It depends on the therapist you get. My husband is on medicaid and I have good insurance through my work. I had to search for a therapist that would bend the rules for me. It is cheating and I admit that. I talked to MANY therapists and finally found one that agreed that it was in my best interest to have couples counseling. She bills my insurance but sees us together and separately. If it is an emergency then she will see hubby alone because keeping him stable keeps me stable and is in my best interest. I'm sure if my insurance ever found out they would be livid but meh what can ya do?