Minnesota Medicaid can help cover the costs of mental health care, making therapy and treatment more accessible. This guide will outline what’s covered, any limitations, and tips on how to maximize your mental health benefits. From therapy sessions to prescription medications, understanding your coverage can help you get the support you need. Read on to find out how Minnesota Medicaid supports your mental health journey.
Key takeaways
- Minnesota Medicaid (Medical Assistance) covers a range of mental health services, including individual therapy, family counseling, group therapy, crisis intervention, and medication management.
- Low-income residents, including children, adults, seniors, and individuals with disabilities, can qualify for coverage. Services must be deemed “medically necessary” by a provider.
- Services covered include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and other evidence-based treatments. Online therapy (telehealth) is also included.
- Issues like denied claims or pre-authorization requirements can be resolved with proper documentation and communication with Minnesota Medicaid.
Introduction to Minnesota Medicaid
Minnesota Medicaid, known as Medical Assistance (MA), provides health benefits to eligible low-income residents, including families, seniors, and individuals with disabilities. It covers a range of services — medical, dental, and mental health — to ensure comprehensive care for its members.
Mental health care under Minnesota Medicaid includes coverage for various types of therapy, such as individual counseling, family therapy, and group therapy. Common treatment options such as cognitive behavioral therapy (CBT) and medication management are covered. Additionally, Minnesota Medicaid supports substance use treatment and high-intensity services such as crisis intervention.
Who is eligible for Minnesota Medicaid?
Eligibility for Minnesota Medicaid, or Medical Assistance (MA), is managed by the Minnesota Department of Human Services (DHS). Criteria include income, residency, and specific health needs. Minnesotans with limited income who meet income thresholds and are U.S. citizens or qualifying noncitizens may qualify. Coverage extends to low-income adults, families, seniors, and those with disabilities, with a special focus on accessible mental health services.
For adults seeking mental health care, Medicaid offers significant support, including individual and group therapy options. Additional benefits are available for specific groups, such as children under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program, which ensures preventive and developmental care, autism support services, and enhanced support for pregnant women and those with disabilities.
To qualify for therapy, services must be considered “medically necessary” by a provider — meaning they are rendered “to achieve a level of physical or mental function consistent with prevailing community standards for diagnosis or condition.”
Does Minnesota Medicaid cover therapy?
Yes, Minnesota Medicaid typically covers therapy — including in-person and online therapy — as well as a wide range of mental health services that are designed to help with substance abuse, depression, anxiety, stress, relationship issues, and more.
What therapy does Minnesota Medicaid cover?
Minnesota Medicaid insurance covers many types of therapy that serves as quality care options for many types of conditions. You will need to confirm what types of therapy your specific Minnesota Medicaid plan covers, but in general the types of therapy Minnesota Medicaid typically covers includes:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Individual psychotherapy
- Family therapy
- Group therapy
Other types of therapy that Minnesota Medicaid may cover, depending on diagnosis, previous therapies, and your Minnesota Medicaid plan details:
- Ketamine and esketamine (Spravato)
Minnesota Medicaid covers mental health services from the following types of providers:
- Licensed Independent Clinical Social Worker (LICSW)
- Licensed Marriage and Family Therapist (LMFT)
- Licensed Professional Clinical Counselor (LPCC)
- Licensed Psychologist (LP)
- Certified Psychiatry or Osteopathic Physician
- Nurse Practitioner (NP)
- Clinical Nurse Specialist (CNS)
- Tribal-Certified Professional
Learn more about other types of therapy you might find when seeking mental health care, and be sure to double check your specific Minnesota Medicaid health plan, or reach out to the Department of Human Services of Minnesota directly, to understand what therapy may be covered by your Minnesota Medicaid insurance.
Medication coverage with Minnesota Medicaid
Minnesota Medicaid provides coverage for a wide range of psychiatric medications to support mental health treatment. Commonly covered medications include antidepressants, antipsychotics, mood stabilizers, anti-anxiety medications, and medications for ADHD. These medications help manage conditions such as depression, bipolar disorder, anxiety disorders, and schizophrenia.
