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Clients & Clinicians

Is EMDR Therapy Covered By Insurance? A Comprehensive Look for Therapy Seekers

Brandon Grill
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December 29, 2023

Is EMDR Therapy covered by insurance? This is a common question for many seeking therapy. EMDR, which stands for Eye Movement Desensitization and Reprocessing, is a type of therapy that helps people heal from stress and bad experiences.

In this article, you’ll discover:

Let's explore EMDR therapy and understand how insurance can help in getting it.

What is EMDR Therapy?

EMDR Therapy, or Eye Movement Desensitization and Reprocessing, is a unique form of therapy designed to help individuals cope with distressing memories. Unlike traditional therapy that primarily involves talking, EMDR incorporates a physical element – eye movements – to aid in processing these memories.

Aaron, a 43-year-old father, grew up in a home chrionically burdened by marital stress. As an adult, this childhood trauma affected Aaron's daily life and mood, so he decided to try EMDR therapy.

During his EMDR sessions, Aaron's therapist guided him through specific eye movements while he recalled his childhood experiences. This process helped Aaron's brain work through these old, painful memories. Over time, he found that the emotional weight of his past lessened, making it easier for him to enjoy the present and be there for his family.

This therapy is often sought for issues like:

The goal of EMDR is to change the way these memories affect you. Many find that after EMDR, their emotional distress is significantly reduced, leading to improved well-being.

The Benefits of EMDR Therapy

Developed in the late 1980s by psychologist Francine Shapiro, EMDR therapy has become a recognized and effective form of psychotherapy. It originated from Shapiro's observation that eye movements can reduce the intensity of disturbing thoughts, thus forming the basis of this therapeutic approach.

Here are key benefits of EMDR therapy:

  1. Reduces Stress from Past Traumas: EMDR is particularly effective in processing and reducing symptoms of traumatic experiences.

  1. Quick Results: Many notice significant changes after just a few EMDR sessions, making it an efficient therapy choice.

  1. No Need for Detailed Discussions: This therapy allows individuals to process traumatic memories without extensive verbal discussions, which is helpful for those uncomfortable with talking about their past.

  1. Improves Daily Functioning: By addressing past traumas, EMDR helps improve focus on the present, enhancing life quality.

  1. Supported by Research: EMDR's effectiveness, especially in treating PTSD, is backed by numerous studies.

Given these benefits, who wouldn’t want to know if EMDR is covered by insurance? 

Insurance Coverage for EMDR Therapy

Understanding insurance coverage for EMDR Therapy involves examining typical mental health policies and how they apply to this specific therapy. Here's a closer look:

Typical Insurance Policies: Most insurance plans cover a range of mental health treatments, including psychotherapy. However, EMDR therapy's coverage depends on whether the insurer recognizes it as a standard form of psychotherapy. While this still varies, it may not for long. The American Psychological Association (APA) recognizes EMDR as an effective PTSD treatment.

Impact of Session Length: The duration of EMDR sessions can influence coverage. Some insurance plans may have limits on the length of each therapy session they cover. For instance, they might cover an hour-long session but not the extended session that some EMDR therapies require.

Insurance Companies' View on EMDR: The acceptance of EMDR by insurance companies largely depends on how they perceive its effectiveness and legitimacy. Despite EMDR's proven success in treating trauma and PTSD, some insurers may be hesitant to cover it if they are not familiar with its methodology or recent research findings.

Now let’s look at coverage by a few popular insurance plans.

Coverage by Specific Insurance Plans

When it comes to EMDR therapy, coverage can vary significantly between different insurance providers. As always, be sure to contact your insurance before starting a new therapy. That way you can ensure you’re covered.

Here's a look at how some major plans approach EMDR:

Is EMDR Covered by Medicare?

Generally, Medicare covers mental health services, including psychotherapy. If EMDR is recommended as part of your treatment plan by a healthcare provider, there's a good chance it will be covered under Medicare. However, specifics can depend on individual circumstances and the details of your Medicare plan.

Is EMDR Covered by Medicaid? 

Medicaid's coverage for EMDR also varies. As a state-regulated program, the extent of coverage for mental health services, including EMDR, can differ from one state to another. It's advisable to check the specifics of your state's Medicaid program.

Is EMDR Covered by OHIP?

OHIP typically covers services provided by physicians and certain other healthcare practitioners. However, OHIP does not usually cover psychotherapy services like EMDR unless they are performed by a doctor or within a hospital setting.

Is EMDR Covered by Cigna?

