Many couples are surprised to learn that insurance usually doesn’t cover true couples counseling—even when both partners are deeply committed to improving their relationship. This is because insurance companies require a mental health diagnosis for coverage, and even then, the focus of therapy must be on treating that diagnosis, not on improving the relationship itself.

To bill insurance, there must be an “identified patient” with a diagnosable mental health condition, such as anxiety or depression. In that case, therapy must focus on how the condition affects the individual—not on the couple’s dynamic or communication as a whole. While relationships may be discussed, the work is not considered relationship counseling by insurance standards.

Couples counseling, marriage counseling, and relationship-focused therapy—including work on communication, conflict resolution, or rebuilding trust—do not meet the medical necessity criteria required by insurance, even though they can be life-changing and preventative in nature.

For this reason, true couples counseling is typically considered private pay. This allows us to focus fully on the needs of your relationship without the limitations or requirements of a diagnosis or insurance plan.

Couples counseling may be covered when it is necessary to assess and treat the diagnosis of one family member.

We can use insurance if the following two conditions are met: 

1. At least one of the partners (who is covered by the health plan) has a diagnosis, and
2. We can reasonably make the case that the treatment being provided will help reduce the symptoms of that member’s diagnosis.