In light of the growing demand for telehealth, insurance providers continue adapting their coverage options. That’s also true for mental health treatment, as an increasing number of people prefer receiving online therapy from the comfort of their home. The good news is that most insurance plans cover teletherapy, some even encouraging it for its affordability and ease of use.
Telehealth Insurance Coverage for Mental Health Services
Online mental health treatment started gaining popularity at the height of the COVID-19 pandemic, with many people preferring this method of receiving care even after restrictions were lifted. Many companies, including private insurers and government-funded programs like Medicaid and Medicare, cover teletherapy services. Teletherapy coverage often includes benefits similar to in-person therapy, making it a viable, flexible option for people seeking mental health treatment. Some insurance companies prefer covering online therapy, as it’s more cost-effective and convenient for patients and providers. The exact coverage depends on the provider and your specific plan.
Florida law allows licensed mental health practitioners to offer teletherapy services, expanding access to care. According to state regulations, insurers should provide teletherapy insurance like in-person services. This means that if a therapy session is covered in person, it will also be covered if conducted via telehealth. However, online therapists must hold a valid Florida license and adhere to state-specific guidelines.
Private Insurers
During the COVID-19 pandemic, many of the nation’s largest insurance companies, including Blue Cross Blue Shield, Aetna, UnitedHealthcare and Cigna, expanded their teletherapy coverage. Initially rolled out as temporary measures to meet the growing demand, these changes allowed the reimbursement of virtual therapy sessions at the same rate as in-person visits. Even post-pandemic, several states like Florida have maintained laws ensuring that teletherapy remains covered under private insurance plans.
Private payers generally cover common types of therapy, including individual counseling and cognitive behavioral therapy (CBT). Specific criteria must be met, such as being provided by licensed professionals. However, co-pays, deductibles and in-network provider requirements can vary significantly by plan and state. Some insurance companies have also introduced teletherapy platforms that work directly with their coverage plans, making access to virtual treatment even more straightforward for patients.
Medicare/Medicaid Coverage
Medicare provides teletherapy benefits under Part B, which includes several mental health services like psychotherapy and counseling. However, coverage may vary based on your plan, with some Advantage plans offering more teletherapy options. Medicare beneficiaries are set to continue receiving teletherapy coverage until December 2024.
In most cases, Medicaid will reimburse for teletherapy and other mental health services provided through virtual platforms. While federal guidelines support telehealth services, each state can determine the extent of its coverage. Florida residents enjoy Medicaid coverage for teletherapy under the state’s telehealth insurance guidelines. Medicaid covers live video, store-and-forward and remote monitoring in the state, but coverage doesn’t include audio-only sessions such as phone calls.
Differences Between In-Person and Online Therapy Coverage
What makes teletherapy convenient and more accessible for patients applies to why some insurers prefer covering it over in-person treatment. Virtual therapy insurance is often more cost-effective for insurance companies due to the reduced overhead expenses for providers, such as maintaining a physical office. Some plans may offer incentives for choosing teletherapy over in-person sessions, such as lower co-pays or deductibles.
However, some insurance plans may have specific rules regarding the types of therapy that can be done via telehealth. While CBT and other widely used methods are typically covered in both formats, more specialized treatments or group therapy could be excluded. Some companies may have limits on how many sessions you can attend. Teletherapy might also be limited to particular platforms or require you to use specific in-network providers.
Checking Your Provider’s Teletherapy Benefits
There are advantages to choosing a teletherapy provider. However, before you schedule your first appointment, you should verify your coverage.
- Speak to your insurance company. Call the customer service number on your insurance card and ask about teletherapy coverage. Be sure to ask about co-pays, deductibles or limits on the number of sessions covered. You can also log in to your insurance portal, where most policies outline mental health services.
- Ask your therapist. If you already have a therapist in mind, contact them to find out if they accept your insurance. Most therapists and platforms will be familiar with insurance requirements and can help verify coverage on your behalf.
- Review your policy. Your insurance plan’s benefits booklet or website often has detailed information about mental health coverage, including teletherapy.
Out-of-Network Coverage
If your preferred therapist is outside your insurance network, you may sometimes incur higher deductibles or reduced reimbursement rates. However, this doesn’t necessarily mean teletherapy is off the table.
Your insurance provider can offer partial reimbursement for out-of-network therapists. Review your out-of-network coverage limits, as some plans may cover a percentage of the session cost. After learning about your insurer’s policies, you can submit a claim for reimbursement. This may require you to pay the therapist directly and seek reimbursement from your insurance company.
If you plan on seeing an out-of-network therapist, ask if they offer a sliding scale fee based on your income. Many therapists, especially those based at nonprofit organizations, provide flexible pricing to make care more accessible for clients. You can also use your health savings account (HSA) or flexible spending account (FSA) to cover your therapist’s fee.
Navigating insurance coverage for teletherapy may seem overwhelming, but now is the time to take that step if you’ve been considering getting support for your mental health. Teletherapy’s convenience makes receiving the care you need more accessible than ever.
Finding a Teletherapy Provider
Teletherapy lowers the barriers to receiving mental health care and can be as effective as in-person therapy. Sun Health Center offers several treatment options, both in person and virtually, to help you address the issues that hold you back. Contact us today; one of our compassionate counselors can take your call anytime, day or night.