As a private insurer, Cigna's coverage for EMDR can depend on the individual's policy and plan. It's important to review your policy details or contact Cigna directly to understand if EMDR is covered under your plan.

Is EMDR Covered by Blue Cross Blue Shield?

 BCBS coverage for EMDR can vary depending on the state and the specific plan. Some BCBS plans may cover EMDR as part of mental health services, while others might have exclusions or specific requirements.

For the most accurate information, it's crucial to contact your insurance provider directly. They can provide details on whether EMDR is covered under your plan and any specific conditions or limitations that apply.

Navigating Insurance for EMDR Therapy

Figuring out if your insurance covers EMDR therapy can be a bit tricky, but there are some practical steps you can take to navigate this process effectively:

  1. Review Your Insurance Policy: Start by carefully reading your insurance policy documents. Look for sections on mental health coverage and see if EMDR or psychotherapy treatments are mentioned.

  1. Contact Your Insurance Provider: For the most accurate information, call your insurance provider directly. Ask specific questions about EMDR coverage, including any conditions or limitations. Be sure to note down who you spoke with and the details of the information provided.

  1. Consult with Your Therapist: Often, therapists are knowledgeable about insurance coverage in their field. Your EMDR therapist might have experience with various insurance plans and can offer insights or even assist with the insurance process.

  1. Prepare for Possible Denials: In some cases, insurance companies may initially deny coverage for EMDR. Be prepared to appeal such decisions. Collecting documentation from your therapist about the necessity of EMDR for your treatment can be helpful in these cases.

  1. Understand Out-of-Pocket Costs: Even if your insurance covers EMDR, there may be out-of-pocket costs like co-pays or deductibles. Make sure you understand these costs upfront to avoid surprises.

By taking these steps, you can better understand your insurance coverage for EMDR therapy and make informed decisions about your treatment options.

Explore These Alternative Payment Options

If you find that your insurance doesn't cover EMDR therapy, or only covers a portion of it, there are alternative payment options you can consider:

  1. Sliding Scale Fees: Many therapists offer sliding scale fees based on your income. This means the cost of therapy is adjusted to what you can afford. This flexible payment option can significantly reduce the financial burden, making therapy more accessible.

  1. Out-of-Network Benefits: If your insurance offers out-of-network benefits, you can see a therapist who doesn’t directly work with your insurance company. You might pay upfront, but your insurance could reimburse a portion of the cost. Always check the terms of your insurance policy to understand the reimbursement process and what percentage of the cost might be covered.

  1. Paying Out of Pocket: If other options aren't viable, you can choose to pay for EMDR therapy out of pocket. While this might seem costly at first, consider it an investment in your mental health and well-being. Some therapists may offer discounted rates for upfront payments or multiple sessions, so it's worth discussing your situation with them. And for more on why some therapists don’t take insurance, read this.

By exploring these alternative payment options, you can find a way to access EMDR therapy even without full coverage. Financial constraints don't have to stop you from getting the help you need.


How Much Does EMDR Therapy Cost Without Insurance?

Want EMDR but don’t have insurance? Generally, the price for EMDR therapy can range from $100 to $250 per hour or session. The total cost depends on several factors, including the therapist's rates, the region where you receive therapy, and the specific needs of your treatment plan.

Since EMDR therapy usually requires multiple sessions to achieve the desired outcomes, the overall expense can add up. On average, the total cost for a complete course of EMDR therapy typically falls between $800 and $2,000. This cost reflects the cumulative price of all sessions needed to reach effective results. (Of course, this number can go much higher depending on the amount and type of your challenges.)

It's essential to consider these figures when planning for EMDR therapy. While the initial cost may seem significant, the benefits of this therapy, in terms of improved mental health and well-being, can be substantial. Always discuss the expected number of sessions and the total cost with your therapist upfront to plan your finances accordingly.

Conclusion

Finding out if your insurance will pay for EMDR therapy can be a bit tricky, but it's important.

Different insurance plans like Medicare and others have their own rules about EMDR. Contact your insurance to ask them about coverage. Know that sometimes, you might need to look at other ways to pay for it, like sliding scale fees or paying out of pocket.

If you’re serious about finding an EMDR therapist, get to know the ins and outs of your own insurance plan, then work with your chosen therapist to get started.

About the Author
Brandon Grill

Brandon Grill is a mental health copywriter and marketer based in Las Vegas, NV. He loves helping mental health professionals build fulfilling businesses. You can find Brandon going on a walk with his adorable nephews.