Illustration of couple with bright future, wondering if they can use insurance for premarital counseling.

Premarital Counseling Questions:

Can You Use Insurance for Premarital Counseling?

It’s a reality for the overwhelming majority of Americans that money often plays a significant role in the making of a wide variety of decisions. From where you choose to live to what you’re willing to put up with at work and much more, putting it simply: Money matters. 

So it’s no surprise that a couple who’s on the verge of marriage — perhaps having already committed thousands of dollars toward wedding event plans — would end up thinking twice about premarital counseling due to concerns about the cost of premarital counseling. They may make the understandable extrapolation of premarital counseling = counseling = therapy = mental health treatment = insurance! Yes! That’s why we get questions about whether you can use insurance for premarital counseling.

If you too have been wondering: “Is premarital counseling covered by insurance?” This article is for you.

You may be disappointed to learn that the short answer to this question is “no,” but that’s okay — and it’s also not where the conversation ends. There’s much more to this story.

Why Doesn’t Insurance Cover Premarital Counseling?

The goal of premarital counseling (or pre-engagement counseling) is to strengthen your relationship with your partner, explore growth opportunities together, and build healthy relationship skills that will lead to a strong, successful, and satisfying marriage for decades to come. This is important stuff: Premarital counseling can literally make or break a marriage.

In contrast, health insurance pays for “medically necessary treatment” of health-related issues. When health insurance covers therapy, it is only paying for the medically necessary treatment (i.e. “behavioral healthcare”) of mental health disorders and psychiatric illnesses, such as generalized anxiety disorder, major depressive disorder, etc. Nothing else. (Learn more about using insurance for therapy, if you’re interested). 

As important as all the perks of premarital counseling are — of which there are many — a couple’s desire to proactively build healthy relationship skills to make their marriage last a lifetime is not considered “medically necessary treatment” from a healthcare standpoint.

Health insurance does not pay for you and your partner to feel happy together, improve your communication, create alignment around goals, teach you how to get on the same page with finances, repair trust after betrayal, or stop unproductive fighting. 

Health insurance does not pay for relationship improvement; it only pays for the diagnosis and treatment of mental health conditions.

How Come Couples Counseling Is Covered By Insurance?

It’s actually not. Couples therapy and marriage counseling for the purpose of relationship improvement is not covered by insurance. Family therapy for the treatment of a psychiatric diagnosis is.

In some cases, if while working with a licensed psychotherapist, you or your partner were diagnosed with a mental health condition that required treatment, and your therapist felt that treating you with your partner present was the most direct route to healing and recovery (i.e., family therapy) health insurance may cover it. 

In these cases, either you or your partner were labeled as the “identified patient” and the other was participating in treatment. The therapy you underwent was for the explicit purpose of treating the diagnosed psychiatric condition…. But it’s not marriage counseling or couples therapy.

Fun fact: neither couples therapy nor marriage counseling exist as “treatments” though the eyes of your insurance company. There is individual psychotherapy, family psychotherapy, and group therapy. That’s it. For much more on this topic, check out “Is marriage counseling covered by insurance?

Why Is Family Therapy Covered By Insurance?

Family therapy is often covered by insurance, and rightly so. For example, if you or your partner is being treated for a psychiatric condition, such as bipolar disorder, post-traumatic stress disorder, an eating disorder, or a substance-use disorder, therapy that focuses on helping the family system support the identified patient’s recovery can be intrinsic to long-term symptom management. 

There are evidence-based types of couples and family therapy that research shows to be highly effective in reducing symptoms of conditions like post-traumatic stress disorder and depression, among others. High quality-therapy that teaches partners how to manage conditions like this are very valuable.  

When a child in a family system is experiencing mental health problems, it is also vital to have the parental system involved in their recovery through family therapy. Family therapy is often a more effective intervention for kids than individual therapy.

Under these circumstances, you certainly can and should use health insurance to pay for family therapy that includes you and your partner, and potentially your children too.

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Premarital Counseling Is Not Healthcare

Premarital counseling is not a treatment for a psychiatric condition, and that is okay. There are lots of reasons that people get involved in therapy or relationship growth work that have nothing to do with the treatment of mental illness. Personal growth, relationship improvement, self actualization: these are all incredibly important and valuable things to do.

The idea that premarital counseling is not covered by health insurance definitely should not turn you off to the idea of enrolling in a premarital program. Premarital counseling is an invaluable growth experience that helps you and your partner understand the strengths and growth opportunities that exist within your relationship. In turn, this process makes it more possible for you to develop skills and strategies that will keep your new marriage healthy and strong for years to come. 

Research shows premarital counseling helps marriages work better, and there’s also proof that couples who do not attend premarital counseling are at a bigger risk of experiencing difficulties and divorce.

It’s okay that insurance doesn’t pay for premarital counseling. Premarital counseling is incredibly valuable, and important to do anyway. Think about it: You didn’t try to use health insurance to pay for your college education either. Premarital counseling is like that: A long term investment in the things that matter most in this lifetime — Love, Happiness and Success.

