Does Medicaid cover couples therapy

Couples therapy is not covered by Medicaid. Many couples still find it beneficial to visit a therapist jointly, though. There can be ways to reduce the cost, such as sliding scale, if you’re still interested in working with a couples therapist.

Whether Medicaid Covers Couple Therapy In Texas

In the state of Texas, Medicaid does not cover couples therapy. Therapy for couples is not listed as a benefit under the traditional Medicaid program, nor is it part of the medical care offered by Medicaid managed care organizations. 

Couple therapy

Couples counseling and therapy can be quite expensive and require multiple visits in order to effectively address and resolve issues. While many private health insurance plans may offer coverage for some types of mental health services, this type of service is typically not covered by Medicaid. 

Alternative options

For individuals who are in need of couples therapy but lack financial resources to foot the bill, there are some options available in the state of Texas that may help offset the costs

Sliding Scale

The first option is to look into sliding scale programs that provide reduced-fee therapy and counseling services. Many mental health professionals are willing to work with clients on a sliding scale basis, meaning they adjust their fees based on a client’s income level. 

Faith based organizations

The second option is to inquire about specialized services offered through local community or faith-based organizations. Churches, synagogues, mosques, and temples often provide counseling services to those in need at no cost or at reduced rates. 

Training clinics 

Additionally, universities and colleges frequently have training clinics where graduate level students offer discounted counseling services under the supervision of experienced faculty mentors. 

Keep in Mind

It’s important to note that while these options may help reduce costs associated with couples therapy, they do not replace comprehensive care offered by licensed mental health professionals who have specialized experience and expertise in treating couple relationship issues. Therefore individuals should make sure they find an experienced counselor who has the appropriate credentials and qualifications before engaging in any kind of therapeutic work together as a couple outside of traditional insurance coverage models such as Medicaid.

What kinds of therapy are NOT covered by Medicaid?

Life coaching, career counseling, or holistic therapies like acupuncture, massage therapy, or aromatherapy are not covered by Medicaid. Additionally, it excludes sessions with non-credentialed therapists and energy therapy like healing.

How can I find out if therapy is covered by my Medicaid plan?

1. Locate your Summary of Benefits document, which is typically mailed to you along with your Medicaid card or is available online, to see if your Medicaid plan covers treatment. Your copayment or coinsurance amounts for each type of service are listed on this sheet. You can find out how much your plan covers — and how much you’ll have to pay out-of-pocket, if anything — by looking for “outpatient mental health treatments” on the list.

2. Find the customer support phone number on the back of your Medicaid card if you are unable to discover this information using your Summary and Benefits document. The hotline operators will be able to look up your health insurance policy and provide you with information on your mental health.

Conclusion

Medicaid in Texas provides basic coverage for a wide variety of health care services, but couple therapy can be a tricky case. Unfortunately there is no hard-and-fast answer as to whether Medicaid in Texas covers couple therapy; it depends on individual circumstances and the kind of therapy requested by the couple.

In some cases, coverage might be offered through Texas’ Medicaid Managed Care Organizations (MCOs) while other instances might require approval from the Texas Health and Human Services Commission before payment can be accepted.  It is important to check with your MCO or speak directly with the commission if you are seeking assistance and unsure where to begin.