How Much Do Pilot Mental Health Services Typically Cost Per Month on Average?

A Comprehensive Guide to Costs, Coverage, and Care in Aviation Mental Health

Mental health is no longer a fringe issue in aviation—it’s a core component of flight safety, professional longevity, and personal well-being. Pilots are subject to intense physical and psychological demands, from sleep disruption and circadian rhythm instability to high-stakes decision-making and cognitive overload. And while conditions like anxiety, major depressive disorder, and substance abuse remain prevalent in the aviation field, the stigma surrounding mental health treatment still lingers.

If you’re a pilot considering therapy, psychiatry, or psychological evaluation, understanding the monthly cost of care—and what your insurance, airline, or employee assistance program (EAP) might cover—can help you take action without fear. This guide explains the average monthly costs of mental health services for pilots, insurance reimbursement, therapy types, medication considerations, and more.

Understanding the Cost of Mental Health Services in Aviation

What does therapy cost per month?

The average cost of individual therapy for pilots ranges from $100 to $250 per session. Most pilots attend weekly sessions, which adds up to $400 to $1,000 per month. These costs may vary based on your location, whether the provider specializes in aviation medicine or psychiatry, and whether you’re seeking outpatient or more intensive treatment.

Pilots who work with licensed mental health professionals like those at StephenRought.com often pay slightly more—but receive specialized support that addresses the intersection of civil aviation, emotional regulation, aviation medical examiner (AME) requirements, and Federal Aviation Administration (FAA) medical certificate eligibility.

Insurance and Mental Health Costs for Pilots

Does insurance cover pilot mental health treatment?

Yes—many major carriers such as Cigna, Aetna, and Blue Cross Blue Shield offer behavioral health coverage under health care plans or health savings accounts (HSAs). Coverage typically includes therapy, psychiatric evaluations, and sometimes medications such as selective serotonin reuptake inhibitors (SSRIs) like sertraline, fluoxetine, escitalopram, or citalopram—as long as the treatment doesn’t interfere with your medical certification or aviation safety requirements.

However, not all providers work directly with insurers. For example, Stephen Rought operates on a private pay model, offering superbills so pilots can seek out-of-network reimbursement through their insurer.

What does insurance typically cover?

• Individual and group therapy

• Psychiatric consultations

• Medication management (e.g., for mood disorders, anxiety disorders, or PTSD)

• Psychological evaluations for AME submission

• Substance abuse counseling, when needed

• Peer support and suicide prevention resources

The Role of FAA and Aviation Medical Examiners in Mental Health Reporting

Will therapy impact your medical certificate?

Not always. Under current FAA guidelines, seeking therapy doesn’t automatically result in the loss of your medical certificate. But certain medications, diagnoses (e.g., psychosis, bipolar disorder, personality disorder), or behaviors like suicidal ideation, substance dependence, or alcohol abuse may require clearance from an aviation medical examiner and/or flight surgeon.

In these cases, pilots may be referred for psychiatric observation, evaluation, or follow-up treatment. However, aviation-focused providers understand how to document treatment in good faith, providing accurate information without violating confidentiality.

Mental health and aviation safety

As agencies like the National Transportation Safety Board (NTSB) and the European Union Aviation Safety Agency (EASA) continue to push for stronger safety management systems, mental fitness is now seen as critical—not optional. Incidents such as Germanwings Flight 9525 underscore the life-or-death importance of early intervention, proper diagnosis, and ongoing mental health monitoring.

Breaking Down Monthly Costs by Service Type

1. Individual Therapy

• Cost: $100–$250/session

• Monthly total: $400–$1,000+

• Used for: anxiety, depression, burnout, emotional processing

2. Group Therapy & Peer Support

• Cost: $30–$80/session

• Used for: stress coping, fatigue, performance pressure

• Some EAPs and pilot unions offer these programs for free.

3. Teletherapy and Mobile App Services

• Cost: $90–$150/session

• Platforms: Zoom, secure mobile apps tailored to aviation medicine

• Benefits: Convenient for aircrew, especially those on irregular schedules

4. Psychiatry and Medication Management

• Initial evaluations: $200–$400

• Follow-ups: $100–$200

• Medications: SSRIs like venlafaxine, duloxetine, or bupropion may cost $20–$100/month (before insurance)

Note: Not all medications are FAA-approved. SSRIs such as fluoxetine and sertraline may be permitted on a case-by-case basis following FAA psychiatric clearance.

What Influences Mental Health Costs for Pilots?

• Type of provider: Aviation-informed therapists, AMEs, and psychiatrists typically charge more

• Geographic location: Urban areas often have higher rates, though teletherapy bridges the gap

• Session frequency: Weekly sessions cost more but may speed recovery

• Diagnosis: Complex diagnoses like major depressive disorder, PTSD, or generalized anxiety disorder may require more frequent visits or medication

• Service setting: Outpatient therapy vs. intensive outpatient or inpatient treatment

Where to Find Reliable and Affordable Support

Aviation-specific resources:

• StephenRought.com: FAA-informed, confidential therapy for pilots

• ALPA: Peer Support & HIMS programs

• AOPA: Mental health advocacy and education

• International Civil Aviation Organization (ICAO): Guidelines on global aviation medicine

General resources:

• National Suicide Prevention Lifeline (988)

• Crisis Text Line (Text HOME to 741741)

• Primary care physicians: Often the first step in referral or screening

• Community mental health centers: May offer sliding scale therapy options

• Educational institutions: Some offer no-cost therapy with graduate-level providers

Therapy, Medication, and Career Longevity in Aviation

Pilots often feel the pressure to maintain a flawless record, avoid any perception of emotional instability, and power through symptoms like insomnia, stress, or fear. But this outdated culture ignores what we now know from aviation medicine, psychology, and neuroscience: untreated mental illness is more dangerous than disclosure.

Whether you're dealing with fatigue, panic attacks, or past trauma from an aircraft accident, the right support system can help you manage your symptoms, maintain your medical certificate, and stay safe in the cockpit. Many pilots who pursue mental health treatment go on to fly for decades—often with greater clarity, productivity, and emotional regulation.

Conclusion: The Cost of Support Is Worth the Safety

On average, pilot mental health services cost $400–$1,000 per month, depending on your needs, location, and insurance. But when you factor in the value of protecting your career, cognition, and safety, it’s a worthy investment.

With aviation-specific professionals like Stephen Rought offering confidential support, more pilots can now get help without jeopardizing their future. Don’t let outdated fears or misinformation keep you from seeking care.

Mental health is not a weakness. It’s part of your fitness for duty, and it could save your life—or someone else’s.