Can i get a therapist with medicaid

Deborah C. Escalante

Medicaid covers mental health, behavioral health, and substance use disorder services, including therapy, so if you’re a Medicaid beneficiary, take note of this benefit.

Since the start of the pandemic, Medicaid enrollments have been steadily increasing, and now 82.8 million Americans are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).

If you’re a new or returning Medicaid member, you’ll want to understand which mental health services are covered. We offer a breakdown below. Just know that health care coverage will vary state by state and plan, so it’s important to check with your insurance provider before scheduling an appointment. 

Therapy Is Covered By Medicaid

Over the years, the Affordable Care Act has adjusted the Medicaid requirements to ensure that Medicaid members have access to more comprehensive mental health care.

Thanks to these policy improvements and the enactment of the Mental Health Parity and Addiction Equity Act (MHPAEA)—which prevents limitations on mental health benefits for those enrolled in managed care organizations and state alternative benefit plans—Medicaid members now have access to a plethora of mental health services.

Medicaid also covers in-person and online individual and group therapy. Many providers offer family therapy, too. So long as you have a diagnosis and a medical prescription for a specific therapy, your health insurance provider should cover it. This means that health coverage also includes evidence-based therapies. 

Some of these therapies include:

What’s not covered is couple’s therapy, career counseling or coaching, massage therapy, acupuncture, and other holistic treatments. Other types of therapy will depend on your plan. Transcranial magnetic stimulation (TMS), for instance, may or may not be covered. If you’re on Medicaid, you should ask to work with a care coordinator who can help you manage your care and treatment plans.

Verywell Mind’s Cost of Therapy Survey found that even with insurance, many Americans have struggled to find adequate care:

  • 30% of Americans currently in therapy say they’ve encountered a lack of appointment availability or flexibility of the mental health professional
  • 27% have had difficulty finding a mental health professional who is taking new patients
  • 24% have had difficulty finding an in-network mental health professional

Medicaid Offers Additional Mental Health Support

Medicaid is the single largest payer for mental health services in the United States. While they didn’t always include therapy as a benefit and limitations do still exist, Medicaid now covers this and a myriad of other substance use, mental health, and behavioral health services. 

If you’re enrolled in a Medicaid plan, some of your covered services may include:

  • Psychological testing and evaluation
  • Medication evaluation, prescription, and management
  • Mental health clinic services
  • Mental health rehabilitation
  • Inpatient and outpatient treatment
  • Residential rehabilitation
  • Crisis services
  • Inpatient psychiatric hospitalization
  • Social work services
  • Case management for chronic mental illness

Other services like tobacco use cessation, mental health skill-building, and peer support should also be covered. If you’re experiencing mental health concerns or battling a substance use disorder, it’s important to seek professional care and get the diagnosis and treatment you need.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

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For more mental health resources, see our National Helpline Database.

Affording Out-of-Pocket Costs

Medicaid provides more mental and behavioral health coverage than Medicare. Both children and adults under Medicaid and CHIP have access to many different behavioral health services. Unfortunately, not every mental health service will be covered. 

Here are some things to consider as you begin therapy or mental health treatment:

  • Your plan may require a copay or coinsurance, which is the percentage or dollar amount you have to pay out of pocket.
  • To get coverage, you need to choose a provider in your network.
  • Your plan may set limits on the number of therapy sessions covered. 
  • You may need to get a referral from your primary care physician (PCP) before seeing a therapist.
  • If the specific therapy isn’t covered, you will be expected to pay the full cost.

For patients with a severe mental health condition or illness, this can be problematic. Make sure you make the most of your plan before seeking alternative options. You may be surprised to find out just how much coverage you have.

If your therapy session, service, or treatment isn’t covered by Medicaid, for whatever reason, then you can make an appeal to your provider. If they are unwilling to pay for the service, then you’ll have to consider alternative options.

