Does Insurance Cover Sex Therapy?

Written By

Erica Barnes

Updated:

Fact Checked

does insurance cover sex therapy

Note: This post is supported by our readers and contains affiliate links, which will earn us a small commission at no extra cost to you. Therapy Helpers does not accept money for reviews.

Sexual health is an important component of overall wellbeing. However, many people experience challenges in their sex lives that can negatively impact relationships, self-esteem, and quality of life.

Sex therapy aims to help individuals and couples overcome these issues. But a common question is – does insurance cover the cost of sex therapy?

What is Sex Therapy?

Sex therapy is a specialized form of talk therapy provided by licensed mental health professionals known as sex therapists. The focus is helping people address sexual difficulties like:

  • Low sexual desire
  • Pain during sex (dyspareunia)
  • Inability to orgasm (anorgasmia)
  • Early ejaculation
  • Compulsive sexual behavior
  • Intimacy issues
  • Sexual trauma

Sex therapists use techniques like cognitive behavioral therapy (CBT) to help clients improve sexual self-esteem, communication, performance, and satisfaction.

Ad, keeps our community free. Therapy Helpers does not accept money for reviews.

betterhelp logo
review

4.5 (7,108+) FROM TRUSTPILOT

Fill out a brief questionnaire and get matched with an experienced therapist online in as little as 48 hours.

✓ Over 33K licensed professionals

✓ Financial aid available

✓ Subscriptions as low as $65/week, billed every four weeks

✓ Cancel plan or change therapist anytime

✓ 20% off your first month through Therapy Helpers

Common Questions About Insurance Coverage

Many clients wonder:

“Will my health insurance plan cover sex therapy sessions?”

Coverage varies greatly by plan. Most insurers view sex therapy as a mental health service and cover it the same as regular psychotherapy. Typically, large employer-provided policies offer the best benefits.

“Do I need a diagnosis for insurance to pay for sex therapy?”

In many cases, yes. Insurance plans often require a diagnosed mental health or medical condition to qualify services as medically necessary and covered.

Common diagnoses include sexual dysfunction, intimacy disorder, depressive disorder, and post-traumatic stress disorder (PTSD).

“What is the typical cost if my plan doesn’t cover sex therapy?”

Out-of-pocket rates range widely from $50-$200+ per session based on the provider’s credentials and location. Sessions usually last 45-60 minutes and average 12-20 visits.

Navigating Insurance Plans

Here are some tips for understanding sex therapy coverage under your health insurance:

1. Call your insurance company. Verify if your plan covers “sex therapy” or “psychosexual counseling” as an outpatient mental health treatment. Ask about visit limits.

2. Check if your provider is in-network. Search for an in-network sex therapist to minimize costs. Confirm they can bill services appropriately.

3. Get coded invoices. Ask to have each bill coded with a covered diagnostic and procedure code. This facilitates proper filing andclaim processing.

4. Appeal claim denials. If your insurer declines payment, appeal the decision if there’s reason to believe services qualify as “medically necessary care.”

Type of PlanTypical Coverage
MedicaidCovered
MedicareNot covered
Large Group PlansCovered if medically necessary
Small Business / Individual PlansNot covered usually

When Sex Therapy May Be Covered

In many cases, insurers will cover sex therapy if:

  • Provided by a properly licensed mental health professional
  • Deemed medically necessary treatment
  • Supported by a diagnosed physical or mental health condition
  • Billed under acceptable diagnostic and procedure codes

By taking the right steps to document medical need and network status, many clients can get coverage for issues like sexual pain, erectile dysfunction, vaginismus, and more.

sex therapy

Checking Your Specific Benefits

Navigating health insurance can be complicated. To determine your specific coverage details for sex therapy or similar services, always check directly with your insurance plan or the Healthcare Marketplace.

Contact a prospective provider to discuss medical coding procedures as well. Addressing these considerations proactively makes accessing care easier.

The taboo around sex difficulty is lifting, and help is increasingly available. Sex therapy gives the tools to unlock a happier, healthier sex life – and insurance coverage can aid affordability.

With some diligence about plan specifics, many can get their treatment costs covered.

YouTube video

Looking for more mental health tips? Make sure to follow our Mental Health Board on Pinterest!

Recommended Insights:

Cultural Bias And Anti Discimination In Ai Assisted Therapy

Cultural Competence, Bias, and Discrimination: Ethical Considerations for AI-Assisted Mental Health Therapy

Ethical implications of using AI and machine translation in mental health therapy for linguistically diverse populations are complex, requiring careful consideration of cultural competence, bias, discrimination, accuracy, privacy, and the need for therapist training to ensure responsible and equitable implementation.
How Does Mental Health Assessment Work

Mental Health Assessment Near Me & Online: Finding Best Option

Find the support you need with convenient online mental health assessments or resources for in-person evaluations near you.
Onlinetherapy Success In Native Languages

Exploring the Role of Native Language Therapy in Telemedicine and E-therapy Platforms

Telemedicine and e-therapy platforms expand access to mental health care, and offering therapy in a client's native language enhances comfort and potential effectiveness.

About the author

Erica Barnes

Erica Barnes

I’m an African American woman living in New York, with a Bachelor's degree in Communication. I’m passionate about researching mental health topics, spirituality, and breaking down stigma in my community. I’ve dedicated my life to shedding light on important issues surrounding mental health and working towards creating a more understanding and compassionate society. As a researcher at Therapy Helpers, I’m here to use my skills to educate and inspire others through insightful articles. Thank you for being here!Social

Leave a Comment