For high-cost or specialized psychiatric medications, such as certain long-acting injectables or newer medications, Minnesota Medicaid may require prior authorization. This process involves a provider submitting documentation to confirm that the medication is medically necessary, helping ensure that you receive the most effective and appropriate treatment for your needs.
What types of therapy does Minnesota Medicaid not cover?
Minnesota Medicaid covers many types of therapy which may help an individual with their mental health needs. However, there are some types of mental health services which are not covered by Minnesota Medicaid. These services include, but may not be limited to:
- Hypnotherapy: Hypnotherapy uses hypnosis to help people with their mental health problems. Although some people find it helpful, Minnesota Medicaid does not believe it is a reliable or effective treatment for mental health issues.
- Non-traditional therapy: Non-traditional therapy, such as biofeedback therapy, aims to help people control their body’s response to stress and anxiety by giving them feedback about their body’s functions, like their heart rate or blood pressure. Minnesota Medicaid does not cover this type of therapy because they do not think there is enough evidence to prove that it’s an effective form of treatment.
- Conversion therapy: Minnesota Medicaid does not cover conversion therapy, as it is widely regarded as harmful and is not an accepted practice within the mental health profession.
Does Minnesota Medicaid cover online therapy?
Yes, Minnesota Medicaid covers online therapy (also known as telehealth or virtual therapy) in addition to in-person therapy sessions. This option allows beneficiaries to access mental health services remotely, which can be especially beneficial for those in rural areas, those with limited transportation, or individuals with mobility challenges.
One important consideration if you’re searching for online therapy is that some types of therapy or assessments may still need to be conducted in person due to their clinical nature. Overall, Minnesota Medicaid’s coverage for online therapy ensures greater flexibility and access to mental health support.
Does Minnesota Medicaid cover out-of-network therapy?
Minnesota Medicaid covers out-of-network therapists in specific situations, such as an emergency or if you can’t find the type of specialist you need in-network. If you want to see an out-of-network mental healthcare provider with Minnesota Medicaid, it may cost much more than seeing an in-network provider. You may have to pay out of pocket, and you should check beforehand to see if you will be able to file for any kind of reimbursement from Minnesota Medicaid. If you have questions about out-of-network therapy coverage, please refer to your Minnesota Medicaid summary of benefits (SOB) as described below, or contact Minnesota Medicaid directly.
Search for therapists who accept Minnesota Medicaid
How to check if your Minnesota Medicaid plan covers therapy
There are twp main ways to find out if your Minnesota Medicaid plan covers therapy and, if so, what it covers and how much it will cost.
1. Check your Minnesota Medicaid “Summary of benefits”
On the summary of benefits (SOB), look for a row that references mental health, behavioral health, or substance abuse services, as well as “outpatient services” (because therapy is considered to be outpatient care).
If the “Network Provider” and/or “Out-of-Network Provider” give cost information, such as a copay or coinsurance, then your Minnesota Medicaid plan does cover mental health services.
If the “Network Provider” and/or “Out-of-Network Provider” say “not covered”, then your Minnesota Medicaid plan does not cover mental health services such as therapy.
To learn more about how Summary of Benefits are structured, you can refer to this sample SOB from the Centers of Medicare & Medicaid Services website.
2. Contact your Minnesota Medicaid plan directly
Contacting your Medicaid plan or the Minnesota Department of Human Services directly is the best way to get the exact information you need about what types of mental health care are covered.
- Find the phone number to call, located on the back of your insurance ID card
- Visit the Department of Human Services Health Plan member services phone numbers page
How much does Minnesota Medicaid therapy cost?
Most people who are insured by Minnesota Medicaid will either be fully covered by their plan, or have to pay a small copay amount of $3. For most clients, the average cost of Minnesota Medicaid for therapy is minimal or none.
However, if you are insured by Minnesota Medicaid the cost of therapy will depend on your plan’s specific coverage — you should always confirm your out-of-pocket costs before your appointment.
Minnesota Medicaid therapy copay
When paying for therapy, your copay (or copayment) is an important potential cost you should know about.
The copay is a fixed amount you may have to pay for each therapy session. Copays can vary depending on your plan, as well as the therapist you see, so it’s important to double check for a potential copay under the mental health coverage section on your summary of benefits.