Here’s what you can do:

  • Ask your provider about sliding-scale payment options which are based on income 
  • Consider community health centers or free clinics in your area
  • Check available community mental health service programs in your state
  • Consider using an app for free online therapy 
  • Call the NAMI HelpLine at 800-950-NAMI (6264) or text NAMI to 741-741 to talk with a crisis counselor

A Word From Verywell Mind

If you’re enrolled in Medicaid, you may be eligible for federal- or state-run programs, as well as free or low-cost services. Check with your state’s Medicaid program to see what’s available to you. There are many pathways to treatment, so don’t suffer in silence. 

If you’re suffering from anxiety or depression, grieving a loss, battling a substance use disorder, or undergoing a major life change. Look for a therapist in your area. There are many cost-considerate providers willing to offer low-cost services to those in need.

When you see a therapist who is in-network with Medicaid, each session you’ll pay only a copay, which typically ranges from $0-$75/session. Depending on your plan, you may first need to pay the provider’s full session fee until you meet your annual deductible, which is the total amount of medical expenses required before your health insurance starts to cover costs. Some plans cover the cost of in-network therapy sessions before the deductible is met; to verify whether your specific plan covers therapy sessions and at what rate, visit the Medicaid website or call the number on the back of your insurance card and ask about your coverage for outpatient mental health.

3 In-Network Providers

If you have a PPO or POS insurance plan, you can likely receive some reimbursement when you see a provider out-of-network. Some providers also offer a sliding scale payment system; consider filtering by Session Fee to find providers who fit your budget.

FAQs about how to find a therapist in Texas

How do I find a therapist in Texas ?

Find a therapist near you in Texas on Zencare. Narrow your search by using filters like insurance, therapy budget specialty, and provider identity. Mental health professionals on Zencare are vetted for their extensive experience treating individual adults, children and adolescents, as well as couples and families. Explore each potential therapist profile to learn more about their specialties, and watch an introductory video to get a sense of their personality. Book a free initial call to find the right therapist for you!

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Does insurance cover therapy in Texas ?

Yes, most Texas health insurance carriers provide mental health benefits that cover therapy. However, the exact amount of coverage will vary based on the plan details and whether the selected provider is in-network or out-of-network with your insurance. If the therapist is in-network with your insurance, you’ll pay only a copay at each session after meeting your annual deductible. If the therapist is out-of-network with your insurance, you may still be able to receive reimbursement after paying the fee at the time of therapy session. If you have a PPO or POS insurance plan, you can likely receive some reimbursement when you see a therapist out-of-network in Texas . If you have an HMO, EPO, or Medicaid/Medicare plan, you likely cannot receive reimbursement, and would be responsible for the full out-of-network session fee. Note that services designed to treat topics which are not diagnosed mental health conditions, such as couples counseling and life coaching, are not typically covered by health insurance. The potential mental health provider must also be a licensed therapist in your state for the insurance company to cover services.

How do I find an affordable therapist in Texas ?

Many therapists offer a sliding scale, or a range of session fees based on financial need to clients who would not otherwise be able to afford typical therapy rates in Texas . If you are struggling to pay for therapy, consider asking for a sliding scale, looking for an in-network therapist , or seeking services through a local agency, college counseling center, or hospital.

How can I make an appointment with a therapist in Texas ?

Start your search for an appointment with a therapist in Texas on Zencare. Many mental health professionals located in Texas require clients to have an introductory call before booking a full appointment online. In this free call, the prospective therapist will ask about your goals for treatment, and make sure that their skills, specialized training, and scope of private practice are a match for your mental health issues. At the same time, you should assess if you feel comfortable talking with the therapist , as studies show that the most important determinant of successful therapy is the relationship between therapist and client. After an initial call, you’ll typically be given the option to book an appointment with the therapist , or continue your search if it’s not a good fit. At the initial session, you’ll likely discuss the therapeutic process and determine goals for your personal growth. Common therapy goals include learning effective coping strategies to deal with negative feelings, increasing self-awareness, and gaining a deeper understanding and insight into relationship patterns.

