Does My Insurance Cover Therapy? Understanding Mental Health Benefits
Seeking therapy is a significant step toward better mental health — but figuring out what your insurance covers can feel like an entirely separate challenge.
Many people delay getting the mental health support they need because insurance terms and paperwork feel confusing or intimidating.
Whether you're dealing with marriage or family stress, managing parental burnout, seeking ADHD support, or working through other mental health concerns, understanding your insurance benefits shouldn't be a barrier to care.
In this article, we’ll demystify the basics of mental health insurance coverage and give you concrete starting points to understand what's available through your plan.
Decoding Common Insurance Terms
Before diving into the coverage specifics, let's start by clarifying some basic industry terminology you'll encounter while researching your mental health insurance benefits.
Deductible: The amount you must pay out of pocket before your insurance starts covering health care. Deductibles reset annually. With some exceptions, you’ll pay 100% of many health care costs until those expenses add up to your deductible.
Coinsurance: The percent of a medical bill (such as 20% of the session fee) you have to pay even if you’ve met your deductible for the year.
Co-pay: A fixed amount you pay for each therapy session (for example, $25 per visit) when it’s covered by your insurance plan.
Out-of-pocket maximum: This value represents the most you'll have to pay for covered health care services in a year. Take the yearly grand total of your deductible, plus co-pays or co-insurance expenses, and if it’s greater than your out-of-pocket max, your health insurance plan pays 100% of eligible care.
In-network vs. out-of-network: In-network providers (like a therapist or a doctor) have contracts with insurers, typically resulting in lower costs for you. Insurance providers may restrict or deny coverage for out-of-network providers, so be sure that you choose a provider that your plan will cover.
Authorization/pre-approval: Some plans require advance approval or prior authorization before you can begin certain treatments to determine whether the care you’re seeking is “medically necessary.”
Did you know?
Insurance providers often have provider databases on their websites.
Take advantage of these directories to take the guesswork out of choosing a he althcare provider.
Does Health Insurance Cover Therapy?
To understand your therapy coverage, look at the back of your insurance card or check your online benefits portal for your plan’s customer service number.
Your enrollment documents should include the number of covered therapy sessions per year, telehealth vs. in-person coverage options, and whether a referral from your primary care doctor is needed.
You may have a set number of therapy sessions covered at no extra cost to you, or you may have a flat-fee co-pay associated with using mental health benefits.
You can also provide Building Resilience Counseling's information to your benefits representative to specifically check your coverage. Remember that group health plans may be available through your own employer, your spouse's coverage, your parents' plan (if you're under 26), or through the health insurance marketplace.
What's Covered: In-Network vs. Private Pay vs. Medicare
When you choose an in-network therapist, like those at Building Resilience Counseling Services, your therapist typically bills the insurance company directly — making the process much easier for you.
Building Resilience Counseling Services accepts these major insurance providers: Aetna, Cigna, Blue Cross Blue Shield, Humana, MedCost, Medicare Part B, UMR, and United Healthcare.
Even with in-network therapists covered by insurance, you may still owe a co-pay or coinsurance depending on your specific plan details.
With private pay, you pay 100% of the cost of your therapy services out of pocket. This is an option for clients without insurance, patients whose preferred therapist isn't in their insurance network, or whose plan doesn’t cover therapy. Patients may also choose private pay for greater scheduling flexibility or privacy considerations.
Medicare Part B covers a comprehensive range of outpatient mental health services, including:
Individual and group therapy sessions
Diagnostic testing and assessments
Medication management
Visits with psychiatrists, psychologists, social workers, and licensed counselors
With Medicare coverage, you typically pay 20% of the Medicare-approved amount once your Part B deductible is met. Medicare also covers telehealth mental health services in certain circumstances — particularly if you live in a rural area or can't easily access in-person care. Always confirm whether your mental health provider accepts Medicare to avoid unexpected costs.
Did You Know?
Many employers include an Employee Assistance Program (EAP) through your benefits package, which offers confidential counseling services that are often completely free for a limited number of sessions (typically 3-6). Contact your HR team or benefits portal to connect with a benefits representative or EAP counselor who can walk you through your options.
Still Unsure?
Insurance paperwork can feel overwhelming, but it shouldn't prevent you from getting the mental health support you deserve. At Building Resilience Counseling Services, we offer free consultations to help you:
Ensure our therapist is a good fit for your communication style
Share more about your goals in therapy
Understand your specific benefits and coverage details
If you need help, don't hesitate to ask questions. Call your insurance company's benefits line, or schedule a consultation with a mental health provider. Understanding your insurance coverage is an investment in your mental health journey.
Here's Where To Start
If you're ready to get started, we'd love to discuss how therapy at Building Resilience Counseling Services can work with your insurance plan and support your wellness goals.
Interested in learning more? Sign up for a free 15-minute consultation here.