United Healthcare Therapy Coverage
United Healthcare is one of the largest health insurance companies in the world (and the biggest by revenue). United Healthcare coverage includes mental and behavioral health and therapy. This guide outlines the covered medical services that United Healthcare typically supports for mental and behavioral health services.
Does United Behavioral Health cover therapy?
Yes, nearly all United Healthcare Behavioral Health plans cover therapy for mental and behavioral health conditions.
Insurance coverage offered through the health insurance Marketplace or through small employers is required by the Affordable Care Act to cover mental health services. While not required by federal law, the vast majority of large employers also offer mental health benefits.
While rare, your United Healthcare plan may not include mental health benefits if:
- You work for a large employer that does not include mental health benefits in its insurance coverage.
- Your insurance plan was created before 2014, when the ACA’s requirement that insurance plans ensure mental health benefits was enacted. There are other situations in which your United Healthcare plan may not cover the specific type of mental health services you are looking for, or where your coverage may not apply until you spend a certain amount on medical services first. Learn more about these cases below.
How do I check my United Healthcare therapy coverage?
To check whether your United Healthcare insurance includes behavioral health and therapy, which encompasses mental health, look for the “Outpatient Mental Health” line item on your Summary of Benefits.
Therapy is considered a type of outpatient mental health care. You can find your Summary of Benefits by logging into your United Member Services portal (called “myUnited”), calling member services, or checking your employer’s benefits portal.
Here is an example of what your United Healthcare Summary of Benefits may look like, and where to find the Outpatient Mental Health line item:
If the Outpatient Mental Health line item shows these mental health services are not covered, your health insurance plan does not cover behavioral health programs and services.
If you cannot find health insurance coverage information for Outpatient Mental Health, you can call the number on your card to contact United Healthcare for assistance and behavioral health resources. If you receive health insurance through your employer, reach out to your employer’s human resources department regarding your mental health benefits.
While your United Healthcare plan likely covers therapy, the extent of coverage and requirements for coverage depends on your particular plan. Read on to learn more.
How much do therapy sessions cost with United Behavioral Health plan?
The cost of therapy sessions with United Healthcare depends on your plan’s coverage for behavioral health services: in the best-case scenario, your therapy sessions may be fully covered, meaning you don’t pay anything at the time of the session; most likely, the cost ranges from $15 to $50 per session. In the worst-case scenario, you need to pay the full fee that the therapist charges at the time of the session, which generally ranges from $80 - $200 per session. Find the scenario that applies to you below:
If you choose a therapist who is in-network with United Healthcare, your therapy sessions will likely cost between $15 - $50 per session, after you meet your deductible. The $15 - $50 amount is your copay, or the fixed amount that you owe at each therapy visit to your mental health provider. The deductible is the total amount you need to spend on medical costs in any given year before your health insurance begins to cover the cost of services. Here are examples you may see on your Summary of Benefits under the “In-network Outpatient Mental Health” category and what they mean:
- $15 copay, after $5,000 deductible → After you spend $5,000 in medical costs this year, your therapy sessions will cost $15 per session.
- $15 copay, after $1,000 deductible → After you spend $1,000 in medical costs this year, your therapy sessions will cost $15 per session.
- $15 copay, deductible does not apply → Your therapy sessions will cost $15 per session regardless of your deductible amount (i.e., even if this is your first medical visit of the year, you will only pay $15 at the time of your therapy session).
If you choose a therapist who is not in-network with United Healthcare and you have a United PPO Plan, your therapy session will likely cost between $50 - $100 per session, or 20% - 50% of the full amount that your therapist charges per session. This percentage is called a coinsurance: you pay the therapist’s full fee at the time of the session, send a claim to your health insurance company, and receive a check or direct deposit for the remaining percentage that your plan covers. PPO plans typically only cover out-of-network services after you meet your deductible. Here are examples you may see on your Summary of Benefits under the “Out-of-Network Outpatient Mental Health” category and what they mean:
- 20% coinsurance, after $5,000 deductible, therapist charges $100/session → After you spend $5,000 in medical costs this year, your plan will reimburse you $80 of your therapy session fee; your effective therapy cost is $20/session.
- 20% coinsurance, after $1,000 deductible, therapist charges $150/session → After you spend $1,000 in medical costs this year, your plan will reimburse you $120 of your therapy fee each time you submit a claim; your effective therapy cost is $24/session.
If you choose a therapist who is not in-network with United Healthcare and you have a United HMO or EPO Plan, your plan will likely not reimburse you for sessions with a therapist who is not in-network with United. You would owe the therapist’s full fee at the time of session and not receive reimbursement from your plan. If cost is a barrier to seeking therapy, you can look for a therapist who offers a sliding scale, or lower session fees based on financial need.
What types of therapy does United Healthcare cover?
Mental health testing, evaluation, and behavioral health care are among the top mental health benefits. The modalities that United Behavioral Health covers may include, but are not limited to, the following:
Any therapy type that is evidence-based and used for the purposes of diagnosis and treatment of mental health conditions should be covered by United Healthcare plans.
Mental health programs and resources for substance abuse, domestic violence, suicide and crisis management are always available for support.
What kinds of therapy does United not cover?
Like most insurances, it is not typical for United Healthcare to cover services unrelated to possible mental health concerns that are not diagnosable, such as:
- Couples counseling - Couples counseling is typically not covered by insurance, because relationship issues, while a significant source of stress, are not considered a diagnosable mental health condition.
- Life coaching - Life coaching is not covered by insurance because it focuses on achieving personal goals, rather than mental health counseling for a treatable disorder.
- Career coaching - Career coaching is not covered by insurance because it focuses on achieving professional goals, rather than treatment of a mental health condition.
United Healthcare services are also unlikely to cover therapy sessions occurring outside the therapy office, because of the greater potential for risk involved.
While clients may sometimes benefit from services rendered outside of the therapy office for mental health disorders, such as a client with an eating disorder needing support in the grocery store, or a client with a phobia of driving needing support in the car, these behavioral health resources are not likely to be covered by insurance and must be paid for out-of-pocket.
Does United Behavioral Health cover couples therapy?
No. While it depends on your specific plan, it is unlikely that United Healthcare services will cover couples counseling.
That said, even if your insurance doesn't directly cover it, you still have options for getting affordable couples counseling. Here are five ways to pay for couples counseling if it’s not included in your health insurance plan.
Do I need to see my doctor before visiting a therapist with United?
If you need to see your primary care doctor before visiting a United therapist depends on your insurance plan type:
- HMO or POS (Point of Service) plan: Yes, you are typically required to see your primary care physician for a referral to therapy before United Healthcare services will pay for therapy.
- PPO or EPO plan: No, you typically don’t need to see your primary care physician for a referral to therapy before United will pay for services.
This referral requirement is also called pre-authorization (or prior authorization). Pre-authorization is a process where a health provider, in this case your behavioral health specialist, must get approval from your insurance company before providing you with care for the services to be covered.
Your Summary of Benefits should show whether you need pre-authorization for outpatient mental health services.
Does United Healthcare cover therapy online for behavioral health?
Yes, United does usually cover video therapy sessions, which you can use in place of an in-person visit to your local healthcare provider’s office.
Mental health benefits often include video sessions as an option for managing medications without an office visit.