Can Marriage Counseling Be Covered by Insurance? A Complete Guide for Couples

Relationships go through challenges, and seeking professional help is one of the healthiest steps a couple can take. But before starting therapy, many couples have one important question:

Can marriage counseling be covered by insurance?

The short answer is sometimes—but not always. Insurance coverage for couples counseling depends on your plan, diagnosis codes, the provider, and the purpose of treatment. To help you understand exactly how it works, this guide breaks down insurance rules, what’s typically covered, costs, and how places like Enrichment Wellness help couples access affordable care.

What Is Marriage Counseling?

Marriage counseling (also called couples therapy) focuses on improving communication, resolving conflict, healing emotional wounds, rebuilding trust, and strengthening the relationship. A licensed marriage and family therapist (LMFT), psychologist, psychiatrist, or clinical social worker typically provides the sessions.

Common Reasons Couples Seek Therapy

• Constant arguments or communication breakdown

• Infidelity or trust issues

• Emotional distance

• Parenting conflict

• Financial or life-stress challenges

• Premarital counseling

• Navigating major transitions

• Mental health symptoms affecting the relationship

While these issues impact emotional well-being, insurance companies often classify marriage counseling as a non-medical service unless a diagnosable mental health condition is involved.

So, Can Marriage Counseling Be Covered by Insurance?

Yes — but only under specific conditions.

Insurance may cover marriage counseling if:

1. One partner has a mental health diagnosis (e.g., depression, anxiety, PTSD).

2. The therapy is medically necessary according to your policy.

3. A licensed provider who accepts your insurance is treating you.

4. The focus of therapy is treating the diagnosed condition, not purely relationship issues.

Insurance companies do not cover services considered relationship-only counseling, such as:

• Improving communication

• General relationship dissatisfaction

• Premarital counseling

• Resolving typical relational conflict

These are seen as non-medical and therefore excluded from insurance benefits.

How Insurance Companies Decide What to Cover

Insurance providers follow strict criteria when determining coverage. Here are the major factors that matter:

1. A Mental Health Diagnosis Must Be Involved

For insurance to pay, there must be a billable diagnosis (such as: anxiety disorder, major depression, adjustment disorder, etc.). The claim is filed under one person’s diagnosis, even if both partners attend therapy.

The focus of treatment must be:

• Treating symptoms

• Improving functioning

• Stabilizing mental health

The relationship issues are addressed in support of the individual’s well-being, not as the primary reason.

2. The Therapist Must Be In-Network

Insurance only covers licensed providers recognized by your plan. Providers may include:

• LMFT

• LPC / LCPC

• LCSW

• Psychologist

• Psychiatrist

Clinics like Enrichment Wellness typically help clients verify insurance coverage ahead of time to avoid surprises.

3. The Session Type Must Be Allowed

Even with a diagnosis, some plans do not cover couples counseling codes (such as CPT 90847). Other plans do cover it, but only a limited number of sessions per year. It varies by:

• Insurance company

• Plan type

• Employer-sponsored policy

• Medical necessity review

Common Insurance Providers & Coverage Trends

While coverage varies, here is a general guideline:

Usually Covers (with diagnosis & medical necessity)

• Blue Cross Blue Shield

• Aetna

• Cigna

• UnitedHealthcare

• Kaiser (depending on region)

• Medicaid (varies widely by state)

Rarely Covers or Partially Covers

• EAP (Employee Assistance Programs) may cover a few short-term sessions

• Catastrophic or high-deductible plans

• Marketplace “bronze” plans

The best approach is always to request a benefits check, which clinics like Enrichment Wellness can do for you.

What Marriage Counseling Typically Costs Without Insurance

If your sessions are not covered by insurance, here’s what you can typically expect:

• $125–$250 per session with licensed therapists

• $175–$300 per session with psychologists

• $200–$400 per session with psychiatrists

Most sessions last 50–60 minutes.

At Enrichment Wellness, transparent pricing, flexible scheduling, and payment options make quality care more accessible.

How Enrichment Wellness Helps Couples Use Insurance for Counseling

Finding out whether insurance covers marriage counseling can feel confusing, but our team at Enrichment Wellness makes the process simple.

