Insurance & Psychotherapy: Understanding Coverage

By Author: JUDI
Total Articles: 122
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Therapy can be expensive, and often times those expenses can really add up. As a clinician in private practice I fully recognize that for many people, financial access to services is often the biggest hurdle in accessing therapy. At the same time, therapy often is an important first step for many wanting to take control of their mental health and create positive change in their lives.

Fortunately, times have changed and are continuing to change. Many Insurance policies now offer some form of therapy coverage in their plans and benefits.

For those that have insurance coverage, coverage for therapy is confusing, even for someone in the business. My hope is to help you gain some clarity in this post.

This post serves as an introduction of insurance coverage for psychotherapy purposes, I hope it can offer both Clients and Practitioners some more clarity in regards to how Psychotherapy is covered by private insurance.
If you’ve been doing a bit of research and digging into finding the right therapist already, you might already know about this coverage. Many therapists (including ...
... myself) ask clients to check with insurance providers themselves to find out if services are covered. Most therapists will accept payment first and provide a receipt afterwards. Client can utilize these receipts afterwards with their insurance company to receive reimbursements for their sessions.

Similar to Dentists, Chiropractors, Massage Therapists, and other Health Professionals, our services are covered by private insurance companies (think Manulife, SunLife, Blue Cross, etc.).

Billing of psychotherapy services are often times fully or partially reimbursed by such companies. However unlike Dentists, Chiropractors and other Health care professionals, not many insurance companies have infrastructure for therapists to directly bill such insurance companies. Hence, why we ask clients to work with their insurance coverage without our involvement. We have found in recent years that Blue Cross has implemented bill direct. If you have insurance under Blue Cross you will most likely be able to ask your therapist to bill the insurance company directly for that appointment instead.
There are several ways psychotherapy is covered by your insurance, and the words they use here matter.

The top categories that insurance providers cover are:

Psychotherapy

Counselling

Psychological Services

Social Work

Sometimes insurance companies will specify what coverage entails, they will often state service provider credentials, this can include (but not limited to):

Registered Psychotherapists

Registered Psychologists/ Registered Psychological Associate

Registered Social Worker

Certified Canadian Counsellor

Registered Marriage and Family Therapist

Seems simple enough right? In many cases, insurance providers are clear and concrete in their policies and I have found that as therapy and counselling become more mainstream and socially accepted, insurance companies have also become more expansive in their coverage.

Now here is the tricky part, many insurance companies also simply state ‘Psychological Services’ in their policies. Always check with your service provide to confirm exactly what is covered in your policy, Insurance companies are slow to update the eligibility of policies so it is always best to call and check to ensure you know the most up to date coverage.
It can be pretty disappointing to finally find a therapist in the right area, with the right availability, and the right modality, only to find that your insurance won’t cover the fees. For many Registered Psychotherapists like myself, I have found a way to eliminate this barrier to access for my clients. The solution? I am supervised by a Social Worker and therefore when issuing receipts I can issue receipts showing my credentials as a Registered Psychotherapist or indicate that I am working under the supervised practice of a Social Worker.

How am I able to do so? I meet with my supervisor who is a social worker once a month to discuss cases and continue my own development and training as a therapist. Supervised practice allows me to give my clients better access to their insurance benefits without having to sacrifice their freedom to choose their own clinician. While I am no longer a student and no longer require supervision, I truly believe that my work and development as a therapist never ends and supervision allows me to stay aware and sharp in my practice.
Many professionals work under supervisors of other expertise to provide a more breadth of coverage for their clients like myself. It is always best to inquire about financial and insurance coverage options prior to booking a session to avoid unwanted surprises.