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Who Pays for Mental Health Treatments? If you are lucky enough to be wealthy or have excellent medical insurance, you can pay for any mental health problems that you or your family may have. However, most insurance plans have limits on how many treatments you can receive in a given year, or what providers you can use. The same thing is true of health maintenance organizations (HMOs) and managed care companies (MCCs). Most give you some coverage of mental health problems, but most also have limits. Some employers have employee assistance plans, also with different coverages and limitations. Therefore, if you are covered under any of these four arrangements, you should check very carefully to find out just what your coverage is. Insurance companies, HMOs and MCCs are under a lot of political pressure these days, so they are reluctant to deny coverage, especially if you insist on the need for treatment of yourself or a family member. Don't be afraid to ask questions or request mediation if you think you aren't being treated fairly. Many people don't have enough income to belong to an HMO or MCC or buy medical insurance, and don't have an employer who furnishes them with assistance for mental health problems. If you are in this category, you may be eligible for Medicare, a federal program that provides help with the costs of mental health care. You must be over 65, have an eligible disability, or have kidney problems to qualify for Medicare; click here to visit the excellent Medicare web site, or call 1-800 MEDICARE (that's 1-800 633-4227). You can get information on eligibility, benefits, and other topics either place. For other federal programs, you can go to a government "home page" that became available on September 22, 2000. If you click here, you'll go to their index to over 20,000 government web sites with over 27,000,000 pages! You should also check with Medicaid, a combined federal-state program that, in some states, includes coverage for mental problems. You should check with your state Medicaid program to find out whether you qualify. It takes time to enroll in Medicare or Medicaid, so if you think you might qualify for coverage you should apply for it immediately, even if you have no physical or mental problem now. The income limits are higher than you might think, so you should check the limits for your state before deciding that you make too much money to qualify. There are also so-called "pay down" arrangements that make people eligible for help if they have high medical bills, even though their income is otherwise too high to qualify. We provide links to the web sites for all state programs below, so you only need to click on the name of your state in order to visit your state's web site. Unfortunately, the sites are not equally good; however, some are excellent, and most at least give you a telephone number that can get you started on the application process. Also unfortunately, the site addresses sometimes change or our links are broken for other reasons. If our link to your state Medicaid site doesn't work, use a search program and find the site by typing in "(name of your state) Medicaid," and the search engine will almost certainly find the correct Internet address for you. Even if you are caught in never-never land, with an income too high for Medicaid, too low for insurance or a health plan, and too low to pay for mental health care comfortably, you should know that many mental health professionals adjust their charges according to the income of the patient. Don't hesitate to ask about charges when you contact a professional for treatment for yourself or a family member. Some professionals do "pro bono" work several hours per week and charge nothing for people who are unable to pay. Finally, if you are in the non-Medicaid group that's on a tight budget, you may be able to get free medicine, whether it's prescribed for physical or for mental problems. You can find out about it on a web site maintained by a couple in a tiny Missouri town; click here to go there, or call their help line at (573) 996-2114. Who can I ask about getting treatment? If you belong to a health maintenance organization, managed care company, or have private insurance, you can contact your carrier for a referral. Your family physician, if you have one, also can refer you to someone. Ask a friend or family member if they know of anyone to recommend. Check your phone book's yellow pages under mental health, psychologists, psychiatrists, counselors, psychiatric nurses, or marriage and family therapists (you can also go to web sites for these professional groups from this web site). Also, check under clinics and hospitals if you think inpatient care is indicated. You may be lucky enough to have a community mental health center or a mental health association in your area; if so, you can check with them. You already know that if you have to deal with an emergency situation, you can get help by calling 911 in most areas. Click on any state name below to go their Medicaid
web site, but remember the caution above, and use a search engine if our
link fails to work. Alaska Division
of Medical Assistance
Arizona Health Care Cost
Containment System California Medical Care Services /
Last updated 12/19/03 |
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