Does Health Insurance Cover Marriage Counseling?

Most of us pay a pretty penny for health insurance. Even if you are partially covered through an employer-sponsored benefit plan or you receive some governmental assistance, you may still find yourself paying quite a bit for insurance premiums, deductibles, co-pays, and so on. The long and short of it is that you want your insurance to pay off when you need it, covering the larger portion of your healthcare costs.

Unfortunately, there is still a stigma associated with mental health issues that extends to health insurance coverage. In other words, many insurance policies limit their coverage to issues related to mental and emotional health and well-being.

Although the Affordable Care Act (ACA), more commonly known as Obamacare, includes ten categories of essential health benefits, one of which is mental health, you may find that there is a slew of caveats involved when you actually seek counseling services. Here are a few things you need to know if you want your marriage counseling covered by insurance.

Finding a Doctor
Before you even start looking for insurance providers and policies that offer mental health coverage, including counseling services, you should know that some psychiatrists, psychologists, and counselors don’t accept health insurance, preferring to be paid directly by clients rather than having to submit claims to insurance providers for payment. You therefore need to find professionals that will take insurance, after which you should ask what types of insurance they accept.

Grandfathered Plans
It’s important to understand up front that you may not receive ACA benefits, including essential health coverage requirements, if you’ve elected to hang onto a grandfathered plan, which is to say, a health insurance policy you kept when Obamacare took effect. By now, most policies have been upgraded to meet federal standards, but it’s worth looking into before you seek counseling services.

How to Get Coverage
There are a couple of different things you need to research if you want to ensure that your health insurance will cover marriage counseling. For starters, you need to compare providers and policies.

Technically, all providers must meet mandatory minimums for coverage under Obamacare. That said, the coverage provided may not include the services you’re seeking. In some cases, the coverage for mental health will only include diagnosis and treatment of mental health issues.

This may exclude certain types of treatment, including counseling sessions for married couples interested in solving their differences. Coverage could also depend on the specific policy you choose. Even if a provider offers policies that cover mental health concerns, each policy could offer different levels of coverage.

It is your job as a consumer to comparison shop and find the provider and policy that best meets your needs. You should also pay attention to where your state stands with Obamacare.

Some states elected to expand Medicare and Medicaid coverage by adding state funding to the federal funding they received for these programs. If you’re eligible for assistance under Obamacare, the amount of money your state decided to put into the pot could have a marked impact on the benefits and coverage you receive.

Although marriage counseling may not be covered, or at least not in full, you might still be able to save some money by using a Flexible Spending Account (FSA) that allows you to set aside pre-tax dollars for known medical costs.