Does Insurance Cover Family Therapy?

Mental and emotional health are just as important as physical health. This is true of individuals and families alike. At Kayenta Therapy in Las Vegas, we offer various services to assist family members dealing with major life transitions, difficult circumstances and specific mental or behavioral issues. A question commonly asked by our clients is whether or not insurance covers their family therapy.

In most cases, the answer is yes. However, insurance plans must follow the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA). Commonly referred to as the Federal Parity Law, this 2008 act requires most healthcare insurance companies to ensure the same coverage of treatment for mental illness and addiction as they do for physical ailments.

Understanding Insurance Plans for Family Therapy in Las Vegas

If you have the following types of healthcare plans, your insurance will likely cover family therapy as much as it covers physical-based healthcare:

• Any employer group plans that include 51 or more employees
• Most employer group plans with 50 or fewer employees – with the exception of any plans grandfathered in, i.e. plans that remain unchanged since the law’s enactment date which was March 23, 2010
• Any healthcare plan purchased through the Health Insurance Marketplace
• Most individual and group health plans purchased independently – with the exception of any plans grandfathered in
• Medicaid managed care plans
• Federal Employees Health Benefits Program
• State Children’s Health Insurance Program
• Nevada health plans
• Various local government health plans

Currently, in addition to any grandfathered in plans, the following types of health insurance are not required to follow federal parity (although some still comply):

• Medicare
• Medicaid fee-for-service plans
• Any healthcare plan that explicitly offers an exemption or decreased premium in exchange for an increase of costs associated to parity

Will My Employer Know I Requested Family Therapy?

Some of our clients are reticent to attend family therapy due to a concern that their employer might find out. If you are self-insured, your employer cannot obtain any type of health information about you from any healthcare provider without your authorization, with a few legal exceptions requiring disclosure. At Kayenta, we provide special low-cost therapy solutions for those who would rather pay out-of-pocket for complete privacy than have claims listed on their insurance.

For those on a group plan through an employer, the insurer can provide your employer with an overview about your healthcare, including the name of a therapy clinic. However, the Americans with Disabilities Act provides protection and prevents an employer from using mental and emotional treatment therapy as a reason to terminate or otherwise discipline employees. To learn more about family therapy in Las Vegas or to book a session, contact us today at 702-438-7800.