Sometimes. Many sex therapists do not take insurance, but for those who do, coverage depends on your insurance provider and the kind of insurance you have. If your problem can be defined by a diagnosis code, treatment may be deemed “medically necessary” and coverable.
A good place to start looking for the answer is your insurance provider’s website. Or, you can call the phone number on the back of your insurance card and ask to talk with a benefits representative.
Find a Therapist First
You may be required to see an in-network provider to get coverage, so to find a therapist, you might want to look at your insurance company’s in-network list. (Log into your account on their website.)
You could also ask your insurance company or primary care provider for a referral to someone in your area.
Alternatively, you can use the provider locator on the American Association of Sexuality Educators, Counselors and Therapists (AASECT) site to find a therapist near you, then see if they are in-network for your insurance.
Look for certified or licensed sex therapists with graduate degrees and credentials from AASECT. Certified sex counselors work in accordance with regulated standards.
Ask Your Prospective Therapist if they are Usually Covered by Your Insurance
Once you have a therapist in mind, call their office or send them an email to ask whether they take insurance and whether their services are usually reimbursable by your insurer.
Many Charlotte sex therapists are willing to adjust their fees on a “sliding scale” based on your income, or work out a monthly payment plan. Your local hospital may be able to steer you to a less-expensive sex therapy clinic.
Your Therapy Might Require a Team
Depending on your specific situation, your sex therapist may consult with a team of other providers, including your
- primary care physician,
- psychologist/counselor and/or
- physical therapist.
Sex therapists usually require medical evaluations before or shortly after their treatment begins, in order to properly diagnose the problem and identify the appropriate treatment plan.
Using Your Mental Health Coverage
Insurance companies usually only provide mental health coverage when there is a diagnosis they cover. Some sex therapy concerns, such as delayed ejaculation or female orgasmic disorder, are billable diagnoses for most insurance companies. If that diagnosis is the primary reason for seeking therapy, your insurance company may cover the cost.
If you have a coexisting diagnosis, such as an anxiety disorder, that may be covered. Even if your sexual issues are not billable, you may be able to get your sex therapy for the anxiety covered.
It is easier for individuals to get sex therapy insurance reimbursement than couples.
A lot of insurance companies say they cover couples or relationship counseling, but there is no couple’s therapy code for insurance claims, nor is there a couple’s diagnosis that qualifies for mental health treatment.
Sometimes insurance companies allow a person with a diagnosable mental health concern to have their partner present while they work with a sex therapist.
But other times, even if you meet all the rules to have your partner present while we work on your depression, low libido, or erectile dysfunction, having a partner in the session is not considered “medically necessary,” so the couples therapy claim is denied.
Using Your FSA or HSA Account
If you require sex therapy for the treatment of a medical condition, a Letter of Medical Necessity (LMN) will allow you to use your
- flexible spending account (FSA),
- health savings account (HSA) or
- health reimbursement arrangement (HRA).
Your therapist can provide the necessary paperwork for your records.