Many people want therapy but feel stuck when they think about money and insurance.
You might wonder:
- Does my Medicaid plan pay for therapy?
- What about Medicare or my work insurance?
- Will I get a surprise bill later?
You are not alone. This guide explains how Medicaid and other insurance can help pay for therapy, in simple steps.
What Medicaid and insurance can cover
Medicaid, Medicare, and many commercial plans often help pay for:
- One-on-one therapy
- Family or couples therapy
- Group therapy
- Some kinds of testing or assessments
Each plan is different, but in many cases you can see a licensed therapist and only pay a small copay or sometimes nothing at all.
The most important things to know are:
- Is your plan active?
- Is the therapist "in-network"?
- Are there any visit limits or special rules?
If a therapist is "in-network," it means they have a contract with your plan. This usually makes your cost much lower than seeing someone who is "out-of-network."
Common words you will see on your plan
Insurance words can feel confusing. Here are a few you may see, in simple language.
- Copay: A set amount you pay each visit. For example, $0, $5, or $20.
- Deductible: The amount you must pay for covered services each year before your plan starts to pay more.
- Coinsurance: A percent of the bill that you pay, like 20%, while your plan pays the rest.
- Visit limit: The number of therapy visits your plan will pay for in a year, unless more are approved.
- Prior authorization: When your plan asks for extra approval before it will pay for certain services.
If any of these words are confusing, you are allowed to ask for plain language. You can call the number on the back of your insurance card and say, "Can you explain my mental health coverage in simple terms?"
If you want to understand more about coverage terms, you can also read Understanding mental health coverage and benefits. It goes deeper into how plans think about mental health care.
How to check if your therapy is covered
Here is a simple way to check your coverage:
Step 1: Look at your insurance card.
Is it Medicaid, Medicare, or another plan like Blue Cross Blue Shield, UnitedHealthcare, Aetna, or Cigna?
Step 2: Call the number on the back.
Ask questions like:
- "Do I have mental health coverage for therapy?"
- "What is my copay for an outpatient therapy visit?"
- "Do I need a referral or prior authorization?"
- "How many visits do I get each year?"
Step 3: Ask about in-network therapists.
You can ask:
- "How do I find an in-network therapist who takes my plan?"
- "Can you send me a list, or can I search on your website?"
Step 4: Ask about telehealth.
If you want video visits, say:
- "Does my plan cover online video therapy?"
You do not have to ask every single question at once. You can write down 2 or 3 that feel most important and start there.
How Lavni helps with Medicaid and insurance
Lavni is built as a Medicaid-first platform. We also work with Medicare and commercial plans in the states we serve.
When you use Lavni:
- We focus on showing you therapists who are in-network with your plan.
- We help check your benefits so you know what to expect before you start.
- We send many of the claims for your visits in the background, so you do not have to chase paperwork.
If you want to see who is available, you can look for a Medicaid therapist near me and see therapists who work with your plan and live in your state.
Right now, Lavni supports clients in North Carolina, Georgia, and Virginia through online care. As we grow, we will add more states over time.
Avoiding surprise bills
Here are a few tips to lower the risk of surprise bills:
- Always ask if the therapist is in-network with your exact plan name.
- Ask, "What will I likely pay per visit?" before you book.
- Ask if there are any visit limits, like "20 visits per year."
- If something seems wrong on a bill, call and ask for a review.
On Lavni, our team can help you understand a confusing bill or claim. We want you to focus on your mental health, not on billing codes.
When coverage is limited or you have no insurance
Sometimes coverage is not enough, or you may not have insurance right now. In those cases, you still have options.
You can:
- Ask the therapist if they have a sliding scale or reduced fee.
- Look for community clinics that offer lower-cost care.
- Ask your doctor or school if they know low-fee options.
We also have a post called Getting started with therapy on a budget that shares more ideas for saving money while still getting help.
How this connects to your symptoms and progress
Insurance is not just about paying bills. Many plans and clinics now care about "outcomes." That means they want to see if therapy is actually helping you feel better.
One way to do this is by tracking scores over time with simple tools like:
- PHQ-9 for depression
- GAD-7 for anxiety
- Other short check-ins about your mood, sleep, and daily life
On Lavni, we make it easier for therapists and clients to track changes over time. This helps you and your therapist see what is working and where you may need more support.
When Lavni is a good fit
Lavni is a good fit if you:
- Want to use Medicaid, Medicare, or a commercial plan for therapy
- Want clear, simple language about what you will pay
- Want help finding an in-network therapist who understands your needs
You can learn more about how Lavni works and see the steps to get matched with a therapist who takes your plan.
You do not have to figure out Medicaid and insurance on your own. With the right information and support, you can use the benefits you already have to get care that helps.