MEDICAID

Medicaid is a joint state and federal healthcare program meant for low household income individuals, elderly, and people with disabilities. It offers mental health benefits including:

  • Evaluation

  • Diagnosis

  • Treatment: individual therapy, group therapy, family therapy, detoxification, medication management, and more.

What is my state required to provide?

Medicaid programs vary from state to state. All state Medicaid programs provide some mental health services and some also offer substance use disorder services. Children’s Health Insurance Program (CHIP) recipients receive a full array of mental health services. You can find state specific information here. 

Parity: Due to the Mental Health Parity and Addiction Equity Act (MHPAEA), coverage for mental health and substance abuse disorders must be equal or comparable to the coverage provided for other medical conditions.

Medicaid Specific to Texas

Because we are currently based in Texas, we will include some basic Medicaid information. 

Texas Medicaid contracts private insurers to provide coverage through a number of Medicaid programs (administered by HHSC). You will need to determine what program you are eligible for, and therefore, what coverage you will receive. 

Legal Help

Disability Rights Texas can provide pro bono legal services if you are having problems with your Medicaid services.

As of 2015, 1 in 7 Texans rely on Medicaid for health care coverage.

Texas Medicaid covers the following behavioral health services:

  • Psychiatric diagnostic evaluation and psychotherapy performed by psychiatrists, psychologists, licensed clinical social workers, licensed professional counselors, and licensed marriage and family therapists;

  • Psychological and neuropsychological testing performed by psychologists and physicians;

  • Inpatient psychiatric care in a general acute care hospital

  • Inpatient care in psychiatric hospitals (for persons under age 21 and age 65 and older);

    • Psychotropic medications and pharmacological management of medications;

    • Rehabilitative and targeted case management services for people with severe and persistent mental illness or children with severe emotional disturbance; and

    • Care and treatment of behavioral health conditions by a primary care provider.

Find a Psychiatrist accepting Medicaid here.

Find a Therapist accepting Medicaid here.

Medicaid YES Waiver offers special therapy options for children with severe mental health needs. Check it out and see if it is right for you and your family.

 

Medicaid for Long-term care

This provides coverage for long-term coverage for something like hospitalization for mental illnesses. Recipients are expected to initially pay out as much of their own money as possible (allowing for basic personal living costs). This is considered to ‘pay part of the cost’ of the coverage.

 

Disclaimer: We are not mental health providers.