Does Insurance Cover Couples Counseling?

Does Insurance Cover Marriage Counseling? Here’s What You Need to Know

If you and your partner are considering couples therapy, you might wonder: Will insurance cover it? The answer? Sometimes, but not always.

Unfortunately, most insurance plans don’t cover marriage counseling because it’s not considered a "medical necessity." That doesn’t mean therapy isn’t valuable, just that insurance companies tend to focus on diagnosed mental health conditions rather than relationship issues. But there are a few loopholes, and some plans might offer partial coverage. Let’s break it all down.

Why Insurance Usually Doesn’t Cover Couples Therapy

Under laws like the Affordable Care Act (ACA) and the Mental Health Parity Act, insurance providers have to treat mental health care the same way they treat physical health care. Sounds good, right? Well, there’s a catch, and these laws apply only when there’s a diagnosed mental health condition involved.

Most of the time, couples therapy is about improving communication, resolving conflicts, or rebuilding trust. Those are all incredibly important but don’t count as medical conditions, so they usually don’t qualify for coverage.

When Insurance Might Cover Couples Therapy

There’s one major exception: if therapy is being used to treat a mental health condition.

For example, if one partner is struggling with anxiety, depression, or even something like sex addiction, and couples therapy is part of their treatment plan, some insurance plans may cover it. But even then, getting approved can be tricky, and coverage varies from plan to plan.

The Insurance Loophole Most People Don’t Know About

Here’s something most people (including many insurance reps) don’t realize: “Family therapy” and “couples therapy” are billed under the same insurance code.

That means if your insurance covers family therapy (which many plans do), it technically covers couples therapy, too. The official billing code (CPT 90847) is “therapy for two or more people working on relational issues.” Sounds a lot like couples counseling.

If you call your insurance provider, don’t just ask if they cover marriage counseling. Instead, ask:

“Does my plan cover family therapy under CPT code 90847?”

That wording can make a big difference in getting an accurate answer.

What If Insurance Won’t Cover It? Here Are Your Options

If your plan doesn’t cover couples therapy, don’t worry, as there are still ways to make it more affordable:

• Sliding scale fees or reduced rates: Many therapists adjust their rates based on income.

• Employee Assistance Programs (EAPs): Some workplaces offer short-term counseling benefits.

• HSA/FSA accounts: You can use pre-tax dollars if therapy is tied to a mental health condition.

• Payment plans: Some therapists allow you to spread the cost over time.

How Much Does Couples Therapy Cost Without Insurance?

Couples therapy rates vary depending on where you live and your therapist’s experience, but sessions range from $75 to $300 per hour on average. Many therapists charge slightly more for couples therapy than individual sessions because it requires specialized training and a unique skill set.

Most couples meet with their therapist weekly so that costs can add up quickly. But when you compare it to the cost of divorce (which can be tens of thousands of dollars), therapy is often a good investment—whether it helps you strengthen your relationship or navigate a separation with less stress.

Is Couples Therapy Worth It? (Spoiler: Yes.)

Relationship stress isn’t just frustrating, it can affect your mental health, work, sleep, and overall happiness. Therapy gives you tools to communicate better, work through conflict, and build a healthier connection. Even if your relationship isn’t on the rocks, it can help prevent issues from becoming big ones.

So whether insurance covers it or not, couples therapy is worth considering. Many therapists (including us!) offer ways to make it more accessible, so don’t let cost be the thing that stops you from getting support.

If you’re curious about therapy options, reach out, and we’ll be happy to help you navigate your choices.