Insurance Doesn't Cover Couples Counseling – Here's How to Use It Anyway

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Seeking couples counseling is a great, proactive step towards resolving all kinds of relationship problems. Unfortunately, health insurance doesn’t technically cover couples or marriage counseling, because “relationship issues” in itself is not a mental health diagnosis (which is a requirement for health insurance to pay for therapy).

But don't let that stop you from getting relationship guidance! There are creative ways to use your insurance benefits to cover the cost of couples counseling.

Here are five possible ways to use your insurance for couples counseling, as well as considerations, pros, and cons to each scenario:  

1. Use one partner’s  individual insurance to cover sessions

Couples sessions can be covered as part of individual treatment if you, or your partner, are given a mental health diagnosis.

Let's say, for example, you're experiencing symptoms of a mental health condition – like depression, anxiety, or adjustment disorder. You'd use your individual insurance to cover couples counseling as part of your treatment plan.

Pros of using individual coverage to pay for couples counseling:

Cons of using individual coverage to pay for couples counseling:

2. Alternate covering sessions with your partner, using your individual insurance plans

As with scenario #1 above, you are using health insurance for treatment coverage. In this case, however, both you and your partner are using the benefits of your individual plans.

Pros of alternating your individual insurance plans to pay for couples counseling:

Cons of alternating your individual insurance plans to pay for couples counseling:

As with scenario #1 above, there are insurance-specific downsides to using coverage for couples counseling, including:

3. Ask the therapist to bill as "family sessions" under one partner's insurance  

In this scenario, either you or your partner uses individual insurance to cover the cost of therapy – but rather than individual sessions, your sessions are billed as family sessions.

Pros of using your "family sessions" code for couples counseling:  

Cons of using your "family sessions" code for couples counseling:  

The disadvantages to this option are the same as #1 outlined below, namely:

As with scenario #1 (and #2) above, there are insurance-specific downsides to using coverage for couples counseling, including:

4. Use your (and/or your partner's) out-of-network benefits

Out-of-network benefits can be a major perk, since it often significantly expands your pool of therapist options. If either you or your partner have out-of-network benefits, you may be apply to apply them towards couples counseling, too.

Pros of using out-of-network benefits for couples counseling:

Cons of using out-of-network benefits for couples counseling:

It's often helpful to call your insurance company once you have found an out-of-network therapist to make sure you fully understand your coverage. Here’s a guide to using out-of-network benefits.

5. Skip insurance, and pay for couples counseling entirely out of pocket

If you aren't able to find a therapist who's in-network with either of your insurance plans, don’t have out-of-network benefits, or prefer to keep the content of your sessions entirely private, you may prefer to pay out of pocket altogether. This means you pay the full couples session fee at the time of your appointment and don’t seek coverage by your health insurance plan.

Pros of paying for couples counseling sessions out of pocket:  

Cons of paying for couples counseling sessions out of pocket:  

You may have to make a few extra calls to your insurance company, or pay more than you initially expected, to get couples counseling. But at the end of the day, you've made an important and mutual decision to work on your relationship – so don't let insurance limitations keep you from seeking help!

Find couples counselors near you

Find vetted couples counselors near you on Zencare, below! Click on a therapist's profile to watch an introductory video, and book a free initial call to find a great fit for you and your partner: