What to know about Blue Cross Blue Shield mental health coverage

If you’re thinking about starting therapy, you may wonder, “Does Blue Cross Blue Shield cover therapy?” 

Many Blue Cross Blue Shield (BCBS) plans cover therapy and other mental health services. However, what your plan covers and how much you pay can vary.

BCBS offers different health plans across the country. Your coverage may depend on where you live, your plan, and if your therapist accepts your insurance. Knowing what your plan covers can help you find care that fits your needs and budget.

What’s usually covered by Blue Cross Blue Shield 

Many BCBS plans ^[1] cover individual therapy for adults, children, and teens, as well as family therapy and psychiatry. Some plans may also cover couples therapy when it’s part of treatment for a mental health condition.

Coverage often includes common therapy approaches like cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and applied behavior analysis (ABA) for autism. Other benefits may include online therapy, group therapy, medication management, and inpatient mental healthcare.

BCBS companies also support mental health programs for children and teens. For example, they’ve invested in trauma-informed programs ^[2] to help young people feel safe, supported, and understood.

Common exclusions of BCBS coverage

Some plans may not cover couples counseling for relationship concerns alone, life coaching, or experimental treatments.

Out-of-network care may also cost more or may not be covered. If a service isn’t covered, you can ask BCBS about other options, appeal a denied claim, or look for providers who offer lower fees.

Does Blue Cross Blue Shield cover online therapy?

Many Blue Cross Blue Shield plans cover online therapy and online psychiatry. This means you may be able to meet with a licensed therapist or psychiatrist from home. Online psychiatry may also include mental health exams and medication management.

However, coverage depends on your plan and if your provider is in network. Check with BCBS before booking an appointment to learn what's covered and how much you’ll pay.

How Blue Cross Blue Shield coverage works

Blue Cross Blue Shield offers different health plans, so your therapy benefits may vary. Health maintenance organization (HMO) plans typically require you to use providers within a specific network. Preferred provider organization (PPO) plans offer more flexibility, including some coverage for out-of-network care, but may cost more. 

Here’s what to know before starting treatment:

• Referrals: Many BCBS plans don’t require a referral to see a therapist. However, some HMO plans may require one from your primary care doctor.

• Plan types: HMO plans often require you to use in-network providers. PPO plans usually offer more choices, including some coverage for out-of-network care.

• Session limits: Many plans don’t set a fixed limit on how many therapy sessions you can have each year. You may be able to attend weekly or more often if needed. However, your plan may have rules about which services it covers.

• Copays: You may pay a set fee for each therapy visit. This is called a copay, and the amount depends on your plan.

• Deductibles: Some plans require you to pay for covered care until you meet your deductible. After that, your plan may pay more of the cost, while you pay a copay or a percentage of the bill.

Check your plan details or call the number on your insurance card to learn about your benefits and costs.

The basics of using BCBS for mental healthcare

BCBS offers different health plans, so your mental health coverage may vary. Understanding how your plan works can help you know what to expect when starting therapy, from finding a provider to paying for sessions.

How to get the most out of your BCBS insurance

To make the most of your BCBS mental health benefits, choose an in-network provider whenever possible. This can help lower your out-of-pocket costs. You can also ask about online therapy, review your deductible and copays, and check whether your plan offers additional mental health resources or support programs.

BCBS is working to improve access to mental healthcare ^[3] through expanded provider networks, online services, and community programs. Ask your plan about available resources, including virtual care and help finding a mental health provider.

Does BCBS cover out-of-network providers?

Some BCBS plans, especially PPO plans, offer coverage for out-of-network therapy and psychiatry. However, HMO plans typically don’t cover out-of-network care unless an exception applies.

If you see an out-of-network provider, you may need to pay the full cost up front. You can then request a superbill, which is a detailed receipt you submit to BCBS for possible reimbursement. Your plan determines how much you'll receive, and processing times can vary. You may also owe costs above what BCBS considers an eligible charge.

Which states does BCBS cover therapy in?

BCBS companies offer health insurance plans in all 50 states and Washington, D.C. However, your coverage is tied to your specific plan and provider network.

How much does therapy cost with BCBS?

Your therapy costs depend on your plan and whether you’ve met your deductible. For example, one plan might charge a $25 copay per session, while another may require you to pay the full in-network rate until you meet your deductible. These are examples, not guaranteed BCBS rates.

If you have a high-deductible plan, ask BCBS for the negotiated rate for an in-network therapy session. This may be lower than the therapist’s regular fee. You can also explore community mental health centers or providers who offer sliding-scale fees.

How to check if your BCBS plan covers therapy

You can check your mental health benefits by following these steps:

1. Log in to your BCBS member portal or call the number on your insurance card.

2. Find the section for mental health or behavioral health benefits.

3. Review your copays, deductible, coinsurance, and out-of-network coverage.

4. Ask whether you need a referral, prior authorization, or a mental health diagnosis for the services you’re seeking.

5. Confirm whether online therapy and psychiatry are covered.

You can also request a “summary of benefits and coverage” (SBC) document, which explains what your plan covers and what you may pay.

How to check if your provider is in network

Start by using the provider directory on your BCBS member website. Search for therapists or psychiatrists by location, specialty, and insurance network.

BCBS reported a 55% increase in their behavioral health provider networks ^[4] between 2019 and 2023. This may give members more options for finding care, but it’s still important to confirm that a provider accepts your specific plan.

Before booking, contact the provider to confirm they accept your specific BCBS plan. You can also call BCBS with the provider’s name and National Provider Identifier (NPI) to verify their network status.

If you switch therapists, you’ll need to check again. Even when two providers accept BCBS, they may participate in different networks.

Do Rula providers accept Blue Cross Blue Shield?

Rula accepts many Blue Cross Blue Shield insurance plans for online therapy and psychiatry. This includes plans offered by Anthem, Highmark, and other BCBS companies.

However, not every Rula provider accepts every BCBS plan. Coverage depends on your specific insurance plan, location, and the provider you choose.

To find out if you’re covered, use Rula’s cost estimator. You can check if your plan is in network and get an estimate of your therapy or psychiatry costs before scheduling. Rula also verifies your benefits and provides a cost estimate before your first appointment.

Clinician’s take

I wish more people knew that therapy may be more affordable than they think. Even if you have a high deductible, your insurance may offer benefits that help lower the cost of care. I encourage people to explore their coverage and ask about their options before assuming therapy is out of reach.

Brandy Chalmers, LPC

Clinical reviewer