Mental health services can be critical for those coping with loss, but does insurance cover grief counseling? The simplest answer is sometimes. While federal law and the Affordable Care Act mandate that health insurance plans cover mental health treatment the same way they do physical health, without a clear diagnosis — like prolonged grief disorder (PGD) — some insurers are able to get around compliance and deny coverage.
Unfortunately, the truth is that insurance coverage for grief counseling varies depending on your provider, plan, and diagnosis, and it isn’t required at all unless it’s used to treat a clinically diagnosed condition.
Continue reading to learn everything you need to know to answer the question: does insurance cover grief counseling?
Grief therapy techniques can be a crucial way to maintain mental well-being. Many people turn to it when faced with the passing of someone close. Fortunately, Medicare coverage can help pay for in-person or online grief counseling services.
To get covered grief counseling services under Medicare, you should consult your Evidence of Coverage to review your plan’s benefits.
EAP Coverage Through Your Employer
Learning how to deal with grief can be especially helpful for those who’ve suffered a bereavement or experienced another significant life transition, like divorce or a major move.
Employers may provide Employee Assistance Programs (EAPs) to assist employees in managing the pressures of daily life. What is an EAP, exactly? It’s a program that offers benefits to employees, often including counseling and other resources for mental health, substance abuse, financial concerns, legal matters, and grief counseling. Check with your HR department to find out details about coverage limits and costs associated with grief counseling services through an EAP program.
You should also ask if there are any restrictions about where you can receive care. Some plans only permit visits within their network, while others may offer more leeway about provider selection outside the network. See if your plan requires pre-authorization before seeking treatment elsewhere.
How to Get Grief Counseling Covered by Insurance
Grief counseling can be integral to the recovery journey following any loss. Unfortunately, accessing insurance coverage for grief counseling can sometimes be challenging. Here are some tips on how to get your grief counseling covered by health insurance.
- Check Medicare coverage: The Medicare Part B program covers mental health services, which include grief counseling. Certain criteria must be met to be eligible, and there may be a cap on the number of sessions covered annually. Check with your provider before seeking treatment so you know what’s covered and what isn’t.
- Ask your employer about your company’s EAP: If your employer offers an EAP plan, contact them to find out if they cover any portion of the cost of individual therapy sessions related to grieving a loved one’s death or another traumatic event in your life.
- Seek private insurance: Private insurance plans vary widely when covering grief counseling expenses, so it’s best to contact your insurer directly if you want more information about their policies. In some cases, private insurers may cover a portion of the costs but have pre-authorization requirements or limits on visits per year that could result in higher co-pays or decreased reimbursement levels.
“Although general grief is not covered by most insurance plans due to a lack of diagnosis, in many cases, another underlying issue will be covered. Once in therapy, the client can discuss the grief and other issues (e.g., depression, anxiety, etc.).”– Talkspace therapist Reshawna Chapple, PhD, LCSW
Affordable Grief Counseling with or without Insurance
While insurance coverage for grief will depend on several factors, the reality is that even if you aren’t covered, you can still get access to cost-effective talk therapy without insurance through Talkspace.
Talkspace provides convenient and affordable access to licensed therapists who can offer support through text messaging, video chat sessions, or audio calls from the comfort and safety of your home. Platforms like Talkspace make grief therapy easy, even for people in rural areas or who have limited transportation. You can receive quality care from experienced Talkspace professionals that fit your budget and schedule.
Learn more about Talkspace grief counseling today to get started.
- Assistant Secretary for Public Affairs (ASPA). About the ACA. HHS.gov. https://www.hhs.gov/healthcare/about-the-aca/index.html. Published March 15, 2022. Accessed March 23, 2023.
- Grief and loss. Centers for Disease Control and Prevention. https://www.cdc.gov/mentalhealth/stress-coping/grief-loss/index.html. Published September 6, 2022. Accessed March 23, 2023.
- Mental health care (outpatient). Outpatient Mental Health Coverage. https://www.medicare.gov/coverage/mental-health-care-outpatient#. Accessed March 23, 2023.