Does Insurance Cover Therapy? (February 2025)

Will Insurance Cover Therapy Like Other Medical Care?

That depends on the plan you have. The Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 to ensure that insurance policies covering mental health services treated these benefits the same as medical services. This law is why your policy can’t charge you a higher copay to see a therapist than another kind of specialist.

However, the MHPAEA doesn’t make health insurers cover therapy and mental health services. Instead, it only applies to those that do have mental health plans. Specifically, the MHPAEA requires such plans to have the same coinsurance, copays, deductible and out-of-pocket maximums for medical, surgical and mental health benefits.

What Insurance Plans Have to Cover Therapy?

The insurance landscape can be a challenging one to navigate, and the rules for mental health coverage vary depending on where you purchase your plan. Here’s a quick overview of mental health benefit requirements for some of the most common kinds of insurance.

Employer-Sponsored Coverage: Companies With Fewer Than 50 Employees

Does insurance cover therapy if you get it through your job? In some cases, it does, but not always. If your employer has fewer than 50 employees, it isn’t required to provide health insurance. However, if it has 50 or more, the company must provide insurance that offers mental health services.

Employer-Sponsored Coverage: Companies With 50+ Employees

Larger companies are required to offer health insurance to their employees. However, the law doesn’t force the group health insurance plans they offer to include mental health benefits.

These employers often have several plans to choose from, including plans from many of the largest health insurance companies. They almost always offer at least some plans that include therapy and other mental health benefits. Many plans that don’t cover long-term therapy will at least allow you a certain number of sessions per year.

Marketplace Plans

If you’re self-employed, own a small business or otherwise don’t qualify for employer-sponsored coverage, you may already purchase health insurance through the Health Insurance Marketplace. The Marketplace offers a wide variety of plans, and depending on your income, you might qualify for a subsidy to lower your premium cost.

All Health Insurance Marketplace plans must include mental health coverage. This is true regardless of whether you purchased your plan through the federal or a state-specific marketplace.

Medicaid

Each state has its own requirement for Medicaid. However, no matter which state you live in, Medicaid plans must include therapy and other mental health services.

Medicare

If you have Medicare, your level of coverage for mental health services depends on which of these part(s) you have:

• Part A: Inpatient mental health and substance use disorder treatment
• Part B: Outpatient mental health services
• Part C: Outpatient therapy at the same level as or one greater than Part B

It’s important to note that even though Part B covers therapy, you may still be required to provide copays.

How to Find Out Whether Your Insurance Covers Therapy

Does health insurance cover therapy? If you aren’t sure whether your plan (or a plan you’re considering) covers therapy, there are a few ways to find out.

Read Plan Documents

Each plan comes with extensive coverage details. These are usually summarized in a document called the Summary of Benefits and Coverage (SBC). Your SBC should illustrate what benefits are included and how much they cost.

You may have gotten a copy of the SBC in the mail when you first signed up. If you have an online account with the insurance company, you should also be able to log in and view the SBC there.

Depending on how much detail is in the SBC, you may still have questions. If you do, you should get in touch with the insurance company,

2. Call the Insurance Company

If you can’t find your SBC or still aren’t clear on the answer, consider calling your insurer at the number on the back of your card. Insurance companies know their policies thoroughly, and a knowledgeable representative can help you understand your benefits. When you’re shopping for a plan, they can help you choose one that meets your needs.

3. Get in Touch With Your Employer

If you get insurance through your employer, your HR department will likely be able to answer any questions you have about employment benefits, including insurance. If you’re a new employee and are selecting benefits for the first time, the HR department will also be able to give you an overview of your options.

Remember: Not All Therapists Accept Insurance

So does insurance cover therapy? Sometimes, yes. But even if your plan does, you could come to find out that your therapist of choice doesn’t take insurance at all.

There are many therapists who take insurance, but there are also plenty who do not. Therapists often report low reimbursement rates from insurance companies. Handling insurance paperwork can also be incredibly time-consuming, especially for independent practitioners who have no office staff.

Is Therapy Covered by Insurance? We’ll Help You Find the Answer

Whether you’re hoping to work with a therapist over the long term or just want to benefit from therapy while you’re going through a divorce, mental health support is critical to your overall well-being. If you’re trying to choose a health insurance plan or just want to know whether your current policy covers therapy, we can help.

At ConsumerShield, we’re dedicated to helping consumers find the answers they need to make informed decisions. Have questions? Get in touch today.