If you have any doubts or questions about if you have to pay a copay, or what your copay is, you should reach out to Minnesota Medicaid support directly.
Example Only
What do terms like deductible, copay, and coinsurance mean?
Navigating the insurance system — especially when you’re in need of mental health support — can be challenging and confusing. For help, please visit our Understanding health insurance article.
Does Minnesota Medicaid require a referral to see a therapist?
Minnesota Medicaid does not require a referral to access mental health services. Enrollees can directly seek therapy and other mental health treatments from qualified providers without prior authorization. However, if you’re enrolled in a managed care plan, it’s advisable to consult your specific plan’s guidelines, as some plans may have their own referral requirements. For detailed information, refer to the Minnesota Department of Human Services’ Medical Assistance page.
How to find a therapist covered by Minnesota Medicaid
Finding a therapist who accepts Minnesota Medicaid insurance is not as difficult as you might think.
1. Minnesota Medicaid directory of therapists
The Minnesota Department of Human Services offers an online MHCP provider directory, allowing you to search for mental health professionals who accept Medicaid. You can filter results by location, provider type, and specialty to find a suitable therapist in your area.
Using Minnesota Medicaid’s online directory can save you time and effort in finding a mental health provider. Instead of calling multiple providers to see if they accept your insurance, you can quickly and easily find in-network providers in your area with just a few clicks.
2. Contact Minnesota Medicaid customer service
For personalized assistance, contact the MHCP member help desk:
- Phone: 800-657-3739
- Hours: Monday through Friday, 8 a.m. to 5 p.m.
They can provide information on mental health providers in your area who accept Medicaid.
3. Use a therapy provider like Grow Therapy
With Grow Therapy, you can search for mental health providers who are in-network with Minnesota Medicaid who are licensed in your state and provide both online therapy or in-person therapy. At this time, Grow Therapy works with providers who accept Blue Cross Blue Shield Medicaid and Humana Dual Medicare & Medicaid.
On Grow Therapy, you can browse our growing network of vetted therapists and use filters to search by age, specialty, gender, and more. Simply pick the therapist who meets your unique needs and book your first session.
Navigating common issues with Minnesota Medicaid health coverage
When using Minnesota Medicaid for mental health care, you may encounter some common issues. Here’s a step-by-step guide to help troubleshoot and address these challenges.
Denied claims
Sometimes, a claim may be denied if it doesn’t meet specific criteria set by Minnesota Medicaid or if there’s missing documentation.
What to try: Review the denial notice carefully to understand the reason for the denial. Gather any additional documentation and submit an appeal through Minnesota Medicaid within the specified timeframe. Contact customer service for guidance if necessary and consult your provider to verify that all necessary paperwork was submitted correctly.
Needing pre-authorization
Certain therapies or medications, particularly those that are high-cost or specialized, may require pre-authorization before they’re covered.
What to try: If your provider recommends a service that requires pre-authorization, ask them to submit the necessary forms to Minnesota Medicaid before your appointment. This ensures that your treatment won’t be delayed and reduces the risk of unexpected costs. Be proactive and follow up with both your provider and Minnesota Medicaid if there are any delays in approval.
Out-of-network services
If you need care from an out-of-network provider, you may face restrictions or additional paperwork, as Medicaid primarily covers in-network providers.
What to try: Contact Minnesota Medicaid to discuss your options if you require an out-of-network provider. In some cases, prior authorization or proof of medical necessity may allow for coverage outside the network, especially if there are limited provider options in your area.
Difficulty finding a therapist
Locating a therapist who accepts Minnesota Medicaid can sometimes be challenging, especially if you need specialized care.
Use the MHCP provider directory or contact customer service for assistance. If availability is an issue, consider broadening your search to include online therapy options covered by Medicaid.
Making the most of your mental health coverage with Minnesota Medicaid
Understanding and fully utilizing your Minnesota Medicaid mental health benefits can make a meaningful difference in your overall well-being. Knowing what services are covered, any requirements for pre-authorization, and how to appeal denied claims are crucial steps to accessing quality mental health care.
Stay informed about your plan details, as Medicaid coverage and policies may change over time. Regularly reviewing your benefits can help you take advantage of new services or updates.
