You've decided to try couples therapy, and one of you has a Blue Cross card in your wallet. The next question is a practical one: does Blue Cross cover couples therapy, and how do you find out before the first session? This guide walks through which Blue Cross you likely have, what usually decides whether a session is eligible, how claims can work when you both have benefits, what to ask and how direct billing works with us.
This post is general information, not insurance or financial advice. Every plan is different, and only your plan can confirm what it pays.
The short answer: it depends on your plan and the therapist's credential
Can insurance help with couples sessions at all? It often can, but there's no single yes or no. Whether Blue Cross pays toward couples sessions usually depends on two things: the mental health benefit in your specific plan, and the type of practitioner you see. The label "couples therapy" on its own usually isn't what a plan looks at. The practitioner's designation, and whether your plan lists it, tends to matter more.
So if you're asking "does Blue Cross cover couples counselling for us?", the most useful thing you can do is check your own coverage before you book. The rest of this guide shows you how.
Which Blue Cross do you have?
Many people are surprised to learn that Blue Cross in Canada isn't one company. The Canadian Association of Blue Cross Plans describes itself as an association of independent Blue Cross plans, each serving its own region.
In Ontario, Blue Cross of Canada's own regional page lists two names. Ontario Blue Cross handles personal and family health, travel and life insurance. Medavie Blue Cross handles group coverage, the kind of benefits you might get through an employer.
If your benefits come from work, it's likely a group plan, so questions about Medavie Blue Cross couples therapy coverage go to Medavie. Look at your card or your online account to see which name appears. If you moved here from another province, or work for an employer based elsewhere, you might have a different regional plan. This guide is about Canadian Blue Cross plans only, not the American Blue Cross Blue Shield plans.
How Blue Cross plans list mental health practitioners
Medavie Blue Cross says its standard group offering includes access to a broad range of mental health practitioners, such as psychologists, social workers, counselling therapists, psychotherapists and psychoeducators. Your employer chooses the details, though, so your plan may list some of these and not others, and the yearly amount can vary.
That's why the therapist's designation matters. At our clinic, couples therapists may be Registered Social Workers (RSWs), Registered Psychotherapists (RPs), RP (Qualifying) clinicians or psychologists. If your plan lists social workers but not psychotherapists, for example, the same couples session could be eligible with one therapist and not with another.
What about an RP (Qualifying)?
A Registered Psychotherapist (Qualifying) is registered with the College of Registered Psychotherapists of Ontario in the qualifying class. Some Blue Cross plans may accept sessions with an RP (Qualifying), and others may not. It depends on the plan. If you're thinking of seeing an RP (Qualifying), ask your plan about that practitioner type by name.
Is a session for two claimed differently?
Couples sessions usually have both partners in the room, but a claim is usually made by one plan member. Blue Cross plans can differ on how they handle a joint session, so this is worth a direct question: "If my partner and I attend therapy together, can I claim the session under my mental health benefit, and does it count against my yearly maximum?"
If you're not married, ask how your plan defines a spouse or dependant. Some plans include common-law partners, and the wording in your booklet decides.
When both partners have benefits
If each of you has your own plan, you may be able to use both. Medavie Blue Cross explains that when you and your spouse have separate plans, you may be able to combine them to get up to 100 percent of eligible claims reimbursed, depending on your plans and their limits.
For your own claims, Medavie says to submit to your own plan first, then send a copy of the processed claim to your spouse's insurer. For your spouse's claims, they submit to their insurer first. This is called coordination of benefits. For a joint couples session, ask both plans how they'd like it handled.
Questions to ask Blue Cross before you book
Call the number on your card, or check your online account, and ask:
Does my plan include a mental health practitioner benefit?
Which practitioner types are covered: psychologist, social worker, psychotherapist, RP (Qualifying)?
Can I claim a session that my partner attends with me?
How much is my yearly maximum, and how much have I used?
Is there a per-session limit or a percentage I pay?
Are virtual or online sessions eligible?
Is there anything a receipt needs to show, and is there a deadline to claim?
Can my partner's plan pay the remaining amount?
Write down the answers, the date and who you spoke with. Keep these notes on your Blue Cross couples counselling coverage. Ontario plans can change from year to year, so check again when your benefits renew.
Direct billing and claiming with us
Medavie Blue Cross is on our direct billing list. That doesn't mean every session is covered. Your coverage depends on your plan, so we can't promise what Blue Cross will pay.
When we can direct bill, we send the claim to your plan for you, and you pay any amount the plan doesn't cover. We can direct bill many insurers, including for sessions with a Registered Psychotherapist (Qualifying), though whether your plan covers that practitioner type is up to the plan. When a session can't be direct billed, you pay and claim it yourself with your receipt.
If you're not sure which practitioner your plan covers, our admin team can help you match with a therapist whose designation fits your plan.
If your plan does not cover it
If Blue Cross won't cover couples sessions, or you've used your yearly amount, you still have options:
Health Spending Account. If your employer gives you one, we accept Health Spending Accounts. Our guide to using a Health Spending Account for therapy explains how they work.
Your partner's plan. Their benefits might cover what yours doesn't.
Session timing. Some couples space out sessions over time to stretch their coverage.
Sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover some or all of the cost. Coverage varies, so check your plan.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with a Registered Psychotherapist (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
If you don't feel safe with your partner
Couples therapy works best when both partners feel safe to speak honestly. If you're afraid of your partner, or there's violence or control in the relationship, joint sessions usually aren't the right first step. Individual counselling can be a safer place to begin. If you're in danger, call 911.
Starting couples counselling at our offices or online
We offer couples counselling in person at our Kitchener-Waterloo, Cambridge and Ottawa offices, and online anywhere in Ontario on a secure, encrypted video platform. You can come together, and some partners also choose individual sessions alongside.
Book a free 15-minute consultation with our admin team. Our admin team can talk through your Blue Cross plan, your goals and which therapist might suit you both.
If you're in crisis: if you're thinking about suicide or self-harm, or anyone is in danger, call or text 9-8-8 or call 911. More options are on our crisis lines page.
A few minutes with your plan now can save surprises later, and leave more room to focus on each other.
Last reviewed: October 2026
Sources
Information for Blue Cross Ontario, Blue Cross of Canada
Mental health resources for group insurance, Medavie Blue Cross
Coordination of Benefits, Medavie Blue Cross
Registered Psychotherapist (Qualifying), College of Registered Psychotherapists of Ontario (CRPO)