Sex therapy and insurance coverage

Dear Sick of Quickies,

It’s great that you’re asking questions and seeking support for your sexual well-being! Sex therapy is one option that may be useful to explore. To be able to decide if it's the right thing for you, it may be helpful to first understand what sex therapy entails and the various reasons why people seek it out. Sex therapy is a counseling technique that helps clients change their behaviors and attitudes about sex and intimacy. More specifically, it's an evidence-based form of psychological therapy that focuses on biological, psychological, interpersonal, and other factors that may be impacting someone’s sex life. It has been found to be effective in clients who come to therapy alone, but it’s even more effective (between 50 to 70 percent) with the involvement of the client’s partner(s). Depending on your insurance provider and the type of insurance you have, you may be able to use insurance for coverage.

The number of sessions clients seek out for sex therapy can range based on the client's needs and insurance coverage, though anywhere between five and twenty sessions is common. There are a variety of reasons that might lead a person to seek out sex therapy, such as:

• Erectile dysfunction
• Trouble reaching orgasm
• Pain during penetrative sex
• Dissatisfaction with quality of sex
• Navigation of sexuality or gender identity
• Processing sexual trauma

Relationship conflicts also sometimes lead couples to pursue sex therapy, as conflict can have a negative impact on intimacy. Many sex therapists use the cognitive behavioral therapy (CBT) treatment modality, which promotes behavioral changes by evaluating connections between the client’s thoughts, feelings, and behaviors. Sex therapists that practice CBT often assign “homework,” which encourages clients to practice new behaviors between sessions. As the therapy progresses, clients discuss their at-home experiences to hone in on the specific issues they’d like to work on.

Now, for your question about insurance coverage—whether or not sex therapy is covered by insurance depends on both the type of insurance you have as well as where you live. To find more specific information, it may be helpful to visit your insurance provider’s website or call the phone number listed on the back of your insurance card to speak with a representative. It may be a good idea to know which sex therapists are in-network and out-of-network as this will determine what kind of coverage your insurance provides and how you will pay. To find a therapist near you, start with searching your insurance provider’s in-network listings (typically accessible if you log in to your account on their website) or using the provider locator on the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) website. Always look for a certified or licensed sex therapist with a graduate degree and credentials from AASECT. Certified sex therapists don't have sexual contact with clients and conduct their work in accordance with regulated standards.

Once you select a therapist, call their office or send them an email to determine whether services are reimbursable by your insurer. If you’d like, you could also consult your primary care provider or call your insurance company directly and request a referral to a provider in your area. If your insurance doesn’t cover therapy, many therapists are willing to adjust their fees (often referred to as “sliding scale”) or work out a payment plan. Though it may take some research, there is likely a sex therapist out there that will fit your budget and schedule preferences. You may also consider looking for a sex therapy clinic (which are usually less expensive than private therapists) near you by calling your local hospital or university medical center.

Depending on your specific concerns and health status, you may need to see a sex therapist that works with a team of health care providers, which may include your primary provider, psychiatrist, psychologist, or counselor, or physical therapist. Sex therapists often request complete medical evaluations before or shortly after the treatment begins in order to properly diagnose the problem and identify the appropriate treatment plan. This evaluation may help determine between physiological and psychological concerns. Additionally, when a sex therapist recommends medication, they must collaborate with a licensed prescriber (physician, nurse practitioner, psychiatrist, etc.)

If it turns out that your insurance doesn’t cover sex therapy, don’t fret—you still have several alternate options. Whether you choose to tackle your concerns alone or work with the support of a sex therapist, there are several techniques you could try on your own. For example, you might try delaying orgasm and prolonging arousal. These exercises help people learn to change undesired behaviors (including premature ejaculation) on the road to climax. For these strategies to be effective they must be practiced often, as you’re teaching your body a new skill.

Good luck with your sex-ploration!