Is Marriage Counseling Covered by Health Insurance?

Marriage counseling is not one specific approach that fits all couples. Therefore, if your requirements are different, the costs  may be different, too. Many counselors charge a fixed cost for all couples, while others charge based on a couple’s household income. It is not cheap to undergo marriage counseling, especially if long-term counseling is needed, but in general, therapy is less expensive than a divorce.

What is the average cost of marriage counseling?

First, how much does marriage counseling cost on average? Some professionals charge one session as one hour, so the hourly cost is also the cost per session. Others offer complete packages and bill accordingly. Marriage counseling can range anywhere from $80 to $275 per session, depending on your therapist’s level of training and experience. Most marriage counselors recommend at least 10 sessions (1 per week) and will most likely use the first couple of sessions to assess your marriage and the problems that concern you. Then, they will design a custom-made plan for you and your partner, depending on what they learned from the initial sessions. Therefore, the average cost of marriage counseling is $1,000 for 10 weeks of therapy, but could end up being anywhere between $800 and over $2,750.

Is marriage counseling covered by health insurance?

Most couples who seek marriage counseling are concerned whether their health insurance will cover it. Many couples would like to go through marriage counseling, but are worried about the cost and hope that their health insurance will cover it so they can get the help they need. Being able to use your insurance to cover the costs can make marriage counseling much more accessible and is preferable when dealing with your marital problems. Unfortunately, the answer is no. Insurance companies will not cover the cost of your marriage counselor unless at least one of the spouses is suffering from a mental health disorder. That means, in order for your health insurance to pay for your marriage counseling, either you or your partner need to have a diagnosable mental illness. Furthermore, your marriage counselor has an ethical commitment to resolve the symptoms of the diagnosed spouse, not focus on improving your marriage.

That means that the therapist will view one of you as the “identified patient” or “sick partner” and will help that person get “better.” Sometimes, when there are mental health issues involved, relationships do suffer, but generally, therapy aimed at a mental health disorder is not what most couples want when they seek marriage counseling. Furthermore, most therapists who bill health insurance companies are specialized in treating individuals with mental illnesses and are not licensed or trained to be marriage counselors. So, while you’ll have your bill paid by your health insurance company, your therapy would be focused on one of you, not on treating your marriage; otherwise, your counselor would be at risk of committing insurance fraud.

Basically, keeping all the above aspects in mind, someone could use their health insurance to cover the costs of therapy. However, most couples are not looking for disorder-focused treatment, but for marriage counseling that will strengthen or repair their relationship. They want to learn new ways to communicate, enhance their emotional connection, improve their intimacy, and strengthen their bond.

5 Disadvantages of Having Your Health Insurance Cover Your Marriage Counseling

  • Finding a specialized marriage counselor through health insurance.

Accessing therapy through health insurance requires one of the partners to be diagnosed with a mental illness, and therefore, that therapy will be focused on treating them. Therefore, therapy will be focused on the individual and their problem instead on the marriage and the problems you really want to solve. These professionals specialize in pathology and therapy for mental health disorders, and thus, you are less likely to find a professional who is a licensed marriage counselor and knows how to properly treat your marital problems in a focused way.

  • Your medical record will show a diagnosed mental health disorder.

Covering the costs of marriage counseling sounds good, but the truth is that if you have a mental health disorder on your medical record, you may face issues in your professional life, especially if you are a high-level professional like a pilot, a law enforcement officer, or a doctor. In fact, a University of Illinois study revealed that half of Fortune 500 corporations admitted to using employee medical records in making employment decisions, 20 percent of which did not inform the employee. Don’t let your mental health record shape your future for the sake of paying for marriage counseling.

  • Confidentiality issues and concerns.

Did you know that therapists and counselors can share the information discussed in therapy sessions with insurance companies? Would you be okay with him or her sharing intimate information about your marriage, like your problems with sex, affairs, and so on? You’re probably thinking, “No!” That’s another reason couples should not use health insurance to cover their therapy; counselors who are working with insurance companies often have to disclose confidential information about what is being discussed in the sessions when they submit their billable notes. This can end up being problematic and can feel invasive for most couples, since marriage counseling explores sensitive topics such as affairs, substance use, and sexuality, to name just a few.

  • Labeling one partner as the “sick” or “problematic” person.

When a couple is undergoing therapy under the terms of their health insurance, there is a risk that one of the spouses will be labeled as the “problematic” partner and the one responsible for the problems in their marriage. Furthermore, it may affect the other partner’s will and commitment to do their part in therapy to repair the relationship.

  • Insurance limits the number of sessions you can attend.

Using health insurance to pay for marriage counseling places one important limitation: you have a specific number of sessions that you can enjoy with one counselor. Many couples require long-term therapy because of the nature of their problems, but their marriage counseling may have to end too soon because they have a limited number of sessions available through their insurance company. Counseling takes time to treat a marriage, therefore, short-term sessions may not work and won’t be worth your time and effort.

You get what you pay for. The same applies to therapy.

We all get excited when we think we can use our insurance benefits for freebies, but unfortunately, this means that many couples have to settle for any therapist who is able to see them. Too many of these so-called therapists have no training or experience as marriage counselors, yet they accept couples for treatment. When couples trust these therapists to fix their relationship, they may not see the life-changing results they were hoping for. In the end, while worrying about the cost of marriage counseling, these couples often end up worrying about the financial consequences of divorce, instead. Consider whether marriage counseling through your health insurance is really worth it. Here are some tips to help you with your decision:

  • Read the contract thoroughly. Most people do not read their contracts because they seem too lengthy and technical, but it is important to read the contract thoroughly to understand your rights and obligations and to understand how insurance works. If you’re having difficulty understanding the terms, ask your insurance company to clarify the contract.
  • Consider the costs of marriage counseling versus the expenses of a divorce. The costs can vary depending on which counselor you see and what treatment program you choose. Marriage counseling is cheaper and healthier in the long run. Divorces end up traumatizing the spouses and kids and incur expenses like monthly child support and alimony. Gathering information from both counselors and lawyers will definitely help you choose where to invest your money.

Is marriage counseling worth the cost if you are the one paying?

If you are teetering between getting a divorce or treating your marriage through marriage counseling, go with counseling. Marriage counseling is always cheaper and much more emotionally fulfilling. You will get the opportunity to learn about yourselves as a couple and become better partners. Let’s look at the cost of couples therapy from a different angle. The average cost of a divorce in the state of North Carolina is roughly $13,100. This includes attorney fees, the cost of maintaining separate households, childcare, and the list goes on. You will have to fight over your house, your cars, and your savings and other belongings. On top of all that is the emotional trauma placed on your kids—and we still haven’t mentioned about alimony or child support.

As you can see, divorce should be avoided unless your safety is at risk. Even if you are about to give up, give it one more chance and go to marriage counseling with your partner. It will be worth it if you can get things back on track.

Let’s say you and your partner decide to invest in marriage counseling. You are looking to invest in weekly 60-minute sessions priced at $100 per session. At the end of treatment, your total will be $1,000, compared to the thousands of dollars involved in the average divorce. Regardless of whether your health insurance does or does not cover marriage counseling, you should still consider the other options open to you. Talk with professionals from both fields (both marriage counselors and lawyers) and weigh your options. Getting your relationship back is the most valuable payoff of all.

References:

APA Practice Organization; Coding and Billing Guidelines (2020, June 21). Retrieved from https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/30489_8/L30489_PSYCH014_cbg_070110.pdf

Many companies fail to protect confidential employee data (2020, June 21). Retrieved from https://www.epic.org/privacy/workplace/linowesPR.html

The Mental Health Parity and Addiction Equity Act (MHPAEA). (2020, June 21). Retrieved from https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html

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