Are Therapists Covered By Medicaid

Hepatitis C Drug Coverage Expanded In Stages Now Available To Anyone With The Disease

In the past few years, drugs that can cure Hepatitis C have burst onto the medical scene, heralded as miracles. But they can also be a strain on budgets, as the pill initially could cost more than $1,000 per day, and the treatment course lasts 12 weeks. Medicaid programs across the country have been grappled with how to handle the situation, and Illinois announced in September 2016 that they would loosen their guidelines in terms of when Hepatitis C drugs would be covered.

Rather than restricting coverage only to the sickest patients, Illinois Medicaid began to cover Hepatitis C drugs for people with stage 3 and 4 liver scarring, rather than just 4. Advocates cheered the new rules, but cautioned that there was still no coverage for treatment in people with chronic Hepatitis C that hadnt progressed as far as stage 3 liver scarring, and urged the state to continue to consider the issue.

By 2018, the price of Hepatitis C medications had declined, and a generic version was set to hit the market in early 2019, priced at $24,000 for the full treatment course . And in October 2018, the state eliminated the restrictions on access to Hepatitis C drugs, allowing several thousand Illinois residents to obtain Hepatitis C medication through Medicaid, regardless of the stage of their disease and without having to prove sobriety.

Also Check: Medicaid Ms Gov Programs Managed Care

What Other Mental Health Services Does Medicaid Cover

Medicaid also covers substance use disorder as a mental health service. Most people know this treatment as drug rehab. This process begins with detoxification, which is a supervised withdrawal from substance use. It is not a treatment itself but it is the first step to rehab. There are two different ways that an individual can participate in this rehabilitative treatment:

• Inpatient and residential 24/7 care lasting days or weeks

• Outpatient treatment program site while you live on your own

Medicaid will cover both of these options, to a certain extent. Medicaid will also cover any medication-assisted treatment deemed necessary for recovery. This method of treatment uses FDA-approved medication with counseling and behavioral therapies. Currently, there are three approved drugs: methadone, buprenorphine, and naltrexone.

Illinois Medicaid Insurance Coverage For Addiction And Mental Health Treatment

Illinois residents who have been deemed eligible for Medicaid will first have to enroll in one of the programs managed care plans.

Depending on where they reside in the state, all Medicaid residents have access to at least five different plans.

Managed care plans for Illinois Medicaid are provided through commercial insurance carriers and include the following:

• Blue Cross Blue Shield of Illinois
• NextLevel Health

You May Like: Physical Therapy Offices That Accepts Medicaid

How Can I Book An Appointment Online With A Medicaid Therapist / Counselor

Zocdoc is a free online service that helps patients find Medicaid Therapists/Counselors and book appointments instantly. You can search for Medicaid Therapists/Counselors by symptom or visit reason. Then, choose your location. Based on that information, youll see a list of providers who meet your search criteria, along with their available appointment slots.

Are Video Visits With A Therapist / Counselor Online Covered By Medicaid

Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Therapists/Counselors who accept Medicaid for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.

Don’t Miss: Qualifications For Medicare And Medicaid Benefits

Role Of The Child Therapist

Even if you have experienced therapy for yourself , its good to know that child therapy is a bit different. With that in mind, its important for you to understand the role of the child therapist.

One of the biggest hurdles for a child therapist is the simple fact that children dont think the exact way that adults think. That is not a metaphor our brains continue to develop until we are 25 years old, and functionality changes the entire time. The younger a child, the less like an adult they are thinking.

A child therapist, then, has received special training allowing them to understand a childs changing emotions as well as their mental and emotional development. These therapists understand what is relatively normal for children of this age range, and this understanding can help the therapist identify and treat a mental illness or psychological injury that may be harming your childs mental and emotional development.

The best child therapists understand how stressful this entire experience can be for parents and other family members as well. They can help the family or caretaking group learn how to manage the childs needs while helping the child better integrate with society.

Now that you know a bit more about the role of the child therapist, lets take a closer look at different forms of therapy for children.

How Interpersonal Psychotherapy Works

Interpersonal psychotherapy is a kind of therapy where the name tells you everything you need to know. If your child is struggling with conducting and maintaining interpersonal relationships, this form of therapy is intended to help them address this issue.

Because human beings are social creatures, the ability to maintain interpersonal relationships is very important. However, a child suffering from mental illness or injury will often experience maladaptive thoughts that interfere with these relationships.

As an added bonus, interpersonal therapy is often popular with children who otherwise dont enjoy visiting the therapist. That is because much of this therapy revolves around sending clients specialized information they can study and practice at home to see results regarding their interpersonal relationships.

Recommended Reading: Assisted Living Queens Ny Medicaid

Does Medicaid Cover Mental Health Services And Behavioral Treatment

Yes. All Medicaid programs cover some mental health and substance use disorder services. The specific services covered will depend on your state.

