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Is my therapy covered by health insurance?

A brief overview...
  • Therapy may be covered by health insurance, depending on what type of therapy it is and which insurer administers your policy
  • You should do extensive research into which insurer you choose to increase your chances of getting therapy covered
  • Physical therapy will likely be covered, with mental health therapy less likely and occupational therapy very unlikely

Whether or not therapy is covered by health insurance is a fairly complex issue. Some types of therapy may be covered, while others may not. Also, therapy that is covered may not be completely covered. In the past, therapy of any type was generally not covered by health insurance. However, as therapy has become more medically accepted and prevalent, more health insurance companies have covered it to some extent.

This article will provide an overview of the current state of coverage for therapy by medical insurance. Of course, you need to check your own policy documents and speak to your own insurer to see what their policy is on covering therapy.

It might be a good idea to do research into which insurers are likely to cover therapy before you compare insurance quotes online. To learn more about health insurance covering therapy, read on.

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Therapy Covered By Health Insurance In the Past

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In the past, therapy of any type was rarely covered by health insurers. This is because therapy was not widely accepted by medical professionals, and it was not very well developed. Physical therapy was the first of the therapy disciplines to start being covered by health insurers. This happened a few decades ago.

It is only in recent times that mental health therapy has started to be covered by some insurers. Many still do not cover this therapy, although some within the medical and mental health field feel that insurers should cover it. Occupational therapy is rarely covered by health insurers, even in this day in age.

The More Broad Coverage of Current Health Insurance

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As previously mentioned, health insurers are more likely to cover therapy in the current healthcare climate. This is due not only to the aforementioned acceptance and development of therapy, but also to considerable pressure put on health insurers by their policyholders, politicians, and medical professionals. Physical therapy is now almost universally covered, as long as it is administered by a licensed professional.

Mental health therapy is much more likely to be covered then it was just a few decades ago, although it is very important that such therapy be performed by a psychiatrist. If therapy is performed by a different mental health professional, there is less of a chance of it being accepted by the insurer. Occupational therapy is still frequently not covered, but there are instances in which insurers will cover it.

Different Types of Therapy

There are three main types of therapy: physical Therapy, mental therapy, and occupational therapy. These are the varieties of therapy they may be covered by health insurance. There are many other types of therapy, but they will not be covered by health insurance. More types of therapy may be covered by health insurance in the future, but for now, this is it.

Physical Therapy

Physical therapy is the type of therapeutic treatment most likely to be approved by health insurance company. It has the longest history of legitimate medical use, and it is the most developed and regulated type of health-related therapy.

As long as you are treated by a licensed physical therapist, your insurer will likely cover some or all of your treatment.

Of course, this varies from insurer to ensure. You should check your policy documents and speak to your insurer before you begin physical therapy so that you know what to expect.

Mental Health Therapy

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Mental health therapy will likely be covered by your health insurance long as it’s performed by a licensed psychiatrist. Many mental health therapists are psychologists or Licensed Mental Health Counselors. Therapy performed by either of these professionals is less likely to be covered by health insurance companies. It may still be covered, but it is far from a sure thing.

Even psychiatrists may not be covered by the insurer. As with the other types of therapy mention this article, it is always a good idea to actually speak to your insurer and ask them about it.

Occupational Therapy

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Occupational therapy has not been traditionally covered by health insurers. Even in this day and age, it is rarely covered by health insurers. Often, only the most comprehensive and expensive plans will offer partial coverage for occupational therapy. This is because many insurers do not feel like occupational therapy is medically necessary, although some medical professionals, especially psychiatrists, may disagree.

It is unlikely that you’ll be able to convince your insurer to reconsider covering occupational therapy after they deny your claim. If you do a great deal of research before you compare insurance quotes online, and may be able to find an insurer known to cover occupational therapy.

Disputing a Rejected Claim for Therapy

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The process for disputing a rejected claim for therapy is the same as it is for disputing any claim. All the major insurers have an established dispute process. This process is detailed on your policy documents, and likely on the insurer’s website as well. If you go through this process, you do have a reasonable chance of having your claim accepted. This does not necessarily mean the insurer will pay for all therapy, but they might pay for some of it.

If you do not get the result you want from the dispute process, your only recourse is to sue the insurer. This is time-consuming and expensive, so it may not be worth it.

Finding Health Insurance That Will Cover Therapy

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Possibly the best way to get insurance to cover therapy is to choose the right insurance in the first place. Health insurance is an important part of life in the Modern Age, so you should do your research before you compare insurance quotes and pick the place you’re going to buy.

You should do general research into the insurer’s reputation and customer satisfaction, but you should also look specifically into how they cover or don’t cover therapy. There are many online websites and forums devoted to different types of therapy, and you can likely find the information you need on these websites.

Therapy Coverage and Health Insurance

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In conclusion, there is not a simple yes or no answer to the question of whether or not therapy will be covered by health insurance. Some types of therapy or covered by some insurers.

Mental health therapy is fairly likely to be covered, while physical therapy is almost a sure thing as long as it is administered by a licensed professional. Occupational therapy will probably not be covered, but you don’t have anything to lose by trying to get it covered.

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