Here's how we support you:

1. Insurance Benefit Verification

We contact your insurance provider and check:

• Whether your plan covers couples therapy

• What diagnoses are eligible

• Copay or coinsurance amount

• Deductible requirements

• Any session limits

• In-network vs out-of-network coverage

This ensures you know exactly what to expect before your first appointment.

2. Tailored Treatment Plans

If one partner has a clinically identifiable condition, we create a therapeutic plan that addresses:

• Mental health symptoms

• Relationship dynamics contributing to distress

• Emotional regulation

• Communication skills

This aligns the care with insurance requirements while still supporting the relationship.

3. In-Network Licensed Providers

Our licensed clinicians provide:

• Couples therapy

• Individual therapy

• Integrative mental health support

• Holistic approaches when appropriate

And for out-of-network plans, we can provide superbills for reimbursement.

4. Transparent Fees & Financial Options

If insurance does not cover your sessions, we:

• Offer competitive self-pay rates

• Provide flexible options

• Help prioritize what type of therapy will benefit your relationship most

High-quality, compassionate care should always be accessible.

Situations Where Insurance Will Not Cover Marriage Counseling

Even if your relationship is struggling, insurance may still deny coverage. Common reasons include:

❌ No mental health diagnosis

If neither partner has a condition that meets medical necessity criteria.

❌ The diagnosis is added only for billing

Ethical providers do not add false diagnoses.

❌ Sessions focus exclusively on relational goals

(Communication, intimacy, conflict resolution, etc.)

❌ The provider is out-of-network

Some plans do not reimburse for out-of-network couples therapy.

❌ The plan specifically excludes 90847 sessions

This is the CPT code for couples or family therapy.

How to Check Whether Your Marriage Counseling Is Covered

Here’s a step-by-step way to verify your benefits:

1. Call the number on the back of your insurance card.

Ask: “Does my plan cover CPT code 90847 (family/couples therapy) with a mental health diagnosis?”

2. Ask about

• Copay or coinsurance

• Deductible status

• Number of sessions covered

• Requirements for medical necessity

• Whether your provider is in-network

3. Ask about telehealth coverage.

Many plans now cover virtual couples counseling. If you prefer, Enrichment Wellness can handle all of these verifications for you—and provide a clear summary.

Why Marriage Counseling Is Worth It — Even If Insurance Doesn’t Pay

Couples often delay therapy because they fear the cost. However, addressing issues early can prevent:

• Emotional burnout

• Escalating conflict

• Separation or divorce

• Impact on children

• Mental health decline

Therapy helps you:

• Rebuild trust

• Improve communication

• Strengthen emotional connection

• Resolve long-standing conflicts

• Support mental health in the relationship

The investment can save relationships, families, and mental wellness.

Conclusion: Can Marriage Counseling Be Covered by Insurance?

Yes—marriage counseling can be covered by insurance, but only under certain conditions:

• One partner must have a diagnosable mental health condition.

• The therapist must be in-network and licensed.

• Therapy must focus on treating the diagnosis, not solely the relationship.

If insurance does not cover it, therapy is still highly beneficial—and clinics like Enrichment Wellness work to make support accessible and affordable.

If you want help understanding your coverage, schedule a session today by calling (301) 944-9065 or visit our clinic at Rockville and Silver Spring, MD.

FAQs

1. Can marriage counseling be covered by insurance?

Yes, if one partner has a mental health diagnosis and therapy is medically necessary.

2. Does insurance cover couples counseling without a diagnosis?

No. Insurance does not cover relationship-only therapy.

3. What diagnosis is used for marriage counseling?

Common diagnoses include anxiety, depression, adjustment disorder, or stress-related conditions.

4. How much does couples counseling cost without insurance?

Typically between $125 and $300 per session.

5. Can insurance cover online or telehealth marriage counseling?

Many plans do—coverage varies based on insurer and state regulations.

6. Does Enrichment Wellness accept insurance?

Yes. We verify your benefits and help you understand your coverage before beginning therapy.