Does Medicaid & Medicare Cover Therapy?

Mental health and illness, these are problems that have become more commonplace and accepted in the current day and age. Therapy has now become an important part of our lives. With the awareness towards mental health issues rising, the number of therapists has increased with the demand. After the pandemic, we were all left with some form of mental instability, some more than others. At that time these therapists came through and helped us become whole once again. Insurance policies usually didn’t cover therapists so people used to avoid it as they were expensive. However with the trend we have seen in recent years, mental health and therapists have been brought to their much needed spotlight.

Many of the world’s insurance companies have turned their attention to this and have started providing people with packages that cover therapy, private and government. Let’s talk about the two main government insurance companies, Medicare and Medicaid. Both of which do cover therapy in their plans.

Introducing Medicare & Medicaid

Medicaid is a government and federal funded program that provides health coverage to millions of Americans. This includes eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. Medicare on the other hand is a federal only health insurance program that provides its services to people over the age of 65, young people with certain disabilities and people with end-stage Renal Disease. Both of these plans are unique, with different areas of coverage within the medical community. Both of these cover different forms of therapy. Since Medicare is catered towards the elderly, they offer depression, alcohol abuse screenings and wellness visits. Medicaid offers a more broader service due to the Affordable Care Act. They offer Mindfulness-based cognitive therapy (MBCT), Cognitive-behavioral therapy (CBT), Acceptance and commitment therapy(ACT) along with many more. Both offer pretty good services but the question remains. How does one apply for them? Well here’s an easy to understand guide!

Eligibility & How to Apply

Medicaid is offered to those who are unable to afford high costing insurance companies. It is available to adults with low income, children, pregnant women, people who are age 65 or over and people with disabilities. Now to check your eligibility you can visit this link. It can depend on your age, income, number of family members, pregnancy, disability or a combination of these. As for how you can apply for Medicaid, you can follow two main routes. One is to contact your state Medicaid agency. As a resident of that state you are able to walk in and apply. The other is to fill out their application that is present on the Health Insurance Marketplace.

If your income is above average, your child may qualify for Medicaid’s CHIP program. It covers medical and dental care for uninsured children and teens upto the age of 19. Its eligibility varies state to state but in most cases depends on income. You can apply via the in-state program or directly from the Health Insurance Marketplace. A piece of information to be aware of here is that the name for Medicaid and CHIPS may be different in certain states. Documentations regarding their contact information and such can be found on their website.

What’s the Difference?

Medicare is different from Medicaid in the regards that it has three different parts to its insurance plans. Medicare Part A covers inpatient care in hospitals, nursing facilities, hospice or house care. Part B covers services from doctors, outpatient care, home health care and such. Part D is for prescription drugs which includes shots or vaccines. Plans that offer this are run by a private insurance company that follow a set of rules. There is also Medigap, extra insurance that helps you pay the costs of your original Medicare plan.

After you have decided upon your plan, you have to answer a few simple questions like whether or not you have insurance previously or get any benefits. After you have answered all of the questions, you will be able to sign up for Medicare! Medicare starts when you turn 65 years of age unless you are under 65 with a chronic illness or disability. Depending upon the time you applied it can take from a month upto three for your coverage to start. You can apply for it online or via their phone number available at their website

Both of these provide coverage for therapy, mental and physical. Medicare provides it to the elderly and the chronically ill while Medicaid is for everyone, but only for those who are eligible for it. Both companies have their pros and cons along with areas of specializations but in the end they are providing the people with a newly considered essential service therapy. Unfortunately not all companies and therapists accept insurance nor do insurances cover all therapists. So we must always check the policy of both our insurance providers as well as the therapist if they accept.

Have more questions or need insight into this matter? Feel free to contact us here.