Is Marriage Counseling Covered By Insurance?

Many couples would like to do marriage counseling. But, understandably, they worry about the cost of marriage counseling. Being able to use insurance benefits makes seeing a good marriage counselor regularly much more affordable. The good news is that, especially in recent years, it is much easier to use your insurance benefits to cover the cost marriage counseling.

In the past it was harder to get couples counseling sessions covered by insurance. In fact, in the past therapists had to code “individual” and “family” sessions differently, and some policies that would pay for individual therapy would not cover family, or couples sessions. However, thanks to new legislation, there is no longer a distinction between individual therapy and family therapy in the eyes of the medical field. (Which is wonderful, because approaches are highly effective in helping people with a variety of problems).  Being able to use insurance benefits to cover the costs of marriage counseling sessions can make getting professional help much more accessible.

However, using your insurance benefits comes with some costs too. It’s important to educate yourself about the pros and cons of using insurance benefits to pay for marriage counseling so that you and your partner can make the best choice for your family.

Using Insurance Benefits To Cover Marriage Counseling: Pros and Cons

Pros: The Cost

You may only have to pay the cost of your co-pay every time you see your marriage counselor.

Cons: Having a Psychiatric Diagnosis on Your Medical Record

On the surface, using insurance benefits to cover the cost of marriage counseling sounds great — why wouldn’t you? The truth is that it has some downsides. The biggest is this:  Having a psychiatric diagnosis on your medical record. The only way to use your insurance benefits for any type of counseling or therapy is if you meet criteria for a mental illness the requires “medically necessary” counseling or coaching to treat.

The problem is that relationship conflict itself is not considered to be a problem that therapy is “medically necessary” to treat. In fact, most often neither person in marriage counseling is suffering from any type of mental illness. They just want to improve their relationship. But in order to get insurance to pay for marriage counseling, either you or your partner will need to meet criteria for a mental health diagnosis like anxiety, depression or ADHD.  The most common diagnoses for people in marriage counseling include Anxiety, Depression, and “Adjustment Disorders.” When you meet with your marriage counselor for your free consultation session, you can talk with them about whether or not either you or your partner meet criteria for one of these disorders.

While for some people this is not an issue at all, some high-level professionals can face unexpected consequences if they have a documented psychiatric diagnosis on their medical record. For example, airline pilots, law enforcement officers, people with security clearances, and medical professionals prefer to keep their personal growth work private.

Cons: Confidentiality

Another reason why some couples prefer to not use their insurance benefits to pay for marriage counseling is that therapists who are in-network with insurance companies often have to divulge detailed information about what is being discussed in marriage counseling sessions. This is troubling to some people, particularly when discussing extremely sensitive topics such as sexuality, affairs, substance use, etc.


Cons: Pathologizing One Partner

There is a risk when one person in marriage counseling has the official “diagnosis” for the couple because the implication can be that the person with depression, anxiety, etc. is the one causing the problems in the relationship. (When in fact, someone experiencing depression or anxiety may well be struggling emotionally because of the problems in the relationship). If both partners believe that it’s one persons “fault” it may impair their ability to make successful changes in the relationship system, particularly if couples counseling sessions tend to focus on the reactions of one partner and not the other “healthy” partner.

Cons: Session Limits

Another limitation of using your insurance for marriage counseling is that in-network therapists are often limited to the number of sessions that couples are entitled to. While some marriage problems can be addressed with short-term therapy, it’s also true that many people need more support to successfully and permanently shift long-standing patterns in relationships. When couples are forced to end marriage counseling pre-maturely due to limitations of their insurance coverage (and the problems resume) they can mistakenly conclude that “marriage counseling didn’t work” and begin to lose hope for their relationship.

Cons: Access to a Good Marriage Counselor

Furthermore, even when people are totally okay with having a diagnosis on their record and are not concerned about confidentiality, pathologizing their partner, or having session limits, people seeking to find a good, in-network therapist are often very frustrated. Why? Insurance companies panel only a few marriage counselors in each community. Those counselors are often full and not accepting new clients. We hear from our clients that many marriage counselors they contact don’t even return their first inquiry call.

Unfortunately many couples who really want to use their in-network benefits settle for any marriage counselor who is able to see them. Too many therapists have no specialized training and experience as marriage counselors, yet accept couples clients. The in-network “marriage counselor” may not be the best fit in terms of personality, training, experience, location, hours, or the right specialization. Read: How to choose a good marriage counselor.

Too often, couples on the brink have one shot at fixing their relationship. When they entrust the future of their relationship and their family to… whoever… they may not have the life-changing, positive, productive outcome they were hoping for. The tragic irony is that when couples don’t enlist the support of the best expert marriage counselor they can find because they are concerned about the expense, they may be faced with the severe and devastating financial consequences of divorce. (The divorce that neither of them wants, but that seems like the only solution to the relationship problems they never got expert help in resolving… because it was “too expensive”).