A healthy life revolves around fulfilling relationships. It's natural to feel vulnerable and need assistance when there's a conflict between partners. You and your spouse might find solace in couples counseling when things go bad.

Couples counseling, however, may be rather expensive. Knowing that your treatment sessions are covered by insurance may be a huge comfort if you're having financial difficulties. Learn the ins and outs of when and if your insurance will fund couples counseling.

When Is Couples Counseling Allowed?

Most traditional medical insurance policies won't pay for couples counseling. The many forms of protection available are summarized here. Learn what your responsibilities are under these rules.

Obamacare Health Insurance

Insurance plans purchased under the Affordable Care Act (ACA) will cover mental health care. It's categorized as a "critical perk." However, the Affordable Care Act does not cover couples counseling for most marital problems.

Why Doesn't ACA Cover Couples Therapy?

• It is not meant to cure physical or psychological problems. Rather, it's a method of helping couples strengthen their bond.
• It isn't classified as a service for mental health issues. People in need of these services include those diagnosed with a mental condition or disease and undergoing treatment for it. Discord in relationships is not categorized as such.
• Medical need is often only met when health services are used to address a specific disease, accident, condition, or ailment.

Group Insurance Plans Offered by Employers

Unlike individual therapy, which is typically covered by health insurance, couples counseling is generally not. However, your company's EAP may pay for it. As a result of the correlation between employee happiness, productivity, and attendance, many businesses now provide some employee assistance programs.

Medical Coverage for a Limited Time

Short-term health insurance plans may include "mental health" coverage; however, it's important to note that couples counseling may not meet the criteria for "mental health" coverage. Exclusions are common in short-term health insurance plans. Some insurance plans do not include mental health care.

COBRA

COBRA is centered on providing you with the same health insurance you had when you were working, and it may cover couples therapy if your employer group insurance or EAP provides such coverage.

Medicare

If the primary goal of the counseling is to aid in your treatment, then Medicare Part B will reimburse the costs. A licensed mental health professional, such as a psychologist, social worker, or doctor, must also provide counseling.

Family or couple therapy with a registered marriage and family therapist is often not covered by Medicare. Except in cases where the MFT is working in a clinical setting or the office of a Medicare-approved provider.

Tips For Getting Your Health Insurance to Cover Couples Counseling

Do not assume that you will be reimbursed for the cost of couples counseling by your insurance company if it is not something they cover. Even if your insurance covers couples counseling, there may be conditions you must fulfill before payments begin.

Insurance plans often restrict the therapists you may see or require you to see only those who are part of their provider network. Insurers will each have their own set of requirements. If you want to avoid paying for services out of cash, you should ensure your insurance covers them first.

When it comes to medical billing, the type of therapy you receive is reflected in a very particular code. Ensure that you have thought about everything related to the problem you are trying to solve.

Can You Make Use of a Health Savings or Flexible Spending Account?

Health savings accounts (HSAs) and flexible spending accounts (FSAs) do not cover the cost of couples counseling (FSA). It's possible that you'd have to pay taxes on any money you withdraw from an HSA or FSA to cover therapy sessions. Contact the appropriate administrator if you have questions about your HSA or FSA.

Budget-Friendly Options for Couples Counseling

Couples therapy, like other forms of counseling, may be pricey. However, most health insurance plans do not cover it. If you cannot pay for counseling on your own, look into community resources and non-profits. Following are a few suggestions:

1. Ask your doctor about couples counseling.
2. Inquire at a school or a hospital about mental health services in your area. You can find programs and tariffs that offer discounts.
3. inquire at your church of membership whether they provide marriage counseling. There's a chance you can obtain some free assistance.
4. It is still important to learn about your mental health coverage options, even if your insurance company does not give financial assistance for couples therapy. Individual therapy may be an option that might benefit you in various ways.
5. Verify your partner's health coverage by looking into their policy.