We are often asked, “How much does it cost?” and “Does Medical Insurance Cover Marriage Counseling or Pre-marital Counseling or Couple’s Counseling?”
As we all know, “INSURANCE CAN BE A REAL PAIN” 🙁
The more appropriate question we need to be asking is, “How much is it worth?” Keep in mind this is YOUR life. It’s not easy to put a price on good mental health?
READ CAREFULLY – Insurance coverage can be confusing!
🙂 NOTE: Self-pay clients can skip this whole discussion.
Health Insurance companies limit coverage to only services that are a “medical necessity”. Insurance companies require you have a medical mental health disorder and a diagnosis. This becomes a permanent part of your (or your child’s) medical records. If you are wanting to use insurance, discuss this with your therapist in your first visit. An assessment your symptoms and determine if a mental health diagnosis is appropriate or not. (If you want to learn more about mental health symptoms and diagnostic issues, consult the DSM-5 .)
Professional counseling helps with self-improvement, career guidance, spiritual direction, parenting issues. to name just a few. However, these, as well as marriage and relational problems are not considered a “medical necessity” by almost all insurance companies.
Insurance companies do not pay for marriage, pre-marriage or relationship counseling. We continue to see insurance companies telling subscribers that their insurance covers “marriage counseling” and people get their hopes up. And then when marriage counseling isn’t covered there’s a big disappointed. When you speak to your insurance rep, ask them to send you something in writing that states they cover marriage or relationship counseling. When the claims are rejected by the insurance company, clients end up being self-pay after all.
What Insurance Does Cover?
When the focus of the counseling is a mental health disorder (depression, anxiety, PTSD, etc.), generally insurance covers it. These issues are more commonly addressed with individual psychotherapy however, sometimes these disorders are addressed by “Family Therapy”. (Consult with your insurance company to verify if “Family Therapy” is covered when you, as a couple, are not married. Some insurance companies define “family” as part of a married couple.)
When you come to counseling due to a mental health illness or a “medical necessity”, the therapist’s focus is on treating the disorder. And for those that want to use insurance, the claim can be legitimately filed to your insurance company. The treatment focus is on the person with the disorder. This might indirectly help the relationship but this treatment is not marriage counseling.
Many folks have terrible marriages and want the therapist to provide “marriage counseling” and for obvious reasons, want insurance company to pay for those services. This creates a moral dilemma for the therapist. And it is important to keep in mind insurance companies audit clinical records in an effort to ensure services are appropriate and correct charges have been submitted. If charges for services have been submitted to your insurance company inappropriately, those monies would have to be repaid.
Let us encourage you if you are in a relationship that is spiraling downward; Get Help! If you are seeing the conflicts in your relationship growing; resulting in tension and distance; Get Help! Think about “How much is my marriage & family worth?” Find and work with an effective marriage and family therapist. It is one of the best investments you could make; it is well worth a temporary change in your financial priorities.
We understand some families are reluctant to seek professional help because of finances. Surprisingly, people often benefit greatly from just a few therapy sessions; appointments can be spread out to every few weeks in order to help with the cost.
Some of the counselors are able to adjust the fees for families with struggling with financial hardship. Also, there are a number of churches and other subsidized agencies in our community that offer professional counseling and are able to help with fee adjustments.
A simple, concise way to evaluate are you needing “Family Therapy” or “Marriage or Relationship Counseling” is to answer this question: What is the problem or issue in your life you want help with in counseling? Do you want the focus to be on the Marriage or Relationship issues? Or do you want the focus of the counseling to be on how the spouse/partner can be supportive of the patient that has a specific mental health issue?
As we said earlier, keep in mind: It’s not “how much does counseling cost”; it’s “how much is counseling worth”? Once you’ve made that decision, then change your priorities in order to get the help you need. We have all known what it’s like to want something so much we are willing to make sacrifices to get it. If it’s important, “Where there’s will there’s a way”. (A car, a special gift, a house, a cruise or trip; “where there’s a will …”)
One thing we know for sure, counseling fees are a lot less expensive than attorney fees.
Fee Schedule for VCFR As of August 1, 2022
Initial Intake Appointment (45 to 60 minute appointments) $150.00
Family or Couples Therapy (45 minute appointment) $145.00
Individual Therapy Sessions (45 minutes appointment) $125.00
Individual, Family or Couples Counseling (60 minutes) $155.00
Individual, Family or Couples Counseling (30 minutes) $85.00
Missed Appointment or Cancelled Insufficient Time $100.00 (Must give 24 hour notice)
Four (4) hour Couples/Marriage Intensive $620.00 (Deposit required)
Couples Intensives are designed give a focused enriching experience – like a 50,000 mile check up and preventative maintenance. What a great gift to give your marriage! And for others that might be hurting and their marriage is on the “ropes”, this is an opportunity to have an intense intervention; to assess the problems, to lay the needed groundwork and to introduce new styles of personal interaction. This is a great resource for bringing hope and direction for relationships that have been on a “down hill slide”.
For more information about working with one of VCFR’s skilled marriage counselors, please give us a call at our Charlottesville office at 434 973-5640 or in Staunton at 540 885-3481.
If you don’t get help with VCFR — Get help somewhere!
Copyright Material VCFR 2016-2022 revised