Is Couples Counseling Covered by Insurance? Here’s What You Need to Know

One of the most frequently asked questions we get from clients is: “Does insurance cover couples counseling?”

The answer? It depends.

But here’s the good news: in many cases, yes—if it’s clinically justified.

Let’s break it down.

A happy couple in counseling? Yes! Younger generations are pursuing couples counseling before the relationship reaches a breaking point.

Couples Counseling vs. Individual Therapy with a Partner Present

Insurance companies don’t typically cover therapy that’s solely focused on improving a relationship in the absence of any mental health diagnosis. If you're seeking help purely to strengthen communication or improve intimacy, that’s considered self-pay or private-pay work.

However, if one partner has a mental health diagnosis—like depression, anxiety, PTSD, or another clinically recognized condition—and the therapist determines that the relationship dynamics are directly impacting or contributing to that diagnosis, then couples or family sessions may be covered as part of the treatment plan.

In that case, the therapy is billed as individual therapy with family or partner involvement, and insurance may cover it when the focus remains on treating the diagnosed individual’s condition.

Example: How This Works in Practice

Let’s say your partner is struggling with depression, and their symptoms are worsened by ongoing relationship conflict or emotional disconnection. A therapist may determine that working on the relationship together is crucial for the partner's recovery. In this case:

• One partner is listed as the identified client (the one with the diagnosis)

• The therapist documents how the relationship work is supporting treatment of the diagnosis

This allows the therapy to be covered by insurance, as it falls within a medically necessary treatment framework.

What to Ask Your Therapist or Insurance Provider

If you’re not sure whether your couples counseling will be covered, here are a few questions you can ask:

1. To your therapist:

   • Can couples sessions be included in the treatment plan for my/our diagnosis?

   • Are you in-network with my insurance provider?

2. To your insurance company:

   • What is my co-pay or co-insurance for mental health sessions?

   • Are sessions limited to certain diagnoses or treatment types?

   
   

When Insurance Won’t Cover Couples Counseling

If neither partner has a qualifying mental health diagnosis or if the goal of therapy is solely relationship enrichment, most insurance plans won’t cover the sessions. In these cases, private pay is the route to go.

That said, investing in your relationship can still be incredibly meaningful—and often prevents future emotional and mental health crises.

The Bottom Line

Couples therapy can be covered by insurance, especially when it’s part of a broader treatment plan for a mental health condition. The key is that the work must be medically necessary and tied to improving the mental health of the identified client.

Still unsure? We’re happy to help you navigate it. Reach out for a couples counselor that takes insurance in Colorado, Indiana, or Vermont, or to ask how this might apply to your situation.