Does Health Insurance Cover Online Therapy?

During the COVID-19 pandemic, access to telehealth and teletherapy services became more important than ever. While stay-at-home orders were in place, many therapists, psychologists, and psychiatrists transitioned from in-person office settings to online therapy. Insurance providers had to move quickly to authorize payments.

Virtual visits may be here to stay. They offer more flexibility and in many cases, better accessibility than in-person appointments. However, figuring out how to pay for online therapy can be confusing and stressful. Learn where to start to figure out if it's covered by health insurance, as well as where to look for a few low-cost options.

What Is Online Therapy?

Online therapy, or teletherapy as it is often called, operates much the same way as traditional, in-person therapy—but with a twist. Rather than visiting a therapist’s office, you stay home and conduct a session via video on your computer, tablet, or phone. If video is not an option, your therapist may offer a session on a conference call, a regular telephone voice call, or even via email or text message.

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Will Insurance Cover Online Therapy?

When the COVID-19 pandemic began, most providers and insurers responded quickly to the need for increased access to teletherapy for existing patients and people looking to start therapy. They established new procedures or waivers to existing ones to allow for coverage of online therapy.

Depending on where you live and who your insurance provider is, some of these policies and waivers are still in effect. But the landscape of health insurance coverage for telehealth is in flux. So it's best to check in with your insurance company to see exactly what your plan covers.

In an April 2020 interview, Anna Hindell, LCSW-R, a psychotherapist in New York City, explained that insurance and telehealth coverage changed rapidly during the COVID-19 crisis. For example, Congress expanded Medicare and Medicaid, and the Department of Health and Human Services (HHS) relaxed rules governing HIPAA-compliant platforms for telehealth.

Some states relaxed licensure requirements so that practitioners with out-of-state licenses could provide telehealth to a patient in a different state. Or they allowed audio-only telehealth when previously video was required.

The most important thing to know about online therapy and insurance, according to Virginia Hill, senior insurance analyst at Fit Small Business, is that coverage is going to depend on your carrier. "Some insurance policies will cover sessions, some will only cover sessions deemed medically necessary, and some don’t cover anything," she explained.

Find a Therapist Who Takes Insurance

While many online therapy providers accept insurance, not all do. If you have health insurance, it's a good idea to search for a therapy provider who accepts your plan.

• Check the provider's website. If you've found a therapy provider you are interested in, start by checking their website. Many will include information about the insurance providers they accept. 
• Call the therapy provider. Once you've looked at the website, it is always a good idea to call the therapy provider and double-check to confirm that they will accept your specific insurance plan.
• Call your insurance company. Finally, reach out to your health insurer to ask whether they will cover the treatment, how much they will pay, and what part of the cost you will be responsible for. 
  

Navigating Insurance Issues

The best source of information about what your plan covers is your insurer. Hill says your first stop should be your insurer’s website to see what therapies are covered (and what modalities, such as audio, video, or text messaging), how much your copay is, and which therapists accept the insurance.

Also, check to see what documentation you may need to get reimbursed, especially since a representative of your insurer may say your therapy is covered, but your claim may still be denied once your insurer reviews it.

If your insurer denies your request for prior authorization for telehealth services or denies your claim, consider filing an appeal. “Keep good records of every conversation you have with your insurer,” in case you need to appeal, says Hill.

Do Online Therapy Providers Accept Medicare and Medicaid?

As with other insurance providers, Medicaid and Medicare have also expanded their coverage for online therapy services.

In response to the COVID-19 pandemic and the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, the Centers for Medicare & Medicaid Services broadened access to Medicare telehealth services to include psychotherapy and other mental health practices.

Medicare Part B covers certain telehealth services such as psychotherapy. For most of the services, you'll pay the same amount that you would if you got the services in person. That said, there are always caveats. Contact the customer service number on your insurance card or ask your provider for more information.

Whether or not Medicaid covers online therapy and which providers you're able to see via teletherapy is up to the state (many do offer coverage). So you'll need to check in with your state's Medicaid office.

Check the therapy platform's website. They will generally note whether they accept Medicaid or Medicare. For online therapists in private practice, call to see if they take these types of insurance.

Options for Paying Without Insurance 

If you don't have insurance or your insurance plan does not include online therapy, check to see if the therapist you're interested in seeing offers a sliding scale to make payments more affordable. If you have a health spending account (HSA) or flexible spending account (FSA), you may be able to use those funds to pay for teletherapy as well.

Your local mental health agency and local and state-level health departments may also be able to help. These resources can help you find more information about services available where you live. 

You can also check out the Open Path Psychotherapy Collective, which is a non-profit nationwide network of mental health professionals who charge between $30 to $60 for in-person and online psychotherapy sessions. 

Community-based centers also offer a wide variety of low- to no-cost care, including mental health and substance abuse services. They are also authorized to provide telehealth services including online therapy. To find out if your community has a center or how to access a center close to you, visit the Federally Qualified Health Centers website.

Subscription Services

Teletherapy websites and apps offer affordable subscription services. Sites like Talkspace temporarily offered free therapy services for healthcare workers and first responders in early 2020. While that offer has ended, these groups can now receive 50% off the first month of any plan.

Real, a mental healthcare platform, has historically offered various services, including virtual group meetings and check-ins with therapists, for free during moments of heightened need.

How to Find the Best Online Therapist

Just as with traditional face-to-face therapy, it is important to find a therapist with whom you feel comfortable. Research suggests that this relationship, known as a therapeutic alliance, plays a crucial role in the effectiveness of therapy.

Finding the right therapist for you can be a bit more challenging when you are looking online. Here are some things you can do to find the professional who is right for your needs:

• Filter your options: Some online therapy platforms allow you to search for therapists based on certain experiences or backgrounds that they have. For example, if you are looking for a professional who understands and has experience with BIPOC or LGBTQ+ issues, you may find it helpful to filter out professionals who don't have specific experience in those areas.
• Start with a consultation, if possible: Every online therapy platform is different, but you may be able to spend some time chatting with a potential therapist before you have your first session. This is a great way to determine it seems like a good fit.
• Check their credentials: Whether you are using an online therapy platform or seeing a therapist in private practice, make sure you check the professional's background and credentials. Make sure that they are licensed and credentialed to practice and have experience in the field.
• Make sure they can meet your needs: If you are looking for a certain type of therapy, check that your online therapist is experienced with those techniques. If you also need medication, check that the professional is able to prescribe medications.
  

A Word From Verywell

While more and more insurers are covering teletherapy, the landscape of insurance coverage for mental health care and online services is changing rapidly, it's a good idea to reach out to your insurance company, if you have one, to answer questions pertaining to your specific situation.