Does Medicaid Cover Psychological Counseling?

The Centers for Medicaid and Medicare Services (CMS) report that Medicaid currently provide more mental health services--including psychological counseling--in the U.S. than is offered by any other state or federal health program. The McGraw-Hill Concise Dictionary of Modern Medicine defines psychological counseling as the "interaction between a professional or trained individual, and a patient, intended to help the latter solve difficulties in psychosocial adjustment."

• Some people are eligible to receive counseling under their state's Medicaid laws

Identification

• Medicaid is a state-funded program that provides healthcare--including mental health counseling and prescription drugs--to eligible low-income individuals and families. In 2006, Medicaid provided for more than $241 billion in care, including mental health. By 2009, approximately 58 million adults and children were receiving Medicaid.

Eligibility

• Medicaid's conditions for eligibility and services vary from state to state. In some states, beneficiaries are required to pay a co-pay, a small amount of the cost of the health care treatment or prescriptions they receive. Medicaid does not pay beneficiaries directly--instead, it sends payments for the psychological services or prescription coverage directly to health care providers.

Methods

• Psychological services provided by Medicaid may involve treatment by a psychiatrists, a psychologist or a licensed therapist. They may use traditional or non-traditional treatments. However, traditional methods such as behavioral therapy, cognitive therapy and group therapy are more likely to be covered than non-traditional methods like acupuncture or animal-assisted therapy. Again, the availability of these services through Medicaid varies by each state.

Coverage

• The Medicaid program does not provide mental health services for all low-income people. Individuals and families must meet Medicaid eligibility requirements, including having a low income as well as assets and resources below a certain worth. Due to the excessive medical expenses they would incur, medically needy persons also may not be eligible.

More information

• Individuals can apply for Medicaid by obtaining an application from their local or state Medicaid office. Some states will allow application submissions via the Internet, phone or through community locations. More information can be found on the U.S. Department of Health and Human Services website (www.cms.hhs.gov) or by calling toll-free at 1-800-633-4227.