How can I find a therapist in Texas who sees clients after hours?

Find a therapist who sees clients after hours on Zencare. Many therapists in Texas offer appointments outside of traditional business hours. Simply filter by Office Hours under More Filters to choose the time of day that works best for you, whether that be early morning before work, in the evenings, or even over the weekend. After hours sessions are a good option for busy individuals, couples, and families dealing with hectic schedules and who need a flexible option for their mental health care.

How do I find a therapist in Texas who offers in-person sessions?

Find a therapist who offers in-person sessions on Zencare. Many therapists in Texas have resumed offering in-person sessions; you can filter by “In-Person” to find a provider who is accepting new clients for in-office sessions. You can also search by map to find providers in Texas near you. While some clients prefer in-person sessions because they offer a safe, neutral ground for the session to take place, for the widest range of therapist options, consider expanding your search to also include providers licensed in your state who offer telehealth, or therapy sessions via remote video call.

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How do I find a therapist in Texas who offers online sessions?

Find a therapist who offers online sessions on Zencare. Most therapists in Texas continue to offer appointments online; you can filter by “Online” to find a provider who is accepting new clients for teletherapy sessions. In order to see a therapist , they must be licensed to provide online sessions to clients living in your state. Online therapy is different from text therapy, or asynchronous therapy; online therapy offers the same consistent relationship with a local Texas therapist that an in-person session would, with sessions taking place via phone or a video sessions through a secure teletherapy platform. Online therapy sessions are a convenient way to find a therapist near Texas without leaving the comfort of your home or office.

Where can I get mental health therapy in Texas ?

Start your search for mental health therapy in Texas on Zencare. All therapists are quality-vetted for excellence in clinical care. When you’re struggling with your mental health, it might be time to seek professional support in the form of counseling services, couples therapy, or psychiatric medication management. There are a wide range of private practice therapists to choose from in Texas ; consider narrowing your search by criteria like insurance carrier, therapy budget, specialty, or provider identity to find a great fit!

How can I start therapy in Texas ?

Start your search for a great therapist in Texas on Zencare. First, consider any logistic limitations, like how far you are willing to travel outside of Texas or if you are open to online sessions with a local provider. Also consider how much your therapy budget is, and when you are available for therapy. Then, make a list of priorities for your ideal therapist : do they match your identity, or have expertise in a specific area like anxiety or depression? There is no one reason to start therapy; many individuals in Texas go see a therapist when they need help to move forward through a difficult time, cope with symptoms of a mental illness such as a mood disorder, navigate life transitions, process relationship difficulties or improve their behavioral health. Use your priorities to filter on Zencare by insurance, speciality, and availability. Look through a few provider profiles to find the therapist you might click with, watch their introductory videos, and book a free call to find a great personal fit!

What kinds of mental health providers are available in Texas ?

There are many different kinds of mental health providers available in Texas , 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 Texas include cognitive therapies, like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), 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 Texas also offer specialized treatment services, like couples therapy, premarital counseling, and family therapy. While most Texas 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 , you’ll build a treatment plan that addresses your reasons for seeking therapy and monitor progress toward your wellness goals and overall well being.

How does paying for therapy work in Texas ?

There are several options for paying for therapy in Texas . For many people, the most affordable way to seek mental health services is to look for a provider who is in-network with your insurance. Due to high demand and low availability, in-network providers often have long waitlists; to widen your options and start therapy sooner, you might also consider looking for an out-of-network provider. When you see an out-of-network therapist in Texas , you can ask for a sliding scale if you are unable to afford their typical session fees, or seek reimbursement from your insurance company if you have a PPO or POS plan. For clients who have an insurance plan with a high deductible and low medical costs, therapy costs are often comparable when you see a therapist in- or out-of-network. While paying for therapy can be a substantial investment, it’s also a great way to improve relationships, boost self-esteem, address symptoms of mental illness, and ultimately live a happier, more self-directed life.

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