How Counselling Insurance Actually Works in BC: A Clear Guide for Clients

Most people come to therapy because something in their life has become heavy enough that they need support. The last thing they need is a confusing maze of insurance rules, unclear terminology, and surprise out-of-pocket costs.
If you’ve ever wondered “Does my plan even cover counselling?” or “How does reimbursement work?” — you’re not alone.

This guide walks you through the process in simple terms, with zero jargon, so you can understand exactly what to expect before you book a session.

1. MSP Doesn’t Cover Private Counselling in BC

In British Columbia, counselling or psychotherapy provided in private practice is not covered by MSP.
The only exceptions are:

• Supportive counselling through your local mental health center or if your city has access to a primary care network, you may have access to short term counselling that is publicly funded.

For private counselling — whether you see an RCC, RSW, or psychologist — coverage comes from extended health benefits or paying privately.

2. Extended Health Benefits: What They Actually Cover

Extended health benefits are the employer- or self-funded plans you get through work (e.g., Pacific Blue Cross, Sun Life, Canada Life, Manulife, Green Shield).

Plans vary wildly. You might have:

• A dollar amount per year (e.g., $500, $1,000, $2,000)

• A percentage covered per session (e.g., 80% up to a yearly max)

• A requirement that your provider have a specific credential

Here’s the key part:
It’s not “Does my insurance cover counselling?” — it’s “Which type of counsellor does my plan cover?”

Most plans in BC cover at least one of:

• Registered Clinical Counsellor (RCC)

• Canadian Clinical Counsellor (CCC)

• Registered Social Worker (RSW)

• Psychologist (R. Psych)

But not every plan covers all three.

3. Credentials: Why They Matter for Coverage

You don’t have to know all the professional designations in BC, but here’s what matters for insurance:

• RCC (Registered Clinical Counsellor) — common in BC; many plans cover RCCs.

• RSW (Registered Social Worker) — some plans cover only RSWs.

• Psychologist (Registered Psychologist) — covered by most plans, but higher session fees.

If your plan only covers one type of provider, you need to make sure you book with someone whose credential matches the plan.

This is one of the most common reasons people are unexpectedly denied coverage.

4. Online Counselling: Is It Covered?

Yes — almost all extended benefits treat online/virtual telehealth sessions the same as in-person sessions.

If a provider is covered in person, their online sessions are covered too.

5. How Reimbursement Works (Step-by-Step)

Most private practices in BC (including mine) do not offer direct billing.
This means:

Payment:

You pay the session fee at the time of the session.

Receipt:

You receive a detailed receipt that includes:

• The therapist’s name

• Professional credential (e.g., RCC #)

• Session date + session length

• Amount paid

• Business information

• Tax numbers (if applicable)

Submission:

You log into your benefits provider’s app or desktop portal and upload the receipt.

Reimbursement:

You are reimbursed directly — usually within 2–10 business days.

A quick example:

• Session cost: $160

• Your plan reimburses 80%

• You receive $128 back

• Your out-of-pocket cost: $32

6. What If My Claim Gets Denied?

Most claim denials happen because:

• The provider’s credential isn’t covered

• Missing information on the receipt

• The client has used up their yearly coverage

• The plan has session-frequency limits (e.g., max 1/week)

If your claim is denied:

1. Contact your benefits provider

2. Confirm which credential they require

3. Ask what documentation they need

4. Request clarification in writing (this helps later)

5. Switch to a provider whose credentials fit your plan (if needed)

You will not offend a therapist by asking. We deal with insurance questions all the time.

7. What Insurance Often Doesn’t Make Clear

Here are common blind spots clients run into:

Couples therapy is sometimes NOT covered

Even if individual counselling is covered. Check with your provider or talk with your therapist about finding coverage.

Coverage resets once per calendar year

Not per “year since your first claim.”

Some plans require “psychotherapy,” not “counselling”

A subtle wording issue that causes real problems.

Some employers see only aggregate usage

They don’t see diagnoses or session content — but clients often assume they might.

Health Spending Accounts (HSAs) can cover counselling

These are separate from regular benefits and offer more flexibility.

8. If You Don’t Have Benefits: What You Can Do

Insurance is not the only path. Clients without coverage often use:

• Low-cost or sliding scale counselling

• Intern therapists (lower cost, supervised)

• Extended payment plans

• Community mental-health programs

• University training clinics

• Crisis lines, short-term programs, and specialized supports

9. A Simple Checklist: What to Ask Your Benefits Provider

Bring this list with you when calling:

1. Do you cover counselling or psychotherapy?
2. Which credentials are covered? (RCC? RSW? Psychologist?)
3. How much is covered per session?
4. What is my yearly maximum?
5. Is online counselling covered?
6. Do you need a doctor’s referral first?
7. Are couples/family sessions included?
8. How do I submit receipts?
9. How long does reimbursement take?
10. Do you cover multiple sessions per week if needed?

Clients are often shocked at how much confusion clears up in one five-minute phone call.

10. Final Thoughts: Therapy Shouldn’t Add More Stress

Sorting out insurance can feel like one more thing you don’t have the energy for.
This guide is here so you never have to guess.
If you’re unsure what your plan covers or how to confirm it, I can help you walk through it step by step.

You deserve clarity — and you deserve support without financial surprises.