Medicaid and mental health coverage
For some people with limited incomes or disabilities, Medicaid may be their only resource for health care, including mental health services.
Medicaid is financed jointly by federal and state government to pay some of the costs of medical and long-term care for eligible individuals. State programs typically provide basic services, such as doctor visits, hospital care, lab services and some mental health care. They may provide limited optional services such as dental and vision care, and prescription drugs.
Medicaid serves some low-income individuals and families, certain elderly people and people with disabilities. Others may qualify. Eligibility rules vary widely from state to state and are determined in part by income, resources and disability status.
Medicaid often provides broader mental health benefits than those provided by private insurance, including employment-related services, as well as therapy and medications.
But services and costs vary by state. Some states cover services by a licensed psychologist or social worker, others cover only psychological services offered at clinics, hospitals, or community health centers.
In recent years, Medicaid health coverage in many states has been reduced in cost cutting measures. Some programs require prior approval for certain drugs or the use of generic drugs. Many states are joining together to buy medications at a reduced cost and are establishing a limited list of ‘preferred drugs’ for Medicaid recipients.
Recent parity laws require that, for those in Medicaid managed-care plans and many private group health plans, deductibles, co-payments and limits on the number of visits or days of coverage must be no more restrictive for coverage of mental illnesses and substance abuse than for coverage of medical and surgical treatments.