Is EMDR Usually Covered by Insurance?
Imagine your brain is like a computer that sometimes gets stuck on a scary or painful memory. It makes you feel scared or sad, even when you don't want to. EMDR is a therapy used to help folks who've been through tough things. EMDR is short for Eye Movement Desensitization and Reprocessing. EMDR therapy is like a special program that helps your brain process memories so they don’t get stuck. You feel less triggered by your triggered symptoms as a result. EMDR is a helpful treatment for trauma and PTSD but is it covered by insurance? In this blog, the complexities of insurance coverage for EMDR will be covered!
The Basics of EMDR Therapy
In a session, you will meet with a trained EMDR therapist through EMDRIA. There are 8 stages of EMDR therapy. In the later stages, your therapist will ask you to think about a memory that troubles you. While thinking about this memory, they will invite you to follow their finger with your eyes or tap. This might sound strange but there is a reason they do this! It is called bilateral stimulation. Bilateral stimulation is a fancy term for doing something that moves back and forth. The eye movements or tapping help your brain focus on the memory while also staying in the present moment. This can make the memory feel less intense over time. EMDR helps you untangle a memory like untangling a knot!
Health Care Coverage 101
Having insurance coverage makes mental health treatment more affordable and accessible. Therapy can be expensive, and not everyone can afford to pay for it out of pocket. Insurance coverage can reduce the financial burden. Unfortunately, insurance is not perfect and there are a lot of barriers to access.
There are many types of insurance plans but not all cover mental health treatment, like EMDR therapy. It's important to remember that even if you are in network, it does not mean that treatment is free. Some insurance plans might cover most or all of the cost of EMDR therapy, while others might only cover a little bit or none at all. You have to meet a high deductible before any services are covered. It depends on the specific plan you have and what it includes. Most plans offer at least some coverage for mental health treatment. It's important to check with your insurance provider to see what kind of coverage you have for EMDR therapy.
In-Network vs. Out-of-Network Benefits
When it comes to insurance plans, there are two main types: in-network and out-of-network.
In-Network:
Each insurance company has a big group of doctors, therapists, and hospitals that they work with. These are the "in-network" providers. For in-network insurance plans, your insurance company has agreements with certain providers to charge you a set rate. When you visit an in-network therapist, your in-network benefits apply.
Out-of-Network:
Now, let's say you want to see a doctor or therapist who isn't part of your insurance company's group. These are the "out-of-network" providers. Not all insurance plans have out-of-network benefits. You can call the number on the back of your card to determine if you have these benefits! Out-of-network providers don't have agreements with your insurance to offer services at a set rate. Therefore, you might end up paying a higher fee. You may be able to get some of your appointments covered by your insurance depending on your out-of-network benefits.
Criteria for Insurance Coverage of EMDR Therapy
Insurance providers have rules that you have to meet for therapy including EMDR to be covered. Therapy must be provided by a licensed mental health professional, medically necessary and you must meet the criteria for a DSM-5 diagnosis such as post-traumatic stress disorder (PTSD). You may also need a referral or have a limit on the number of sessions covered. Criteria can vary a lot depending on your insurance plan and provider.
Tips to Determine if Your Insurance Covers EMDR
Before scheduling an appointment for EMDR, it can be helpful to call the number on the back of your card and ask the following questions:
Do I have a deductible for mental health visits? If so, what is my deductible, and how much is left?
Do I have a copay for outpatient mental health visits?
Do I have coinsurance for outpatient mental health visits?
Is there a limit on sessions my plan will cover per year? If yes, how many?
Does my plan cover the CPT codes 90791 and 90837?
Does my plan cover virtual video visits (if applicable)?
Do I need a referral for outpatient mental health services?
Alternative Resources for Accessing Affordable Therapy
If you're unable to get therapy covered by insurance or if you don't have insurance, you can still access EMDR! There are alternative resources available to help you access affordable therapy. Many therapists offer sliding-scale fees based on income. This means they'll adjust their rates to make therapy more affordable for you. Open Path Collective is an online database of therapists who offer low-cost individual and couples counseling. You can also look into community mental health centers or nonprofit organizations in Detroit or Ann Arbor. Great resources include Detroit Community Health Connection, Inc, CHASS Center Detroit, and Washtenaw County Community Mental Health in Ann Arbor. Typically these organizations offer low-cost or free therapy services. If you are in college, many schools including the University of Michigan, Eastern Michigan University, and Wayne State University have clinics where graduate students provide low-cost therapy.
Begin EMDR in Ann Arbor, Michigan!
Do you have more questions about your insurance plan and if it covers EMDR? Embodied Wellness, PLCC is in-network with Blue Cross Blue Shield PPO (BCBS PPO) and Blue Care Network (BCN). If you are out of network with these plans, we offer a superbill for out-of-network reimbursement. We offer limited sliding scale options! Follow these steps to get started with EMDR in Ann Arbor or Detroit, MI:
Reach out via text, email, or phone for a free 15-minute therapy consultation.
Connect with an EMDR of your choice!
Start EMDR to heal from trauma.
Other Services at Embodied Wellness in Ann Arbor, Detroit, and throughout Michigan
Are you looking for other services besides EMDR? Our other services include Empath therapy and Online Therapy. Our specialties include OCD treatment and ERP therapy, DBT, depression treatment, and Internal Family Systems. All these online therapy services are available for teens and adolescents as well as adults. Nosotros tambien ofrecemos terapia en español en Detroit y otras partes de Michigan. Get in touch with our Detroit-based practice today!
About the Author:
Sarah Rollins, LMSW, SEP is the founder of Embodied Wellness, PLLC, a group therapy practice providing online therapy in Michigan. She is passionate about expanding awareness of somatic therapy as a way to treat and heal trauma. She incorporates other holistic treatments into her practice including EMDR, IFS, and attachment theory.