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 to have a mental health disorder and a diagnosis. This becomes a permanent part of your (or your child’s) medical records. If you want to use insurance, discuss this with your therapist during your first visit. Assess 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-TR .)
Professional counseling supports self-improvement, career guidance, spiritual direction, and parenting challenges. to name just a few. However, these, as well as marriage and relationship problems, are not considered a “medical necessity” by most insurance companies.
Insurance companies do not cover marriage, premarital, or relationship counseling. We continue to see insurance companies telling subscribers that their insurance covers “marriage counseling” and people get their hopes up. And when marriage counseling isn’t covered, there’s significant disappointment. When you speak with your insurance representative, ask them to provide written confirmation that they cover marriage or relationship counseling. When the claims are rejected by the insurance company, clients end up having to 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. For those who want to use insurance, the claim can be filed with 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 people have terrible marriages and want the therapist to provide “marriage counseling” and, for obvious reasons, want the insurance company to pay for those services. This creates a moral dilemma for the therapist. It is important to note that insurance companies audit clinical records to ensure services are appropriate and that correct charges have been submitted. If charges for services were submitted to your insurance company in error, those amounts must be repaid.
If you are in a relationship that is spiraling downward, let us encourage you: Get Help! If you are seeing conflicts in your relationship grow, resulting in tension and distance, seek 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 that some families are reluctant to seek professional help due to financial constraints. Surprisingly, people often benefit greatly from just a few therapy sessions; appointments can be spread out every few weeks to help with cost.
Some of the counselors are able to adjust the fees for families struggling with financial hardship. Additionally, several churches and other subsidized agencies in our community offer professional counseling and can assist with fee adjustments.
A simple, concise way to evaluate whether you need “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, adjust your priorities to get the help you need. We all know what it’s like to want something so much that 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 is that 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-minute 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 to 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 who might be hurting and whose marriage is on the “ropes,” this is an opportunity for an intensive intervention: to assess the problems, lay the necessary groundwork, and introduce new styles of personal interaction. This is a great resource for bringing hope and direction for relationships that have been on a “downhill 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.
If you don’t get help with VCFR — Get help somewhere!
Copyright Material VCFR 2016-2026