Are any counseling/therapy services covered by health insurance?

Hi all. My wife’s mother died over the summer (traumatic as usual in such cases, worse because it was sudden and we wound up moving back and taking on the burdens of caregiving). It affected my wife profoundly, and stirred up a lot of issues from her youth that she never bothered to deal with. We both would like her to talk to someone about all of it, but we’ve been having a dickens of a time finding counseling/therapy services that are covered by health insurance. Her primary care physician’s large parent group (it’s one of those big-city mega-practices, with specialists in all sorts of fields, their own radiology and testing facilities, multiple locations throughout the metro region, etc.) does not offer such services at all. The only referral she was able to get (from her PCP) does not take insurance. (And now her PCP is leaving her practice and moving to another city, which doesn’t help.)

We’re diligently paying healthcare premiums and would like to use our insurance first, if possible, rather than having to take MORE money out of pocket to pay for these services. So what’s the scoop? Do ANY counselors/therapists take health insurance? Being fortunate enough to have never needed such services before, I’m out of my depth here.

What state are you in and what kind of health plan do you have?

Most licensed therapists (psychologists and licensed social workers) take health insurance at least in Massachusetts. It depends on your state and your specific plan but counseling services are often covered. Sometimes they are required to be by law in states that force physical/mental health parity health coverage. There are other sources of help as well. Employee assistance plans often offer some counseling and they can certainly help you how to find the most affordable coverage for your specific needs.

If money is an issue, some therapists offer sliding scale rates if you ask.

Check out the “Find a Therapist” section at Psychology Today. You can sort results based on what insurance companies the various practitioners accept.

IME, it depends on your insurance. Call your carrier and ask.

Oregon. Lifewise.

The Lifewise webpage has a Find a Doctor page on its member portal. Scroll down to Behavioral Health and search Grief and Loss within x miles of you zipcode.

https://www.lifewiseor.com/visitor/find-a-doctor/

We’ll check this out. Thanks.

And thanks, Shag and KTK.

Yes.

Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA, P.L. 110-343). Your insurance provider will determine how much/many visits.

New Congressional Research report on that act under Obamacare.

Thanks for this, too.

I know that Blue Cross covers counselors. Something like 50% for the first 20 visits. BC also has a list of “preferred providers” who have agreed to charge the amounts allowed. Perhaps your insurance has the same?

This may not be directly relevant to your situation, but many employers that provide health insurance as one of their benefits also provide an Employee Assistance Program as another benefit. EAPs often provide counselors and other psychological services.

This advice is highly specific to the actual plan you’re on, and differs across BCBS subscribers. For example, on my BCBS plan it’s a simple copay, same as a regular physician office visit.

You’re welcome. Seriously, best of luck. I’ve been through the hunt, and even if you ARE covered, it can be difficult finding a provider who’s taking new patients.

My advice based only on my own experience:

  1. Once you’ve got a list from your health plan’s web site, work in groups of 5-6 and leave messages for them all. You’ll go nuts (pardon the pun) if you place one call at a time and wait for a response, only to find out that they’re not accepting patients.

  2. If there’s even a chance in your mind that this will go beyond counseling and into a combination of therapy and medication, try to find a psychiatrist that does both. It’s hard sometimes to find a good psychiatrist that still does 45 minute talking sessions, but it’s so worth it. It cuts down on getting bounced around providers, with one waiting to take action you’ve met with the other. Also, the doctor that is assessing your state of well being will be much more effective when he has the entire picture.

Again, totally IME, and I’ve done it the other way successfully as well. One last thing is when you talk to a provider who can’t take you, ask if they can recommend someone else. Some of them have colleagues right in the practice, or others they’ve been recommended by their patients in the past. You’ll get good leads this way, too.