All relationships have their ups and downs. When the downswings grow serious or more numerous than the upswings, it's usually time to consider seeing a couple's therapist.

If you're seeking couples therapy, you might find that it's harder than you expect. In particular, insurance is often a barrier to many, even though it's meant to facilitate access to care that would otherwise be unaffordable or out of reach.

Blue Cross Blue Shield of Michigan is the most common insurance provider in the state, covering around half of all those insured throughout Michigan. There's a good chance they're the ones providing your insurance, so how do you find a therapist for your couple's therapy that takes BCBSM?

Fortunately, care is easier to find than you might think. You just need to keep a few things in mind as you go.

DISCLAIMER: This article is for informational and educational purposes only and should not be considered medical or psychological advice. The information presented here is not intended to diagnose, treat, cure, or prevent any mental health condition or replace professional therapeutic care. Every individual's experience with trauma and mental health is unique. Please consult with a qualified mental health professional, therapist, or healthcare provider to determine the most appropriate treatment approach for your specific situation. If you are experiencing a mental health crisis or emergency, please contact your local emergency services or crisis hotline immediately.

Does BCBSM Cover Therapy?

First, to answer the most obvious question you might have: yes, Blue Cross Blue Shield of Michigan covers mental health treatment and substance abuse treatment, including therapy like CBT, DBT, and EMDR.

However, that's not to say that your specific plan will cover all possible treatments.

The good news is that general mental health coverage is required under both federal and state law. Laws like the Mental Health Parity and Addiction Equity Act of 2008, as well as provisions in the Affordable Care Act, and Michigan's Senate Bill 27, all require parity between mental and physical health coverage. We cover this in greater detail in our guide to mental health parity laws here.

The tricky part is what constitutes mental health treatment, according to your health plan. BCBSM is required by law to cover mental health treatment in a similar way as physical health treatment, but they aren't required to cover all possible mental health treatments.

What this means, in practice, is that they tend to cover evidence-based treatments like DBT and EMDR, as well as traditional talk therapies. On the other hand, they will usually refuse to cover more experimental treatments or treatments considered investigational. Examples they have in their documentation include things like Freespira, NightWare, and Stanza, which are experimental devices that haven't been backed by sufficient evidence, at least in the eyes of the insurance company.

BCBSM also generally will not approve treatments that are considered alternative modalities, such as massage therapy, music therapy, or pet therapy. While these can have their benefits, they aren't considered scientifically-backed treatments on the level that BCBSM is willing to accept.

There are other details and exceptions as well. They won't cover therapy provided by an unlicensed care provider, for example. The specific exceptions can be found buried in the BCBSM documentation, but the easiest way to find out if a particular treatment is covered is to call them and ask.

Does BCBSM Cover Couple's Therapy?

So what about couples therapy? Does BCBSM cover couples therapy for you and your partner?

The answer is… actually, probably not. There are two main reasons for this.

The first is that relationship troubles are not considered a mental health condition. Since mental health treatment covered by insurance needs to center around the treatment of a diagnosable mental illness, it just falls outside of the category of things they'll cover.

This applies both to couples counseling and to marriage counseling. A relationship isn't, strictly speaking, a requirement to live a healthy life, so it's not a medical necessity.

The second reason is that couples therapy, by definition, covers you and your partner. Since your partner might not be covered under your insurance, BCBSM doesn't want to pay for services to someone who isn't paying for their insurance. Now, if you have a family plan or the same coverage through work or through private coverage, this isn't a factor, but the first one still applies.

Now, before you panic about not being able to access couples therapy at all, there's good news: you can still get it covered through one of a few possible avenues.

Option one is to determine if there's a valid medical necessity involved. If you or your partner has a diagnosable mental health condition like depression, anxiety, or PTSD, and a therapist recommends couples therapy as one component in treating that condition, you can get couples therapy covered by insurance.

Another possibility is that your plan might cover it regardless. As you likely know, what is and isn't covered by insurance, like BCBSM, depends heavily on the specific plan you have, as well as any add-ons you have added to your plan. For higher-tier plans, you may have couples therapy as an option, or you can get it as an optional add-on in some cases.

Now, do you have that coverage? We can't tell you from here. You'd have to check with your health plan's benefits guide.

The third possibility is that you don't treat it as couples therapy. Getting individual therapy to work on your issues throughout your life, with sessions that your partner sits in on and center around your relationship, can be billed as individual therapy instead of couples therapy. The end goal is the same, but the billing code is different enough to matter.

How to Tell if Your Health Plan Covers Couples Therapy

There are a few ways to find out whether or not your health plan covers the therapy you're after.

The first and easiest is to call BCBSM directly. Your insurance card, issued by BCBSM, will have a handful of phone numbers on the back. In particular, there is usually a general customer service phone number, as well as a specific behavioral and mental health and substance abuse help line. These numbers can also be found on the BCBSM website.

