Is EMDR Covered by Insurance? Here's What You Need to Know
By: Maria Inoa
Sep 23, 2024
Yes, most insurance policies cover EMDR therapy as it falls under the therapy or behavioral therapy category. Though major insurance policies often cover it, you will require a diagnosis to use your insurance for therapy. Most insurance policies only cover a certain length of session. They may also dictate how many sessions you can have, regardless of whether treatment is completed.
A popular question about EMDR treatment is whether or not it's covered by insurance. In the following guide, we will discuss how much does EMDR therapy cost as well as insurance plans. We'll briefly touch on how EMDR works and conditions treatment by EMDR therapy sessions. Then, we'll look at insurance coverage, what to ask your insurance company and out-of-pocket costs for EMDR treatment. Lastly, we'll discuss options if your insurance does not cover EMDR therapy.
How EMDR Works
Eye Movement Desensitization and Reprocessing therapy is a trauma therapy that utilizes brain science to help people heal past traumatic events. It differs from traditional talk therapy as though talking is part of it; EMDR treatment follows a specific, structured process.
The heart of Eye Movement Desensitization and Reprocessing therapy is reprocessing distressing memories so that they are stored in your brain and body neutrally.
Reprocessing traumatic memories is done by using bilateral stimulation, which means utilizing both the right and left sides of the brain to tap into the brain's healing ability.
EMDR treatment started by using back-and-forth eye movements but has since progressed into having the option to use back-and-forth tapping movements that are equally effective. Some EMDR therapists even add music that uses bilateral beats in addition to using eye movements or tapping.
EMDR addresses the past, present, and future. It addresses current concerns and symptoms as well as past distressing memories. In addition, EMDR therapy sessions include future situations that can come up to make sure you are equipped and prepared for success. This form of trauma therapy consists of 8 phases.
The initial phases involve:
Gathering history.
Creating a treatment plan.
Creating internal resources or special coping skills to prepare for the reprocessing phase.
The last phases involve reinforcing the now more neutralized memory and positive beliefs since the negative beliefs have been desensitized, as well as doing a body scan to ensure no remaining negative body sensations come up. Lastly, future situations are discussed to set you up for success.
Related: How Many EMDR Sessions Do You Need?
Conditions Treated with EMDR
Eye Movement Desensitization and Reprocessing therapy is known for its effectiveness in treating traumatic memories and post-traumatic stress disorder. It can also help with conditions including anxiety disorders, panic attacks, grief and loss, eating disorders, substance abuse, and pain.
Insurance Coverage for EMDR Therapy
Most insurance policies cover EMDR therapy as it falls under the therapy or behavioral therapy category. Though major insurance policies often cover it, it's important to note that you will require a diagnosis on file if you choose to use your insurance for any therapy.
In addition, most insurance policies only cover a certain length of session, typically 45-50 minutes. Lastly, your insurance provider can dictate how many EMDR sessions you are permitted to have, regardless of whether therapy is completed or not.
How to Verify Your Insurance Coverage
If using insurance is important to you, I always encourage potential clients to call their insurance company to clarify information before we schedule.
Here are a few questions I suggest asking:
Is EMDR treatment covered under my insurance plan?
Do I have a copay? If so, how much is the copay?
How many EMDR sessions are covered?
How long of EMDR sessions am I permitted under my insurance plan? (can be 45, 50, or 60 minutes; sometimes more)
Can I see an EMDR therapist/provider who is out of network?
If the EMDR therapist/provider is out-of-network, what percentage can I get reimbursed?
You must understand your policy so that you don't get any surprise bills.
Out-of-Pocket Costs for EMDR Therapy
A typical EMDR therapy session costs $150- $200 per session, depending on where in the country you reside. A rough average is $150 - $200, but again, that can vary greatly.
Some licensed therapists maintain a few sliding scale spots for clients. This means that they have a discounted session rate they can offer you.
Most licensed therapists do not utilize payment plans because of ethical concerns.
Related: How Much Does EMDR Therapy Cost?
What to Do If EMDR is Not Covered
It's important to understand that EMDR treatment is a specialized form of therapy where a licensed therapist has received advanced training.
Suppose your insurance company does not cover EMDR therapy. In that case, you have the option of paying out-of-pocket for EMDR therapy work or seeking a different type of therapy.
Most large insurance companies will cover basic therapy sessions unless it is a more experimental or brand-new therapy. As mentioned above, it does depend on whether your specific insurance plan includes therapy.
If you have a Health Savings Account (HSA) that is linked to your insurance plan, you can often use it to pay for part or all of your EMDR therapy sessions.
Depending on where you live, you may be able to find a low-cost EMDR therapist. Making a few phone calls or doing an internet search may provide an option.
Conclusion
In conclusion, this guide has taken you on a deep dive into Eye Movement Desensitization and Reprocessing therapy, whether insurance covers EMDR therapy sessions and out-of-pocket EMDR therapy costs.
We first touched on how EMDR works via reprocessing past distressing memories through bilateral stimulation. We explained what issues or mental health conditions EMDR is helpful for.
Next, we looked at whether EMDR is covered by insurance companies and questions to ask when verifying whether you have insurance coverage. We discussed out-of-pocket costs, which average $150-$200 per session, and what you can do if your insurance does not cover therapy or EMDR treatment, including utilizing an HSA account.
If you are considering EMDR treatment, I'm excited for you! The EMDR healing process can be life-changing in the best ways. Your mental health and any mental health issues you may struggle with are valid. Your well-being truly matters.
