Does insurance cover family therapy?

Ashleigh Knowles
Ashleigh Knowles
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Overview of family therapy

Family therapy aims to improve and strengthen family relationships, and its services directly address family mental health and social concerns. It may involve a family unit, or specific members of a family, in order to resolve conflict and help families identify the root causes of their problems. Family therapy can be used virtually through telehealth, and across a range of situations, including for major life changes and events such as divorce, as well as heavier content matters, such as abuse and trauma. Alternatively, family therapy can be used to improve behavioral issues such as depression and anxiety and can be incorporated for short-term and long-term recovery.

Examples of when and how to use family treatment

Family therapy can be used for a multitude of reasons, especially for ones that are affecting day-to-day functioning and family relationships or dynamics. For example, some families may have difficulty expressing or communicating their feelings with one another, which can cause significant misunderstandings. Family therapy employs families with the capabilities to better recognize and process emotions to avoid miscommunication. Any family conflict can also be worked through and resolved with the creation of beneficial solutions and outcomes.

 For families with children and adolescents, there may be various behavioral issues that are creating tension and disagreements. These include personality and mood disorders, which can also result in increased aggression and emotional outbursts. For children in school, these concerns may result in poor performance. Family therapy, alongside resources such as worksheets, is an extremely effective tool to address these concerns, and help individuals overcome psychological well-being challenges. Sometimes, family therapy is also used when there has been a major life transition that individuals are struggling to come to terms with. This can include divorce, moving to a new city or town, or the death of a loved one.

Does insurance generally pay for family counseling services?

When it comes to family therapy, one of the major questions that many families have is whether their session costs will be covered by insurance. To keep things short, you should know that family therapy is covered by insurance depending on your case.

You should always check your health insurance plan and note whether counseling benefits are included within its terms and conditions. Family therapy can be a clinically recommended treatment, and in such cases, your appointments should almost certainly be covered by your insurance policy. We recommend that you call your health insurance company and ask if mental health benefits are included as part of your package. While family therapy is typically included, you should never make assumptions! Always double-check, and ascertain that your family therapy is absolutely necessary for assessing and treating family concerns.

It is also important that you make note of multiple contingent aspects. For instance, insurance may only cover a limited number of family therapy sessions, and only for in-network providers as opposed to out-of-network providers. There may also be deductibles or medical confirmation required from your doctor. Make sure that you have sufficient evidence, and that your family therapist also accepts insurance.

Questions to ask your family counselor regarding insurance

To ensure that you're covering all bases when it comes to family therapy insurance, make sure to ask the following questions. This will prevent you from running into any extra issues and can provide you with full confidence that all your sessions are paid for and taken care of.

-   How many sessions does my insurance cover?

-   Does my plan cover in-network providers?

-   Does my plan cover out-network providers?

-   Are there any deductibles?

-   Do I need medical evidence from my doctor?

-   Is my insurance accepted by my family therapist?

-   Will my family counselor take care of the insurance paperwork?

-   Do you offer sliding scale fees?

-   Do you offer cheaper telehealth alternatives?

-   Do you need payment upfront?

-   Can my insurance company reimburse you at a later date?

Scope of insurance coverage for family counseling difficulties

It is important that you keep in mind the general principles for securing insurance when it comes to family therapy and counseling.

 Firstly, a medical diagnosis is usually required to inform insurance that family therapy is a medical necessity. As a result, your insurance company may request specific treatment plans and assessment reports to decide how much will be covered. Your insurance company may only approve a certain number of sessions, and what is deemed essential by your doctor. It is important to keep this in mind in case you are not able to continue therapy.

 Your insurance company may also routinely check your coverage. It is not uncommon for insurance companies to review your progress and determine whether family therapy is still required. In the case that you are denied, you can complain if you believe you have a just cause to continue. This process can take several weeks or numerous months.

Not all family therapists and counselors accept insurance plans. To ensure that you are covered, it may be necessary to reach out to other counselors and therapists that are in-network. This is easy enough but may take some additional time to research family therapists that best fit your needs. You should also note that health insurance plans only covers family therapy if they cover mental health benefits. You may find it beneficial to switch to another health insurance plan to ensure that you are able to be covered.

Final thoughts

Family therapy is a highly effective intervention to strengthen family relationships and improve communication. However, we acknowledge that it can be tricky to understand how insurance fits into family therapy solutions. Hopefully, with this article, you have a greater understanding when it comes to whether family therapy is covered, and how to go about seeking support from third-party providers.

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