Another option is to check your plan documentation on the BCBSM website. Go to bcbsm.com and log in to your account. Once logged in, the "coverage" menu at the top of their website has options such as a coverage overview, an explanation of your medical benefits, and a copy of your member handbook, all of which may be able to provide you with the information you need about your plan.

If it sounds like we're being vague about where the information can be found, it's because it can vary, and it can change. HMOs, PPOs, employee plans, Medicaid; all of these have different documentation, and that's before you get to different tiers of plans and different add-ons. You'll need to navigate for yourself, or use the BCBSM virtual assistant to help.

You will also want to check whether or not your coverage can be billed directly or if you need to seek prior authorization. This, too, will be in your plan's documentation.

In broad strokes, you should expect explicit couples therapy not to be covered, but individual therapy that addresses relationship issues will be.

Locating a Therapist that Takes BCBSM in Michigan

When you know you want to pursue couples therapy, even if you have to go through individual therapy with a focus on relationship issues, the tricky part then is finding a therapist who accepts your insurance.

The good news is, as the most popular insurance provider in Michigan, more therapists than not will accept BCBSM.

The bad news is, not all will accept BCBSM, and it can be tricky to tell who does and who doesn't.

This is because you have to consider two different levels of acceptance: the facility level and the provider level.

For example, here at BMC-Troy, we accept Blue Cross Blue Shield. However, there are caveats.

• HMO and PPO networks are different, and a provider can be a member of one but not the other.
• Medicaid offered through BCBSM is treated differently than non-Medicaid insurance.
• While an office can accept BCBSM, providers in the office may or may not.

It's always important to find out whether or not your specific therapist will accept your specific insurance plan, and the best way to find out is to call and ask the provider's office.

This means you have two general approaches to finding a therapist.

You can seek out a couple's therapist, relationship specialist, or individual therapist who will work with you on relationship issues, and then hope they take your insurance. Or, you can seek out a therapist who can work with you through provider directories.

BCBSM has a " find care" option in its dashboard once you're logged in. By logging in, their website has the information about your plan, and can filter their list of providers down to just the ones that accept your insurance. Specifically, the behavioral health section allows you to browse local doctors or search for Teladoc virtual therapy.

There are literally hundreds of therapists in the BCBSM network in the Detroit area. Using their "find a doctor" system, you can filter down the list. Look, particularly, for details including:

• That they're accepting new patients.
• That they offer appropriate behavioral health or psychiatric treatment options.
• That they have a particular role, such as licensed social worker, therapist, or clinical psychiatrist.
• That they specialize in the kind of treatment you want (such as CBT, DBT, PTSD treatment, etc.)

You can also specify details that may be relevant to you, such as whether or not they offer services in your language, or if they are a specific gender (in cases where you or your partner have difficulties working with a provider of a particular gender).

If you find BCBSM's directory to be clunky or difficult to use, there are also public directories, such as the one from Psychology Today, as well. Same story here; filter by location, by services offered, and other details that can be relevant to you.

What About Virtual Therapy?

You might ask: Is jumping through all of these hoops worthwhile, or would it be better to just go with a virtual therapist?

That's up to you.

Through BCBSM's Teladoc system, you can be connected to licensed therapists or board-certified psychiatrists for your treatment, by phone call or video call. It's not like you're getting an unlicensed or untrained individual through one of these services; they're the same providers (and often many of the same people) providing these services remotely.

The difficulty comes in whether or not virtual appointments work for you.

On one hand, virtual appointments are great if you have mobility or scheduling issues, can't travel, or otherwise have difficulty bringing yourself to actually go to a meeting. They can also be cheaper, with lower co-pays and lower coinsurance costs than in-person meetings, though this can vary.

On the other hand, not everyone works well with virtual appointments. You might find it difficult to connect with your therapist when you're talking to them through a screen. If you live with roommates or children, you might find it difficult to feel like you're having a private conversation. It's also generally recommended for severe issues to meet in person, and use virtual visits for less severe appointments.

There can also be technological issues like spotty wi-fi, poor sound quality, and accidental disconnects. Beyond that, without being there in person, your therapist won't be able to watch for and pick up on nonverbal cues.

For some of you, none of these are concerns, and virtual visits will work just fine. For others, you'll prefer in-person visits. Either way, you can find a provider through one of the methods we've listed.

How We Can Help

Here at BMC-Troy, we're proud to offer marriage counseling, individual counseling, specialized therapies, and more. As mentioned above, we accept BCBSM, but you'll need to check with our office whether or not the specific provider you want to see will take your specific plan. It's as simple as reaching out!

To get started with your couple's therapy, call our office at 248.528.9000, or fill out our new patient intake form right here on our website. Both options can get you started with finding the care you and your partner need, and start on the road to an improved and healthier relationship.