By Okbima 13 May 2024 15

Does Health Insurance Cover Therapy?


Therapy is when you talk to a trained person to help with your mental health, emotions, and behavior. It can help you understand your thoughts and feelings better, and learn ways to handle stress and feel better overall. Let’s know if health insurance covers therapy or not & many more terms.


Does Health Insurance Cover Therapy?

Yes, health insurance covers therapy costs. This is mandated by the Mental Healthcare Act of 2017. This means therapy should be covered similarly to other medical treatments. However, the exact coverage amount can vary depending on your specific plan & you may still have to pay a copay or deductible before your insurance starts.


Types Of Therapy Covered By Health Insurance In India

Many best health Insurance plans now cover mental health treatment, including various therapies. Here are some of the common types of therapy covered by health insurance companies in India.

  • Individual therapy: This is the most common type of therapy, where you meet with a therapist one-on-one to discuss your mental health concerns.

  • Group therapy: Group therapy is when people with similar mental health problems meet with a therapist together. It can help you learn from others and feel like you're not the only one going through it.

  • Family therapy: Family therapy can help improve communication and relationships between family members. It can be a beneficial option for people with mental health problems that affect the whole family.

  • Cognitive-behavioral therapy (CBT): CBT is a type of therapy that can help you change negative thought patterns and behaviors. It can be effective for many mental health conditions, including anxiety, depression & eating disorders.

  • Interpersonal therapy (IPT): IPT focuses on improving your relationships with others. It can be helpful for people with depression or other mental health conditions that affect their social interactions.


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Factors Affecting Health Insurance Coverage For Therapy

Health insurance that covers therapy is important for a person's health. However, some factors can make it hard for someone to get therapy through their insurance.

Pre-authorization Requirements

Pre-authorization can affect getting therapy covered by their insurance. This means that some health insurance plans may need people to get approval before they can start therapy. To get pre-authorization, you may need to show documents from your doctor to prove that therapy is necessary. If you don't get pre-authorization, you may have to pay for therapy yourself.


In-Network Vs. Out-Of-Network Providers

When you're looking at health insurance, it's important to know the difference between in-network and out-of-network providers. In-network providers are part of a group that your insurance works with, offering services at a lower cost. If you see a therapist in-network, your insurance might cover part of the cost. But if you go to an out-of-network provider, you might have to pay more or your insurance might not cover it.


Coverage Limitations & Exclusions

Another thing to think about with health insurance and therapy is coverage limits and exclusions. Some plans might only cover a certain number of therapy sessions each year, or they might not cover certain types of therapy. You need to read their policies to know what's covered and any restrictions on therapy coverage.


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Limits & Restrictions On Therapy Coverage

Therapy is important for mental health, giving people support to handle life's ups and downs. But sometimes, insurance rules make it hard to get therapy. It's important to know these rules if you're trying to get therapy covered. Here are some common ones.

Session Limits

Insurance plans sometimes only pay for a certain number of therapy sessions in a set period. How many sessions they cover can change a lot, depending on the insurance and the plan. For example, a plan might cover just a few sessions each year or for each problem. When someone crosses this limit, they might have to pay for more sessions themselves or find other ways to get help.


Pre-authorization Requirements

Some insurance plans require pre-authorization or pre-approval before covering therapy sessions. This means individuals must get approval from their insurance provider before beginning therapy to ensure that the treatment is medically necessary.


Out-of-Pocket Expenses

Even if you have insurance, therapy can still cost you a lot. You might have to pay part of the bill yourself, like through co-payments or deductibles. And if you see a therapist who isn't in your insurance plan's network, you might have to pay for everything on your own.


Pre-existing Condition Exclusions

Sometimes, insurance won't cover therapy for mental health issues you had before getting the insurance. This means you might not get help for those problems, or it might be harder to get coverage. But in India, insurance can't discriminate against you for having these conditions when it comes to mental healthcare.


Read More:

Pre-Existing Disease In Health Insurance: List Of Covered Diseases

Deductible In Insurance: Definition, Types & Factors Affect Deductible Amount

Preventive Health Check-up and Its Benefits

How Many Types of Health Insurance Plans In India?



In conclusion, individuals need to understand their health insurance coverage when it comes to therapy services. While many health insurance plans do cover therapy, the extent of coverage and types of therapy included can vary. Individuals must review their policy and speak with their insurance provider to fully understand what is covered and any potential out-of-pocket costs associated with therapy services. For expert assistance, you can contact “Our Experts”.

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