If you're considering starting therapy, it's crucial to know whether your health insurance includes relevant mental health benefits.
First things first: Are therapists covered by insurance? The answer is yes. Many health insurance plans include therapy as part of covered mental health services.
Under the Mental Health Parity and Addiction Equity Act, coverage for mental health care is often comparable to medical or surgical benefits.
If you're a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) member, we have resources to help you navigate your mental health care with confidence.
Most insurance plans cover a variety of therapy options to address different mental health needs, including:
One-on-one sessions with a licensed therapist, such as talk therapy, can be used to treat anxiety disorders, depression, phobias, grief and loss, and a variety of other concerns.
Therapy in a group setting is often focused on shared challenges or conditions, such as substance abuse, post-traumatic stress disorder, and more.
Therapy to support relationship dynamics and family well-being can help resolve communication issues, behavioral problems, or parenting challenges.
Evaluation, diagnosis, and medication management provided by psychiatrists can help treat disorders related to mood, sleep, eating, anxiety, as well as personality or psychotic disorders, such as schizophrenia.
Many insurance plans cover teletherapy, allowing people to receive therapy services from anywhere by phone or computer. This option has become increasingly popular due to its convenience and flexibility.
Most insurance companies, including Blue Cross NC, cover virtual mental health care for both in-network and out-of-network providers, but it's important to confirm coverage with your insurer before accessing care.
- Network providers: Most plans cover therapy with in-network providers at a lower cost than out-of-network.
- Session limits: Some plans cap the number of sessions you can receive in a year.
- Pre-authorization requirements: Certain plans require a referral from a primary care doctor or pre-approval before therapy sessions are covered.
- Diagnosis requirements: Your coverage might depend on having a specific mental health diagnosis.
Even with insurance coverage, therapy often comes with some out-of-pocket expenses, such as copays and coinsurance.
Because all health plans are different, it's important to do some research to learn about your plan before making your first appointment.
Consider these five steps when planning to begin therapy sessions:
Check your plan documents to understand your mental health benefits, including what's covered and any restrictions.
Blue Cross NC members can find coverage details in their Blue Connect member portal
Use your insurance plan's provider directory to locate therapists in your network for lower out-of-pocket costs.
Confirm if you need a referral or pre-approval to start therapy sessions.
See if your health plan limits the number of sessions covered annually.
If you prefer an out-of-network therapist, check if your plan offers partial reimbursement.
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