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If you’re seeking mental health support, one of your first questions may be: Does Blue Cross Blue Shield cover therapy? The good news is that BCBS often covers therapy sessions, but the details—such as costs, providers, and visit limits—can vary depending on your plan and state. In this guide, we break down everything you need to know about Blue Cross Blue Shield therapy coverage.
Need therapy support quickly? Book a licensed mental health appointment through Klarity Health to find a provider who accepts your insurance and can see you online, often within 48 hours.
Find out if your insurance covers therapy
Providers on Klarity can recommend the right care and help you understand if your plan might cover it.
Does Blue Cross Blue Shield cover therapy?
Yes, most Blue Cross Blue Shield (BCBS) plans cover therapy and mental health services. This includes individual therapy, such as cognitive behavioral therapy (CBT) or talk therapy, psychiatric evaluations, medication management, and both in-person and teletherapy sessions with licensed providers. However, coverage levels, copays, and the number of sessions allowed can vary by plan and state.
What types of therapy does Blue Cross Blue Shield cover?
Most BCBS plans cover a range of evidence-based therapies, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychodynamic therapy. Family or couples therapy may be included depending on your plan. Additionally, many plans cover medication-assisted treatment for mental health conditions and teletherapy with licensed providers.
What types of therapy are not covered by Blue Cross Blue Shield?
You may encounter limitations or a lack of coverage for services such as therapy with out-of-network providers, life coaching, non-licensed counseling, hypnotherapy, or alternative modalities not approved by BCBS, as well as some forms of group therapy. In many cases, therapy sessions that aren’t tied to a formal mental health diagnosis may not be covered.
Eligibility criteria for Blue Cross Blue Shield coverage for therapy
To access therapy through BCBS, you generally need to have an active BCBS insurance plan, choose an in-network licensed provider, and, in many cases, have a formal mental health diagnosis. Some plans also require prior authorization before starting therapy. Local coverage availability may depend on your specific BCBS affiliate, such as Anthem, CareFirst, or Horizon.
How to know whether your Blue Cross Blue Shield plan covers therapy
To confirm your therapy coverage, check your member portal or insurance app for details about mental health benefits. You can also call the customer service number on the back of your insurance card. When speaking with a representative, ask specific questions like:
- Is therapy covered under my plan?
- Are telehealth visits included?
- What are my copays or deductibles?
- Are there visit limits or session caps?
It also helps to ask your provider if they are in-network with BCBS. Or you can use the BCBS “Find a Doctor” tool or “Provider Locator” on their website. Simply log in or search as a guest using your ZIP code, plan name, and select “mental health,” “behavioral health,” or “therapist”.
Does Blue Cross Blue Shield cover therapy prescriptions online?
Yes, many BCBS plans now support online therapy and psychiatric care. This includes video therapy sessions, online psychiatric consultations, and prescription renewals for mental health medications. Virtual care is often available through platforms like Klarity Health, but some plans may require you to use BCBS’s preferred telehealth services or an in-network provider offering virtual visits.
Why Blue Cross Blue Shield might deny therapy coverage
Therapy coverage may be denied for several reasons. This could include seeing an out-of-network provider, lack of medical necessity, not having a formal diagnosis, skipping required prior authorization, or exceeding the plan’s allowed number of therapy sessions.
Tips for improving your chances of therapy approval
To avoid issues with coverage:
- Choose an in-network licensed provider and confirm your benefits before beginning therapy
- Get a referral or prior authorization if your plan requires it
- Ensure you receive a formal diagnosis during your intake
- Consider using virtual platforms that partner with BCBS
Alternatives and savings options if Blue Cross Blue Shield doesn’t cover therapy
If therapy isn’t fully covered, there are still ways to manage costs.
- You can use a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for therapy out-of-pocket.
- Sliding-scale providers may adjust their fees based on your income.
- Many telehealth platforms, such as Klarity, offer flat-rate pricing for individual sessions, regardless of whether the individual has insurance or not.
- Community mental health clinics often provide low-cost or free services.
How to get prior authorization from Blue Cross Blue Shield for therapy
If your plan requires prior authorization before therapy, ask your provider to initiate the request. They’ll typically need to submit documentation, including your diagnosis and a proposed treatment plan. It’s recommended to wait for approval before starting sessions, and follow up with BCBS if you don’t receive a decision within 5 to 7 business days.
The good news is that therapy is usually covered
Blue Cross Blue Shield generally covers therapy, but the details depend on your specific plan, location, and provider. Verifying your coverage, choosing an in-network therapist, and understanding your plan’s requirements can help you access care with minimal issues. If you need affordable online therapy that works with your insurance, Klarity Health makes it easy to get started.
Book an appointment on Klarity Health
Klarity makes it easy to connect with licensed therapists who accept insurance, including many BCBS plans. No waiting rooms. No surprise bills. Book online in minutes.
Not sure if your insurance covers therapy?
Licensed providers on Klarity Health can assess your condition and guide you toward care that fits your needs—coverage varies by plan.
FAQs
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
