Introduction: Love Isn’t Cheap, But Should Help Be?
Let’s be honest: relationships can be complex. Even the most loving couples hit rough patches, and many turn to marriage counseling to work through their issues. But as you’re scrolling through therapist profiles and picking a date for your first session, a significant question pops into your head: “Will my medical insurance cover this?”
It’s a smart question, and one that doesn’t always come with a straightforward answer. While therapy might feel like an emotional investment, it can also be a financial one. In this post, we’ll break down exactly when and how medical insurance may cover marriage counseling, the factors that influence coverage, and what your next steps should be.
What Is Marriage Counseling and Why Is It Important?
Marriage counseling, also called couples therapy, is a type of psychotherapy that helps partners identify and resolve conflicts in a safe, guided environment. It’s led by licensed therapists, often psychologists, social workers, or marriage and family therapists (MFTs), who are trained to work with couples.
Sessions typically focus on improving communication, rebuilding trust, navigating life changes, or managing ongoing conflict. According to the American Association for Marriage and Family Therapy, about 97% of couples report receiving the help they needed through couples therapy.
But here’s the kicker: even though therapy is often vital to a couple’s well-being, insurance coverage can be murky.
Does Medical Insurance Cover Marriage Counseling?
The Short Answer: Sometimes, But It Depends
Unlike individual therapy, which is often covered for mental health conditions, marriage counseling falls into a gray area. Most medical insurance plans don’t automatically cover it, primarily if the sessions are focused purely on relationship dynamics rather than a diagnosable mental health condition. However, some insurance plans may offer partial or complete coverage, especially under certain conditions. Let’s take a closer look at those.
When Is Marriage Counseling Covered by Insurance?
- A mental health diagnosis is involved.
Insurance is more likely to cover therapy if at least one partner has a diagnosed mental health condition—such as anxiety, depression, PTSD, or bipolar disorder—that directly impacts the relationship. In these cases, the counseling may be billed under individual therapy for that person, with the partner attending as part of the treatment.
💡 Example: A couple seeks counseling due to the husband’s severe depression. If the therapist assigns an official diagnosis and treats the depression in sessions where the spouse is present, the sessions may be covered under the husband’s insurance plan. - Your therapist is in-network and properly licensed.
Insurance companies typically require that the therapist be:
Licensed in your state
Credentialed with your insurance provider
Providing services within the scope of practice
Even then, coverage isn’t guaranteed. You’ll need to confirm whether the specific type of couples therapy is considered a covered benefit under your plan. - You have an EAP (Employee Assistance Program)
Some employers offer EAPs that include a limited number of free counseling sessions—including couples therapy. These programs are designed to support employees’ mental health and personal challenges and are completely confidential.
🔗 Learn more about EAPs from U.S. Office of Personnel Management
When Is Marriage Counseling Not Covered?
- Relationship counseling without a medical diagnosis
If you and your partner are attending counseling for non-clinical reasons—such as lack of communication, parenting disagreements, or drifting apart—insurance is unlikely to help. These issues, while real and painful, aren’t considered medically necessary. - Out-of-network providers
Choosing a therapist who’s not in your insurance network can result in:
Higher out-of-pocket costs
Full session fees without reimbursement
Limited documentation support for potential claims - Your plan excludes couples therapy.
Even some of the best insurance plans have exclusions. It’s always worth reviewing your Summary of Benefits and Coverage (SBC) or speaking directly with a representative to ask about:
CPT codes (common ones include 90847 or 90846 for family therapy)
Coverage limitations
Documentation requirements
How to Find Out If You’re Covered
Here’s a quick checklist to determine if your medical insurance covers marriage counseling:
✅ Call the number on the back of your insurance card
✅ Ask if “family or couples therapy” is a covered benefit
✅ Confirm whether a diagnosis is required
✅ Ask for a list of in-network therapists
✅ Request coverage details for CPT codes like 90847 (family psychotherapy with patient present)
🔗 The National Institute of Mental Health also offers resources for finding therapists and understanding coverage.
What If You’re Not Covered? Affordable Alternatives
If your insurance doesn’t cover marriage counseling, you still have options:
🌱 Sliding scale therapists
Many therapists offer sliding scale fees based on income. Sites like Open Path Collective connect individuals to affordable counseling services nationwide.
🏫 University clinics
Graduate programs in psychology often have counseling centers where supervised student therapists offer low-cost sessions.
🌐 Online therapy platforms
Platforms like BetterHelp, ReGain, and Talkspace provide more affordable virtual sessions with licensed therapists, often at a flat rate.
Real-World Story: Jason and Melissa’s Insurance Surprise
Jason and Melissa were on the brink of separation. They turned to a local therapist who came highly recommended, but the $150-per-session fee quickly added up. After three sessions, Melissa decided to call her insurance provider. She learned that since Jason had been diagnosed with anxiety, they could receive partial coverage if the sessions were focused on managing his symptoms within the relationship. With the therapist’s help, they submitted documentation, and their insurance began covering 60% of the costs.
The takeaway? Don’t assume you’re not covered. Ask. Clarify. Advocate.
Conclusion: Don’t Let Finances Stand in the Way of Healing
Marriage counseling can be one of the most meaningful investments a couple makes. While navigating insurance coverage might feel like a hassle, the emotional and relational payoff can be life-changing.
If you’re unsure whether your plan covers therapy, take the time to explore your benefits. It may be more accessible and affordable than you think.
Ready to Take the First Step?
Whether you’re seeking clarity, connection, or just a little extra support, don’t wait for a crisis to take action. Contact your insurance provider today, or explore low-cost counseling options in your area. Your relationship is worth it.
Need help finding a therapist or figuring out insurance codes? Let us know in the comments, we’re here to help you navigate it all.
