Does Medicaid Cover Therapy?

Does Medicaid Cover Therapy? – Overview

Yes, Medicaid pays for mental health and therapy. However, the extent of coverage Medicaid offers you is dependent on your Medicaid provider and the exact program you have enrolled in.

Medicaid is provided on a state-by-state basis, so the extent of coverage for therapy may vary depending on the US state you currently reside in. Although some federal laws govern Medicaid processes, US States are not obliged to include optional benefits.

Also, outlining what therapy comprises and the urgency of getting treatment can have an impact on whether treatment will be covered. Medicaid plans offer therapy for mental and behavioral conditions, but the coverage is limited for issues such as substance abuse.

Kids covered by the CHIP (Children’s Health Insurance Program) qualify to receive mental health services and therapy fully. Initiatives are underway to expand full therapy coverage for patients over 21 years and people battling substance abuse.

What Is Therapy?

Does Medicaid Cover Therapy

Does Medicaid Cover Therapy?

Therapy, also known as counseling or psychotherapy, is whereby appointments are scheduled with a therapist to resolve issues such as difficult relationships, problematic mannerisms, feelings, beliefs, and bodily responses.

Starting therapy can be a massive step towards being the best version of yourself and living a better life regardless of the problems you’re facing. Through therapy, you can learn how to resolve painful feelings, change self-destructive mannerisms and improve relationships.

In all kinds of therapy, you will establish objectives and determine the steps you need to take to get there. Also, note that the subjects discussed in these sessions are confidential, whether personal, couples or group therapy.

What Kinds of Therapy Does Medicaid Pay for?

Medicaid pays for various kinds of therapy. So long as your physician provides a fact-based and medically appropriate plan suited to the diagnosis, Medicaid will provide coverage. Some of the types of Therapy that Medicaid pays for include:

1. Cognitive Behavioral Therapy (CBT)

CBT is a skill-based tactic to conversational therapy. When you begin CBT sessions, you and your therapist work together to determine your personal fears and problems.

Through CBT, you learn to integrate strategic approaches in response to your issues. The duration of CBT sessions varies; it ranges from six sessions to a couple of months. Most of the time, Medicaid pays for once-a-week sessions with a therapist.

2. Dialectical Behavioral Therapy (DBT)

DBT is a skill-based approach to psychotherapy that includes elements of cognitive-behavioral therapy and mindfulness practices. DBT was initially created to assist women dealing with BPD or borderline personality disorder.

However, its utilization has since been extended to include treatment for various patients. DBT normally comprises individual and group sessions to enhance four main sets of skills, including emotional control, stress tolerance, mindfulness, and social effectiveness.

3. Child-Parent Psychotherapy (CPP)

CPP is a therapeutic intervention model meant for kids between 0 to 5 years who have experienced at least one traumatic event. The kinds of trauma, in this case, can include sexual abuse, domestic violence, the death of a close relative, a serious accident, and neglect.

The typical course CPP sessions that Medicaid pays for include one-hour and once-a-week sessions with the child and parent present. If the child is not comfortable leaving the house, the sessions can be done at home.

4. Acceptance and Commitment Therapy (ACT)

ACT is a type of psychotherapy that is aimed at helping you be optimistic about life in general. This type of therapy includes learning to deal with unpleasant experiences, thoughts, or emotions without seeing them as limiting factors.

5. Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a mental health treatment procedure that is based on psychological mediation rather than psychotherapy. EMDR is used to help people cope with trauma, and it involves you informing your therapist about a traumatic experience.

The therapist will then guide you through a sequence of physical eye movements. This is because eye movements are believed to be neurologically connected to the brain’s information processing and can help overcome bad memories and heightened emotions.

6. Mindfulness Practices

Mindfulness practices can include various kinds of activities and exercises. Usually, these practices are meant to help you learn to observe yourself and the direct surrounding in a non-judgmental way. Mindfulness also focuses on calmly controlling your thoughts and emotions.

What Kinds of Therapy Doesn’t Medicaid Pay for?

While Medicaid generally pays for therapy, there are other kinds of treatments that it doesn’t cover, including massage therapy, aromatherapy, reflexology, and acupuncture.

Medicaid also doesn’t pay for energy exertion such as reiki healing or treatments offered by specialists who don’t have professional credentials and aren’t authorized by Medicaid.

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

With most Medicaid plans expect to pay a co-payment of 0-25 USD per therapy session with a therapist approved by Medicaid. This implies that you are liable to pay the amount each time you go for a therapeutic session.

Since every US State offers its own version of Medicaid, the out-of-pocket costs under a Medicaid plan can vary. However, most Medicaid plans simplify the process of seeing a therapist because the government values mental and behavioral therapy.

Note that in some US States, the number of therapy sessions has been capped by Medicaid. Normally the limit is up to 30 sessions per year, and after you have exhausted your paid visits, you will be forced to pay for the sessions entirely.

Does Medicaid Pay for Online Therapy?

Yes, Medicaid does, in fact, pay for online therapy. So if you prefer to have therapy sessions online, you will still get the same coverage as if you saw the therapist in person. However, the online therapist has to be approved by Medicaid.

It’s possible that Medicaid will reconsider its online therapy approach in the coming years because the policy has been relaxed because of the pandemic. So if you’re considering having therapy sessions online, ensure you check your Medicaid plan prior to signing up for a session to ensure that online therapy is still being covered.

Final Thought

Medicaid has had a massive impact on the direction of public mental health care. Medicaid’s therapy coverage has expanded and created incentives for public-based therapy providers. It has also changed the economic laws governing public mental health, forcing State governments to change their approach, resulting in many people accessing mental health care.

See Also

Does Medicaid Cover Dental Implants

Does Medicaid Cover Weight Loss Surgery

Medicaid Alternatives


Got Questions? Ask us @medical_grants

Leave a comment

Your email address will not be published.