How Much Does Premarital Counseling Cost?

You might be thinking, “Well okay. Darn. If I can’t use insurance to cover premarital counseling… how much does premarital counseling cost?” Valid concern! 

Please know that a really good, meaningful, high quality non-religious premarital counseling program is not as expensive as you might think. However, the important thing to remember is that a return on investment in premarital counseling is hardly quantifiable, nor should it be. 

In other words: Can you put a price on a happy, functional marriage that lasts a lifetime? I addressed this question in depth in this article I wrote: How much does marriage counseling cost? I hope that you check it out. 

Growing Self has a few options for premarital programs that vary in price and are very affordable, especially when you put them in context of the long term value. Our options include: 

Our Lifetime of Love Premarital (and Relationship) Course. This is our most affordable premarital counseling program. The Lifetime of Love Class (or “LOL,” as we like to call it) covers the most important relationship skills, like how to keep your love strong, how to communicate, how to keep sexual and emotional intimacy vibrant, how to create agreement, how to resolve conflict, and how to build a shared future together that honors both of your most important values. This is a live class taught either in person or online in real-time. Typically, the class meets for three, two-hour sessions, or for a one-day, six-hour session. We have both evening and weekend options available.

Either Meagan T., MA, LMFT or Brenda F., MA, LMFT will be your instructor. They typically charge $180 for a private 60 minute session, but they charge just $260 per couple for the entire Lifetime of Love class. That’s a savings of over $700, compared to the cost of six, 60 minute private sessions with one of them. It’s a steal.

Private pre-marital counseling is your other option, and it’s truly affordable when you consider the value it brings to your marriage in the decades head.

The cost of premarital counseling varies a bit on who you work with, how many premarital counseling sessions you need, and whether you choose to meet for 45 or 60 minute sessions. If you work with one of our “advanced clinicians” you’ll pay about $145 per 45 minute session, possibly lower if you qualify for our income-based sliding scale rates. If you work with one of our “early career clinicians” you will pay $115 per 45-minute session, or lower if you qualify for their sliding scale rates. (Possibly as low as $75 per session, depending on your income).

But word to the wise here — please don’t get so hung up on the money that you forget about the value. It’s so short-sighted. Personal share: I’ve been married, personally, for over twenty-five years. Over those years, my husband and I have spent so much money on things that were fleeting. Ski passes, trips, and we have had several couches that we eventually brought to Goodwill. Clothing and expensive snowboard gear that has long since been replaced, restaurant meals — literally tens of thousands of dollars on assorted stuff that neither of us even remember now.

We did not do pre-marriage counseling together. Honestly, at that time, we were so young, and it was many years before I went to counseling school — I didn’t even know that it was a thing. So we just got married, because we loved each other, and then, predictably, things got hard. Like every couple, nobody taught us “how” to have a healthy relationship and we had things to work through. We had to adjust our expectations for our relationship as we went along, navigate finances as a couple, and continually find ways to strengthen our relationship.

Forgoing premarital counseling was a mistake. Thankfully, we wound up going to marriage counseling a few years after we were married. That is how long it took for things to deteriorate to the degree that we really, really needed to do something, because our relationship was starting to feel unsustainable. We wound up seeing a marriage counselor for about 8-10 sessions. At the time, we paid her around $95 bucks a session. (She kindly offered us sliding scale rates because we were broke and she felt sorry for us). Ironically, one of the things we had the most conflict around was money.

We may have spent $950 over the course of several months seeing that marriage counselor. A lot of money, more than our monthly rent at the time, but in retrospect, that few hundred dollars was among the most valuable and important things we ever invested in — right up there with buying a house, having children, and investing in my education. It set our marriage up to last a lifetime.

Having a happy, stable marriage is truly priceless. Meaningful and authentic premarital counseling with a marriage counselor is how you set your marriage up for success. (Unless you want to wait, like my husband and I did, and show up for marriage counseling after the inevitable issues arise — which, I can assure you, is a significantly more stressful and less fun way to do it.)

So, the answer to your original question is no. Health insurance does not cover premarital counseling and doing it right costs money. And, it doesn’t matter. Truly.

To put it in perspective, the best premarital counseling is going to cost significantly less than the $2500 that the average couple “invests” in just the flowers for their wedding. Wedding flowers wind up in the trash, along with all the other stuff we buy that doesn’t mean a thing, in the end.

Investing in your relationship with each other is what’s going to make it last as long as the diamond in your ring. Nothing else matters, in the end. That’s the valuable part worth investing in, and I sincerely hope that you do.

There you have it: some free advice from an experienced marriage counselor, as a wedding gift to you. [I have more answers to your premarital counseling questions here.]

Wishing you much love and happiness, and a bright future together…

Dr. Lisa Marie Bobby

Meet a Few of Our Expert Premarital Counselors