Does Medicaid Cover Therapy? Know Your Rights Before Starting Therapy!

After a lot of deliberation, you’ve decided to seek professional mental health services. You’ve researched well about the type of therapy you want, the approach you feel would be the right for you, and the provider to begin the therapy… However, there’s still the matter of your insurance.

If you have Medicaid health coverage, then your next question must be, “Does Medicaid cover therapy?” or if Medicaid covers mental health therapy, to be specific.

Medicaid, a federal health insurance program, provides coverage to lower-income individuals through the Affordable Care Act (ACS). Medicaid is the biggest payer for client mental health services in the United States and since the beginning of the COVID-19 pandemic, more than 82 million Americans have enrolled in the Medicaid program.

Whatever services you need, Medicaid is there to help you. Getting mental health therapy when you have Medicaid can be easy. In this blog, let’s take a look at what and how Medicaid can help.

Does Medicaid Cover Therapy?

In the past years, the Affordable Care Act (ACA) has made subtle adjustments to Medicaid requirements to give members easier access to mental health therapy and care. With these adjustments, Medicaid members now have access to several mental or behavioral health services and substance use disorders.

Medicaid covers therapy and so much more! The program covers not only offline or person-to-person therapy but also online therapy – individual and group. Many mental healthcare providers also offer family therapy, as long you bring an official diagnosis and a prescription for the therapy, your health insurance is coverable.

Your health insurance can also cover therapy approaches such as:

• Mindfulness-based cognitive therapy (MBCT)
• Cognitive-behavioral therapy (CBT)
• Dialectical-behavioral therapy (DBT)
• Acceptance and commitment therapy (ACT)
• Eye Movement Desensitization and Reprocessing (EMDR)

Although, couple’s therapy, career counseling, life coaching, massage therapy, holistic therapy, etc are not covered by Medicaid.

Services Covered By Medicaid…

• Counseling
• Psychotherapy
• Medication management
• Peer supports
• Substance use disorder treatment

To check if your Medicaid covers therapy, you can look for your ‘Summary and Benefits Document’, which usually comes with your Medicaid card. Here, you’ll find your coinsurance rates according to your service type. To find out how much your plan covers, you can look into the ‘Outpatient Mental Health Services’.

If you can’t find this document, you can contact customer care. A representative will help you look up your plan and share any mental health benefits your respective plan covers.

Please check your state requirements before proceeding. The kind of care and services covered under your plan might vary depending on your location.

Medicaid Mental Health Support

If you’re covered by a Medicaid mental health plan, then you can get services such as:

• Psychological evaluation
• Medication management
• Mental health rehabilitation
• Inpatient treatment
• Outpatient treatment
• In-house rehabilitation services
• Crisis services
• Psychiatric hospitalization
• Case management for chronic mental disorders

If you’re struggling with substance use disorder, then it is recommended you seek professional help and care. Get the proper diagnosis before you begin treatment.

If your loved one or you are struggling, you can contact SAMHSA at 1800-662-4357 or NAMI at 1800-950-6264.

Things To Consider!

Before you begin your mental health treatment under Medicaid, here are some things you need to consider:

• Your plan may need coinsurance. Coinsurance is a percentage amount that you may have to pay out of your pocket (approx. $0-25 per session). Check your plan before proceeding.
• To get Medicaid coverage, you need to pick a provider in your state.
• Your plan may have limits on the number of sessions covered. Check your plan before proceeding.
• You may need to have a prescription or diagnosis from your physician.
• If the kind of therapy you require isn’t covered in your Medicaid plan, then you’ll have to pay the full cost. Check your plan accordingly.

If the service you require isn’t covered by Medicaid, you can try alternative options like:

• Ask your mental health provider about sliding-scale payment options or if they offer financial aid.
• You can consider community health clinics in your locality.
• You can check available community mental health programs in your state.
• You can consider free online therapy.

Keep in mind that if you’re a member of the Medicaid program, then you’re eligible for programs run by federal or state governments along with low-cost services. You can check with your state Medicaid program to see what is accessible to you.

Even if you’re not covered by Medicaid, you can try other programs and affordable mental health services such as BetterHelp, Calmerry, or Talkspace. You don’t have to suffer. With online therapy programs, you can find the right help and treatment.

Book Your Appointment Here

If you’re struggling with depression, anxiety, grief, loneliness, or coping with a substance use disorder/addiction, you can get help! Look for a professional near you and see if your Medicaid covers therapy. Even if your Medicaid doesn’t, there are other low-cost and free services that you can use.

I hope this article helped you understand the therapy covered by Medicaid and how you can access those services. Let me know your thoughts in the comments below! You can also write to us at info@calmsage.com for more.

Take Care!