The Mental Health Parity and Addiction Equity Act of 2008 required healthcare plans to provide mental health benefits equal to medical and surgical coverage. This means an individual with a mental illness receives the same coverage as an individual with a physical illness. It also means that your insurance provider cannot charge you a higher copay or deductible for mental health services.

Behavioral treatment for a mental illness can include counseling and psychotherapy also known as talk therapy. Psychiatrists use talk therapy to help individuals with a broad variety of mental illnesses. Counseling services are expert help given by a licensed professional. A licensed professional, such as a therapist or psychiatrist, has to provide these services for Medicaid to cover the costs.

How Cognitive Behavior Therapy And Cognitive Behavior Play Therapy Work

Cognitive Behavior Therapy and Cognitive Behavior Play Therapy are something of a mouthful. These therapy approaches have been particularly effective for disruptive children.

Most families dont notice a childs need for mental health care until that child begins acting in a disruptive manner. However, this disruption is not a cry for attention rather, it is a manifestation of how the child is now thinking thanks to whats going on in their brain.

CBT is designed to help children learn how the way they think affects the way they act. The eventual goal is to help children re-order their thought patterns and create newer and better patterns of behavior.

Where does CBPT come in? This is a CBT approach that emphasizes play and interaction. It is particularly effective on younger patients.

Recommended Reading: Florida Medicaid Change Plan Phone Number

Medicaid Covers Mental Health Services That Most Private Insurance Policies Don’t Cover

Due to growing public awareness of the importance of mental health care and laws like the 2008 Mental Health Parity and Addiction Equity Act, private insurance plans are covering more mental health services than ever before.

However, its rare for private insurance plans to cover intensive services that many Medicaid plans cover, such as nursing home and other long-term care, round-the-clock services, supported employment, case management, and in-home mental health care.

In fact, many older adults who need nursing home care or other intensive services often elect to spend down assets so they can qualify for Medicaid coverage for these specialized and otherwise expensive services.

Most Medicaid plans also cover basic mental health services like therapy, psychiatrist visits, and clinic care.

Who Qualifies For Medicaid

The requirements for Medicaid eligibility vary from state to state. You must be a resident of the state you are applying in. The factors that determine your eligibility are:

• Income: Modified adjusted gross income is the basis for determining eligibility for most individuals.

• Household size: This includes all people occupying the household unit.

• Family size: All the people in the housing unit related by birth, adoption, and marriage.

• Disability:A physical or mental condition that limits a persons movements, senses, and activities.

There are 38 states along with the District of Columbia that have expanded Medicaid coverage under the Affordable Care Act. That means in those states you can qualify for Medicaid based on just your income. You can visit Healthcare.gov and complete an application to see if you are eligible for Medicaid in your state.

The 12 states that did not expand Medicaid coverage under the ACA are in the chart below. You can visit each states website to find out the eligibility requirements and benefits.

Also Check: State Of Michigan Medicaid Phone Number

How To Find Online Therapy That Takes Your Insurance

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Heres our process.

Until recently, you could use your health insurance for face-to-face therapy but not online services. Thats changed dramatically within the past year. During the COVID-19 pandemic, more people have been taking advantage of telehealth services than ever before.

The technology for telehealth has been available for many years, and the pandemic has made it clear that access to online care is a vital service. This change has caused more care platforms to start.

As a result, many insurance companies have begun covering this service. Although this change was brought on by the COVID-19 pandemic, all signs indicate it is here to say. In fact, 97 percent of psychologists surveyed by the American Psychological Association in October 2021, agreed that online therapy should remain an option after the pandemic.

Telehealth allows you to meet with doctors, therapists, and other healthcare professionals online from the comfort of your home.

Online therapy is an especially popular option. It allows people to have sessions with fully licensed therapists using phone apps or their computers instead of going to an office. For people whove been considering therapy but are intimidated or overwhelmed by the thought of office visits or in-person care, online therapy might be the best way to get care.

How Can I Find A Top

You can use Zocdoc to find Medicaid Therapists/Counselors who are highly rated by other patients. These ratings are based on verified reviews submitted by real patients. Every time a patient completes an appointment booked on Zocdoc, theyre invited to review their experience. Each review must comply with Zocdocs guidelines.

Read Also: Does A Trust Protect Assets From Medicaid

What Kinds Of Mental Health Providers Are Available In Illinois

There are many different kinds of mental health providers available in Illinois, including psychologists, clinical social workers, and mental health counselors. As long as the provider is licensed in your state, the factor that matters most to therapy outcomes is the therapeutic alliance, or the relationship you build with your therapist. Common types of therapy provided in Illinois include cognitive therapies, like Cognitive Behavioral Therapy and Dialectical Behavior Therapy , and insight-oriented therapies like psychodynamic therapy. Other providers offer a blend of techniques for a more interpersonal, holistic approach. Some mental health therapists in Illinois also offer specialized treatment services, like couples therapy, premarital counseling, and family therapy. While most Illinois providers are qualified to treat general challenges, like depression, anxiety disorders, trauma, relationship difficulties, and low self-esteem, for concerns such as substance abuse, personality disorders, and eating disorders, consider seeking expert care. Together with your therapist, youll build a treatment plan that addresses your reasons for seeking therapy and monitor progress toward your wellness goals and overall well being.

