Does Medicaid Cover Therapy?

Last Updated on October 19, 2023 by Lori Pace

Yes, I can personally assure you that Medicaid does indeed cover mental health and therapy. However, let me share my own experience – your actual coverage can be influenced by the specific program you’re enrolled in and the Medicaid provider you’re working with.

Here’s something important to keep in mind: each state tailors its Medicaid coverage differently. This can lead to variations in the extent of therapy you can access based on your location. The intricacies can be confusing, I know. While federal laws provide a framework for Medicaid, individual states have some flexibility in offering optional benefits.

So, it is important to clearly define what therapy is and how urgent you are interested in getting it. This will impact whether or not treatment will be covered. Medicaid plans cover therapy for behavioral and mental conditions. However, coverage for substance abuse is not available.

As someone who’s been closely involved, let me share a bright spot: kids covered by the CHIP (Children’s Health Insurance Program) are in luck. They’re entitled to comprehensive mental health services. And here’s something promising in the works: efforts are underway to expand therapy coverage to folks over 21 and those who are battling substance abuse.

What Is Therapy?

Counseling or psychotherapy is a form of therapy that involves sessions with therapists to address issues. These problems, for such as difficult relationships and problematic behavior.

Therapy, from my own experience, has the remarkable power to help you unleash the best version of yourself, leading to a happier life. I’ve personally seen it work wonders, helping individuals conquer tough emotions, build better relationships, and transform self-destructive thought patterns.

Here’s the deal – every therapy journey involves setting goals and charting a path to achieve them. And don’t worry, the sessions are strictly confidential. Whether it’s personal, couples, or group therapy, you can discuss any topic with confidence.

What Kinds of Therapy Does Medicaid Pay for?

You might wonder which therapies Medicaid includes. Let me clarify – Medicaid covers a range of therapeutic approaches. But here’s the catch: your doctor needs to recommend a therapy that’s fact-based and medically fitting for your diagnosis. Here’s a glimpse of the therapies that Medicaid typically includes:

1. Cognitive Behavioral Therapy (CBT)

CBT is a skill-based approach to conversational therapy. These sessions are a team effort between you and your therapist to identify your fears and problems. CBT teaches you how to use strategic approaches to solve your problems. The sessions can last anywhere from six to several months. Medicaid usually pays for once-a-week sessions with a therapist.

2. Dialectical Behavioral Therapy (DBT)

DBT is a skill-based method of psychotherapy that incorporates elements of cognitive-behavioral treatment and mindfulness practices. In short, this is originally for women with BPD, borderline personality disorder, or BPD.

There has been an expansion to include this treatment for a variety of patients. DBT usually consists of individual and group sessions. These sessions aim to improve four key skills: emotional control, stress tolerance, and mindfulness.

3. Child-Parent Psychotherapy (CPP)

This is a therapeutic intervention program for children that are 0-5 years. These children are those who have had at least one trauma. This can be sexual abuse, domestic violence, or the death of a family member. Medicaid covers the cost of CPP sessions for one-hour sessions and once-a-week sessions with the parent and child. Home sessions are available for children that are unable to leave the house.

4. Acceptance and Commitment Therapy (ACT)

ACT is a form of psychotherapy that aims to help you feel optimistic about your life. This therapy teaches you how to cope with negative thoughts and emotions, without seeing them as limitations.

5. Eye Movement Desensitization and Reprocessing (EMDR)

EMDR, a mental health treatment that uses psychological mediation instead of psychotherapy, is a method for treating mental disorders. EMDR helps people deal with trauma. It involves you telling your therapist about a traumatic event.

The therapist will then lead you through a series of eye movements. Eye movements are thought to be neurologically linked to brain information processing. They can also help overcome negative memories and elevate emotions.

6. Mindfulness Practices

There are many types of mindfulness practices. And, these practices can help you to be more aware of your surroundings and yourself in a non-judgmental manner. In short, mindfulness focuses on calmly managing your thoughts and emotions.

What Kinds of Therapy Doesn’t Medicaid Pay for?

While Medicaid does a fantastic job covering most therapy, there are some exceptions you should be aware of. Here’s the scoop – Medicaid doesn’t foot the bill for massage therapy, aromatherapy, or reflexology.

But that’s not all. Medicaid doesn’t cover energy-based treatments like Reiki healing either, and it’s particular about credentials. If the professional providing the therapy isn’t authorized by Medicaid or lacks proper credentials, it won’t be covered.

How Much Do You Pay Out-Of-Pocket for Therapy with A Medicaid Plan?

Understanding the expenses can be crucial, right? Here’s the scoop – most plans require a copayment between 0 and 25 USD for each therapy session with a Medicaid-approved therapist. This means you’ll be covering the copayment every time you attend a session.

But, remember, the cost picture can vary from state to state since each place has its own Medicaid setup. The good news? The government places real value on behavioral and mental therapy, making it easier to access most Medicaid plans.

Now, here’s something to note, especially if you’re planning for the long term. Some states put a cap on the number of therapy sessions they’ll cover – typically around 30 sessions a year. After you’ve used up these paid visits, you’d be footing the entire bill.

Does Medicaid Pay for Online Therapy?

I’m thrilled to share that Medicaid does cover online therapy. But here’s the catch – Medicaid needs to give the thumbs up to your chosen online therapist.

Given the pandemic’s impact, there’s a chance Medicaid might reevaluate its online therapy stance. If you’re thinking about going the online therapy route, my advice is to double-check your Medicaid plan before taking the plunge. This step ensures you’re still fully covered.

Conclusion

Let me sum up by highlighting Medicaid’s transformative role in public mental healthcare. The impact has been significant – more therapy coverage, new incentives for public providers, and even shifts in the economic framework that governs public mental health. This kind of change has prompted state governments to reevaluate their approach, opening doors for many who previously lacked access to essential mental health care.