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Does Insurance Work with Couples Therapy?

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Warm, meaningful relationships are the key to a happy life. They serve as a protective shield against mental illnesses and physical ailments and can even promote longevity. Unfortunately, such healthy relationships don’t just happen on their own! For many couples, it is often couples therapy that can be the difference between partners being able to resolve their conflicts or separating and families staying together or dividing. 

But let’s face it. As important as couples therapy is, it isn’t free. And in many cases, it isn’t cheap! This has many couples asking, “Will insurance work with couples therapy?” The answer is not always so straightforward.

Couples therapy is different from other types of therapy and, thus, is not usually covered by insurance. If you’re a couple on a budget, you may have questions about couples therapy, how much you can be expected to pay for therapy, and whether your therapy can be charged to insurance. Here’s what you need to know about couples therapy, including its costs, how it is handled by insurance, and what it is worth to most couples.

Insurance Covers Medically Necessary Expenses

Most insurance companies won’t cover the cost of couples counseling. This is because insurance covers medically necessary expenses, and couples therapy is not considered medically necessary. While couples therapy can improve quality of life and can help couples enjoy the mental health benefits that come from having quality relationships, most couples do not have a diagnosis, and, therefore, do not require treatment.

In order for a therapist to bill an insurance company for a therapy session, there needs to be a diagnosis and a treatment plan, and the treatment plan must call for therapy.

Why Does Only Some Insurance Work with Couples Therapy?

As already described, couples therapy rarely fits the requirement that would allow it to be covered by insurance. Sometimes, however, some couples therapists do bill therapy sessions to insurance. When this happens, there is usually one of three things taking place to make insurance work with couples therapy:

  1. One of the individuals needs therapy for a diagnosis, and the therapist is working with that individual and their partner in matters relating to the diagnosis. This can be a legitimate reason to bill the insurance company, but this is not a common occurrence.
  2. The therapist may be differently interpreting the rules that allow them to bill insurance. The therapist may genuinely believe they are working within the bounds of what is acceptable from the insurance company.
  3. The therapist is incorrectly billing the insurance company, believing that the means justify the ends.

So, if you are wondering whether insurance works with couples therapy, overall, you will find the answer is no. It may be best to be prepared to pay for couples therapy out-of-pocket.

Why Is It That Many of the Best Couples Therapists Don’t Accept Insurance?

One of the main reasons why many of the best couples therapists don’t accept insurance is due to the constraints and requirements set by insurance companies. Providers refrain from letting insurance work with couples therapy as they typically require a diagnosis to cover therapy services. Many issues that couples face don’t necessarily meet the criteria for a mental health diagnosis. 

Furthermore, the paperwork, administrative burdens, and potential for audits that come with accepting insurance can be time-consuming for therapists, detracting from the time they could spend with clients. 

In addition, insurance companies often dictate the number of sessions covered and the reimbursement rates, which may not align with the therapist’s assessment of the couple’s needs or the therapist’s typical rates. This autonomy allows therapists to offer a higher standard of personalized care to their clients, focusing on the unique needs and progress of the couple rather than meeting insurance mandates.

How Much Does Couples Therapy Cost?

Couples therapy can range as low as $75 per hour to more than $250 per hour. In large cities like Seattle, especially, costs tend to be higher because of the higher cost of living and other associated costs.

What explains the wide range of fees? It’s no different than the wide range of fees you’ll expect to see when choosing a contractor to remodel your kitchen or a videographer to capture beautiful and professional-looking shots on your wedding day!

In the same way, when it comes to couples therapy, you’re paying for the professional’s expertise, experience, and reputation. The best couples therapists are highly sought after and will charge more because there is more demand for their time.

Then the question becomes, “Is a couple therapist worth the higher fees?” That all depends on whether it’s important to you that a couples therapist has the following:

  • A higher success rate. 
  • Is efficient with time, so they require fewer sessions to do the same work as someone less skilled, saving you both time and money in the end.
  • Can equip you and your partner with tools and skills, so that you can work through issues on your own confidently and without having to come back each time for another “spot” treatment. 

It’s important to view couples therapy through the lens of its importance. Given the way that your relationship with your partner impacts your happiness, it’s best to seek out a skilled professional than looking for a “budget” option.

It takes skill and years of experience to hone the ability to help couples find happiness together. Relationships are complicated by layers upon layers of history and dynamics that are difficult to understand and unravel. Working with a skilled couples therapist can dramatically strengthen your relationship, while working with a budget therapist may not produce the desired results, if not worse. 

Need Couples Therapy? Contact Kairos for Relationship Repair

Kairos offers relationship repair for couples who need it. You don’t have to struggle alone with your relationship. You can have help from a professional who understands how to help couples have loving and satisfying relationships together. For more information about how Kairos can help you, contact us for a free consultation.