Does Insurance Cover Grief, Trauma, or PTSD Counseling?

Key takeaways:

If you’re struggling with grief, trauma, or post-traumatic stress disorder (PTSD), counseling is typically covered by insurance.
Original Medicare and private Medicare Advantage plans offer a range of mental health benefits, as do most commercial insurance plans. You may also be eligible for an employee assistance program that offers counseling services through your job.
Free and low-cost counseling resources are available if you’re uninsured or underinsured. This may include local support groups, mobile apps, and mental health hotlines.

Grief and post-traumatic stress disorder (PTSD) are among the many reasons people seek counseling. But are counseling services covered by original Medicare, Medicare Advantage, and commercial plans? Below, we’ll explore how to find help and when counseling may be a benefit covered by your health plan.

What are signs and symptoms of grief and PTSD?

Grief is a normal reaction to a traumatic event, such as the death of a loved one or a pet, as well as to job loss and other major life changes. Common emotional and physical signs of grief include:

Anger
Changes in sleep or appetite
Dizziness
Fatigue
Headaches
Nausea or upset stomach
Sadness or anxiety that persists
Shortness of breath
Tightness in the chest or throat

PTSD is a mental health condition that can also have many different signs and symptoms. Some indicators of PTSD include:

Detachment from other people
Fear
Feeling on edge
Flashbacks
Negative thoughts and feelings
Nightmares
Sleep problems

If you’re experiencing grief or struggling with trauma, the first step toward healing is finding help. It may be especially beneficial to find a counselor who specializes in grief or trauma.

Does private health insurance cover grief, trauma, or PTSD counseling?

Under the Affordable Care Act, mental health services such as grief, trauma, and PTSD counseling are essential health benefits. That means almost every private health insurance plan covers counseling (including psychotherapy), in addition to mental and behavioral health inpatient services and substance use treatment.

You may, however, need to follow certain steps to get coverage. For example, your insurance plan may require you to select a mental health professional who is in network. Or you may have to get approval from your health plan — a process known as prior authorization — for certain mental health treatments. Check your summary of benefits and coverage (SBC) or contact your plan to be sure your care will be covered. If not, you can appeal a coverage denial.

Private health insurance includes both individual and group plans. Group plans are usually offered through employers. If you’re looking for an individual plan, there are four types of health insurance plans you can purchase through the federal marketplace — HealthCare.gov — or your state marketplace.

EXPERT PICKS: WHAT TO READ NEXT

Signs of post-traumatic stress disorder (PTSD): There are more than a dozen symptoms associated with PTSD. Read about common signs and treatment options.
Ways to receive mental health therapy: There are different kinds of mental health therapy. Learn about which type may be right for you.
Physical symptoms of grief: Discover how the emotions of loss can also result in physical symptoms, such as nausea, shortness of breath, and tightness in the chest.

Tips for using private insurance to pay for grief counseling

Here are some strategies to keep in mind when it comes to paying for your care:

Try to find a therapist who is in your insurer’s network. This will help you save money. You can search for grief counselors using your insurance plan’s provider directory, which can help you find in-network healthcare professionals and facilities. If your counselor doesn’t accept your insurance, you will likely have to pay up front. Your insurance plan may reimburse some of the cost, but it’s also possible that out-of-network care will not be covered at all.
Consider asking for a superbill. If you go out of network for counseling, you can ask your therapist for a superbill — similar to a detailed invoice — and request partial reimbursement from your insurance plan. Superbills often include charges for multiple dates of service and the costs can apply toward your deductible. Before starting therapy, check with your therapist or counselor about creating superbills, and contact your insurance plan about how they handle and pay superbills.
Tap into your tax-advantaged healthcare account. You may be able to pay for your out-of-pocket mental healthcare using tax-free funds from a flexible spending account (FSA), a health savings account (HSA), or a health reimbursement arrangement (HRA).

Does Medicare cover grief counseling?

Yes, original Medicare (Part A and/or Part B) covers many mental health services. Medicare Part B helps pay for outpatient mental health services. Part B also covers depression screenings, partial hospitalization for mental healthcare, and intensive outpatient program services (e.g., psychiatric care, counseling, and therapy).

Will health insurance cover telehealth counseling?

Yes, many insurance plans cover telehealth counseling. Telehealth services allow you to have virtual visits with healthcare professionals using an electronic device, such as a computer, smartphone, or tablet.

Private insurance

Many commercial health plans cover telehealth services. Contact your insurance company and check your SBC to learn details about your coverage for remote counseling.

Medicare

Original Medicare and Medicare Advantage plans cover some telehealth services, but you may not be covered with all healthcare professionals or at all locations. Mental health services received at home are covered anywhere in the U.S. But enrollees who live in rural areas have more access to telehealth services.

Medicaid

Medicaid is the single largest payer for mental health services in the U.S. Programs are jointly funded by the federal government alongside states and territories. Check with your state or territory’s Medicaid agency to find out if you qualify for covered telehealth counseling.

