Do Medicare and Medicaid Cover Psychiatric Services for Children?

Statistics indicate one of every four children will have a childhood mental illness. And in Texas, in 2020, over 500,000 children were diagnosed with anxiety or depression. If you have a child or teen with mental health needs, you are not alone. But many families fail to consider mental health needs when planning for public benefits.

Public benefits programs like Medicare and Medicaid cover mental health services in addition to more traditional health care. Families that make over a certain income level may think they do not qualify for these programs. But these programs often increase access to health care and include benefits and programs not available under traditional employer-provided insurance, so it’s worth determining if your family qualifies via benefits planning or other income levels. In addition, Texas has programs for children of families that do not qualify for Medicaid. There are certain estate planning tools that can help aid in Medicaid qualification, such as Miller Trusts or lady bird deeds.

Medicare Coverage

Medicare is a federal health care program administered by the federal government and is available to anyone regardless of income, so long as they are over 65 years of age or have a specific disability. Medicare covers a wide range of mental health services but does not cover most long-term care costs. And Medicare patients may have to pay deductibles, copays, and other out of pocket costs. Medicare Part B covers outpatient mental health services that can include partial hospitalization, depression screenings, diagnostic testing, individual or group psychotherapy, and other medication and counseling needs. Medicare Part A covers inpatient mental health care at a regular or psychiatric hospital.

Medicaid Coverage and Children’s Health Insurance Program

Medicaid is a federal program administered by the state, so Medicaid is administered differently by each state. In Texas, Children’s Medicaid is free of cost. Families in Texas can also qualify for CHIP. The Texas Children’s Health Insurance Program (CHIP) is designed for families that earn in excess of Medicaid limits but cannot afford private health insurance. CHIP fees vary by income. Texas Medicaid covers psychiatric diagnostic evaluation and psychotherapy, psychological and neuropsychological testing, inpatient psychiatric care in general and psychiatric hospitals, and various medications and rehabilitative care services.

Under both programs, access to mental health care, prescription drugs, and treatment of special health needs is available.

Long-term service and support through Medicaid can help children with disabilities get additional benefits and care, such as mental illness hospitalization. CHIP, however, does not cover long-term services. Under the Medicaid Buy-In for Children program, families of children with disabilities can make monthly payments for Medicaid coverage.

A skilled benefits planning and estate planning attorney can help you determine your eligibility for these types of programs.

Consult with a Texas Benefits Planning Attorney About Your Situation Today

For information about Medicare and Medicaid eligibility and benefits planning, contact the McCulloch Miller, PLLC law firm. Our attorneys are well versed in benefits planning, Medicaid crisis planning, estate planning, trust planning, and elder law. Call today to schedule a free, no-obligation consultation at (713) 903-7879.

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