Also Check: Dentist In Glasgow Ky That Accept Medicaid

What If My Insurance Doesnt Cover Online Therapy

There are a few options for free or low cost online therapy. Many services offer free trials, pay-as-go services, discounts, peer counseling, and more ways to try online therapy without insurance.

For example, eTherapyPro does not accept insurance, but they do offer a three-day free trial. You can use the trial to decide if online therapy is right for you. If you decide you want to keep using the service, eTherapyPro costs $40 a week. You can sign up for a membership that will last until you cancel your weekly payments.

For free therapy options in your area, you can call the National Alliance on Mental Illness hotline at 800-950-NAMI to be connected with a mental health professional. You can also email them at [email protected].

If youre a veteran, you can contact the Veterans Crisis Line by text, chat, or phone.

Read Also: What Are The Qualifications For Medicaid In Michigan

Training On Medicaid Managed Care Billing:

As a part of Phase II of the MTAC, ICOY is piloting training resources for providers. We began with the highest priority topic as indicated by oursurvey, to help providers bill Medicaid managed care. In February 2020 ICOY released the 12-part training series How to Bill Medicaid Managed Care: A Training for Healthcare Providers. Trainings are available to all Illinois providers and are not limited to ICOY members.

• Watch on-demand webinars on the basics of billing Medicaid managed care

What Treatments Does Medicaid Cover

The mental health and behavioral health treatments that are covered by Medicaid will vary by state, but may include any of the following:

• Cognitive Behavioral Therapy
• Eye Movement Desensitization and Reprocessing
• Mindfulness practices
• Child-parent psychotherapy
• Acceptance and Commitment Therapy

Medicaid benefits can be used to treat a variety of conditions such as depression, anxiety, alcohol and substance abuse, grief and loss, eating disorders, learning disabilities and more.

Recommended Reading: What Do I Need To Qualify For Medicaid In Texas

Medicaid Coverage And Eligibility Requirements Vary Widely From State To State

Medicaid is a joint federal and state program that allows states to have some flexibility in what and who they cover. Some states have stricter income and categorical eligibility requirements than others, especially the 12 states that have elected not to accept Medicaid expansion as of April 2022.

While federal statutes require state Medicaid programs to cover essential benefits like nursing facility services and physician services, other services, like clinic services and psychosocial rehabilitation, are optional. So, some mental health services are covered by Medicaid in some states but not in others.

According to MACPAC, all 50 state Medicaid programs cover individual and group therapy, and most also cover family therapy. Specifically, every states Medicaid plan currently covers some form of outpatient mental health services, which generally includes individual and group counseling. Many states plans also cover family counseling.

Many Essential Mental Health Services And Safety Net Programs Rely On Medicaid For Most Or All Of Their Funding

Community mental health programs are an essential public resource and a safety net for vulnerable people who would otherwise be unable to live on their own. They help keep people with serious mental health conditions in their homes and connected to essential professional and peer supports.

Public mental health programs also increase access to therapy, as many private practice providers dont accept Medicaid, while publicly-funded mental health agencies do. In some states, Medicaid pays for over 60 percent of the services rendered by these essential public programs.

Don’t Miss: How Do I Find Out What Medicaid I Have

Therapists Fear Denials Audits Clawbacks

Many therapists and psychiatrists say they also shun health insurance because of the frustrations of dealing with insurance companies.

Matthew Jones, a former Chicago therapist, was rocking his 3-month-old daughter to sleep in April, when he took to Twitter. He wrote a screed that started with the declaration, Insurance companies hate therapists.

He detailed why he had recently decided to stop taking insurance, describing low and delayed payments and hours spent on the phone with insurance companies when claims for care were denied.

His tweets drew thousands of reactions, ranging from therapists who agreed with him to patients who lamented that they cant afford therapy because of decisions like his.

I was very surprised, he said of the passion of some of the responses. But Jones, who is now a licensed psychologist in Denver, doesnt regret posting the thread.

I think theres a tendency among the public at large to blame therapists as these gatekeepers who are withholding care because theyre selfish and theyre making so much more than the clients theyre servicing and thats what I wanted to push back on, Jones said.

Therapists who take insurance describe being told by some insurance companies to shorten their sessions from 60 minutes to 45 minutes. They also worry about being audited.

But many therapists find the prospect, along with other insurance company practices, threatening.

Recommended Reading: I Have Medicaid And Im Pregnant