Tricare

Tricare is federally funded health insurance for active duty and retired U.S. service personnel and their family members. If you’re eligible, benefits can be paired with Medicare. Tricare virtual health benefits include mental healthcare, such as counseling for PTSD.

What kind of professionals treat grief, trauma, and PTSD?

There are many kinds of mental health professionals who can provide grief, trauma, or PTSD counseling. Each type of licensed mental health provider offers different skill sets. Some options include:

Psychologists: Psychologists have doctoral degrees (PhD or PsyD) and provide therapy and/or counseling. In a few states, psychologists can prescribe medication.
Psychotherapists: These professionals have at least a master’s degree. Their occupation may be a licensed marriage and family therapist (LMFT) or a licensed professional counselor (LPC).
Licensed clinical social workers (LCSW): These mental health providers hold a master’s degree in social work and often provide counseling.
Psychiatrists: Psychiatrists are licensed medical doctors with an MD or DO who have attended medical school and residencies for specialized training in mental health. These physicians can diagnose conditions and prescribe medications, if needed.
Psychiatric or mental health nurse practitioners and advanced practice nurses: These nurses hold at least a master’s degree and specialize in psychiatry and/or psychotherapy. Those certified as nurse practitioners have some level of diagnosing and prescribing authority in every state and Washington, D.C.

What can you expect when you go to grief counseling, and are there any specialized groups?

Counseling offers a safe space for you to work through your difficult thoughts and feelings with a trusted mental health professional. In one-on-one grief counseling, your healthcare professional will listen and then can offer support and coping strategies, so you can move forward in a positive way. If you have issues such as sleeplessness or depression as a result of your grief, you may be referred to another healthcare professional for treatment.

If you’re more comfortable in a group setting, you may be able to find free or low-cost grief support groups near you. A support group can allow you to get counseling while being surrounded by people with shared experiences. In support groups, members take turns talking, as a counselor — who may be a peer counselor — moderates the discussion.

Unlike support groups, group therapy sessions are considered mental health treatment and may be covered by insurance.

Are resources available if you’re uninsured and struggling to find help?

If you are uninsured or underinsured, you may have access to free or low-cost PTSD treatment, as well as other affordable counseling resources, near you or online. Here are some options to keep in mind:

Some counselors offer discounts or charge on a sliding scale that’s based on what clients can afford.
The National Alliance on Mental Illness (NAMI) has more than 650 chapters and affiliates across the country. One near you may offer free support and education programs.
Community health centers often provide low-cost mental healthcare, including counseling services, on a sliding scale. Find a health center near you.
If you’re employed, check with your human resources department to find out about workplace benefits beyond health insurance.You may have access to an employee assistance program (EAP), which usually offers counseling services. EAP emotional well-being services, like grief counseling, are free and confidential.

Mental health hotlines

There are several national mental health hotlines that provide counseling and other kinds of support, including helping you find resources in your community:

If you have thoughts of suicide or need immediate support, dial 988 to reach the 988 Suicide & Crisis Lifelife.
If you’re facing mental health or substance use issues, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) offers a National Helpline at 1-800-662-HELP (1-800-662-4357).
Veterans can access the Veterans Crisis Line by calling 988 and pressing 1 for immediate support, including suggestions for local resources.
Domestic violence survivors can call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-799-7233). Visit www.thehotline.org to live chat with support staff or to consult an AI counselor. You can also access help by texting “START” to 88788.
Eldercare Locator is a website that helps older adults nationwide find resources in their community. You can also call 1-800-677-1116.

Frequently asked questions

While counselors set their own rates, the average cost of an in-person or online grief counseling session without insurance is $75 to $150 per session, according to Talkspace, a virtual network of licensed therapists and licensed psychiatric healthcare professionals. In-person sessions can cost more — even if the additional expense is parking or transportation. If you have insurance, you may only be responsible for a copay when you have a grief counseling session.

Perhaps the most important thing to look for is a therapist who has experience treating people with PTSD. The American Psychological Association recommends first-choice treatment approaches for PTSD, which include cognitive behavioral therapy (CBT).

The bottom line

It can be normal to feel sad and anxious during challenging times in your life, particularly when you’ve lost something or someone valuable to you. If you’re struggling, support is available through counseling for grief, post-traumatic stress disorder (PTSD), or trauma.

Your options may include individual or group counseling — in person or virtually via telehealth. Most insurance plans, including Medicare, cover counseling as part of their mental health benefits. You may also be able to access mental healthcare through organizations that provide free and low-cost services near you, online, or via hotlines.

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Written by:

Tamara E. Holmes

Tamara E. Holmes is a Washington, DC-based freelance journalist and content strategist who has been writing about personal finance, health, and health insurance for more than a decade. Her work has appeared in various print and online publications, such as USA Today, AARP, Working Mother, and Diversity Woman.

Edited by:

Cindy George, MPH

Cindy George, MPH, is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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