be covered for the sessions or you’ll be reimbursed.
If you can use individual insurance, the out-of-pocket costs will not be quite as high. This is because only you or your partner will be held accountable for the copay. This could make it easier for you to keep an eye on your insurance coverage as there may be less paperwork to deal with.
Using out-of-network benefits
The ability to use out-of-network benefits can be very beneficial. This is because it has the chance to offer you a range of therapists to choose from. In addition to this, you could receive a part reimbursement, which could bring the costs down.
If you don’t have insurance or choose not to use it
There are some clear benefits to not having or using health insurance for couples therapy.
You will not need a diagnosis to have couples therapy. This means you won’t need to pay for a diagnosis before you go ahead and have therapy. You could also find that your therapy is a lot more private. This is because you won’t have an insurance company asking for a copy of your case notes. Finally, your therapist can use a range of modalities and treatments in order to help you. This is potentially a good thing. Many insurance companies limit what modalities and treatments therapists can use. If you would like your therapist to use a range of treatments and modalities, there’s a real potential that they can. You could benefit from different techniques that you may or may not have considered using in the past. What this means is that you could work on the issues that are troubling you and your partner. In some cases, these issues could be resolved sooner than they otherwise would have been.
How Do I Check If My Insurance Will Cover Costs?
To check if your insurance will cover the costs you need to do the following:
Set aside 30 minutes to one hour so you can call your insurance company. Be prepared to wait a while for your call to be answered if you call at a busy time.
Please make sure that you have the following information to hand before you make the call:
- A pen and paper
- Your insurance card
- Your name, date of birth, social security number, address, or the cardholder’s details.
What you need to ask the insurance company regarding insurance for couples therapy
Please ask your insurance provider the following questions:
- If there are any out-of-network benefits for your insurance policy
- If you have a behavioral or mental health policy with any out-of-network benefits
- What the requirements are in order for you to use out-of-network benefits
- If prior authorization is needed for couples therapy
- If a referral is required from your physician
- If you have an out-of-network deductible. If you do, please ask what it is and how much of it has been met. You should also ask your insurance provider what the start date is, based on your network policy. You should also try to find out if your insurance policy covers couples therapy. Please quote this code 90847. Finally, try to find out what percentage of their usual and customary fee is covered.
While this might seem like a lot to ask, the more information you can get, the better informed you will be. This ensures that you know exactly what to expect if you choose to have couples therapy.
Will any Kind of Health Insurance Work for Couples Therapy?
Unfortunately not. As we have already said, many insurance equity laws do not tend to apply when it comes to couples therapy. This is because mental health parity laws always treat mental health conditions as a medical condition. What this means is that couples therapy is not considered to be a requirement as part of a medical diagnosis. In other words, it cannot be compared to any physical health condition.
This is why it is so important that you do your research. If you would like to have couples therapy, you need to know if your insurance will pay for some or all of it. At the time of writing. Heal Your Roots Wellness accepted Highmark Blue Shield plans. Please note, Heal Your Roots Wellness cannot guarantee that any claim you may make for out-of-network reimbursement will be met.
Contact Us Today For A Couples Therapy Consultation
We are often asked, “how does couples therapy work with insurance?” We hope that this article has made things a little clearer. If you are unsure as to whether your insurance covers you, please ask your insurance provider. It may be that you or your partner can use your individual health insurance, depending on your health condition.
Couples therapy is here to help you and your partner with your relationship. You do not need to be about to break up in order to have couples therapy. You can have a few communication issues, or have other concerns about your relationship. Every couple is different and needs to be able to explore their relationship and their concerns. This is where Heal Your Roots Wellness therapists can come in and help you. They can work with you both to help uncover any difficulties, ensuring you can work on them together.
If you would like to schedule a couples therapy consultation, please contact us today. You can contact us at 484-800-1652. We are here to help you and your partner get the most from your relationship. Schedule Consultation.