We've been on Cigna for years. They have covered every bit of therapy for me, my husband, and my son. That is 8 years for me, about 7 years for my husband, and 2 for my son. They have never limited the number of sessions we are allowed. The co-pay for mental health appointments (including psychiatric visits) is actually lower than for other types of doctor visits. They have covered our hospitalizations, our meds, ECT, etc. with really no problems. There are different types of plans though, which is typical of any insurance company, so it may be that your friend had a very basic kind of plan that had more limitations.

And yes, sometimes insurance companies want an update from the therapist. Seems like my therapist had to do that more at the beginning. He hasn't mentioned having to speak to them in years. Even when he did, it wasn't a problem at all. He has no complaints about getting reimbursed. They have covered each and every visit.