So you feel depressed or anxious or stressed, and think mental-health counseling would help.
But you also have an insurance plan that requires you to spend hundreds or even thousands of dollars before coverage kicks in.
Perhaps no surprise, cost is the No. 1 barrier to obtaining mental-health care, according to a 2018 federal survey of 5,000 Americans.
But instead of giving up, it’s important to explore your options — and there are a surprising number for people worried about the cost of mental-health services.
Let’s go through 12 of those ideas.
1. Check your insurance. You may be surprised.
The Affordable Care Act requires private insurance plans to cover outpatient and inpatient mental-care services with the same co-pays and deductibles as other health care. So if you have a low deductible and co-pays for doctor visits, the same would apply to counseling appointments. Even if you have a high deductible, the insurance plan will offer discounted rates for in-network mental-health providers.
It’s worth noting that Medicaid covers mental-health services, and the co-pay for those on the Healthy Michigan plan is $2 to $4 per therapy visit. Healthy Michigan also will cover transportation costs to and from appointments.
2. If you’re uninsured, see if you qualify for Healthy Michigan.
The Healthy Michigan program is available to adults age 19 to 64, and have an income under 138% of the federal poverty guidelines, or about $18,750 for a single person or $27,750 for a family of four.
Subsidies for Obamacare private insurance plans also are available, and people with an income below 250% of the poverty level — $34,000 for a single person and $69,375 for a family of four — benefit from caps on co-pays and deductibles.
If you need help applying for Healthy Michigan or private insurance, mental-health agencies such as Family & Children Services of Kalamazoo and Pine Rest Christian Mental Health Services have people who can guide you through the process.
3. Contact your community mental health agency.
CMHs are county-level government agencies that provide services to people with mental illness, substance abuse and/or development disabilities.
Traditionally, CMHs have focused on people with severe illness. But Michigan recently joined a federal initiative to expand that to people with mild and moderate behavoral disorders, with fees charged on a sliding scale based on income.
The new federal funding that allows some CMHs as well as select nonprofits to create Certified Community Behavoral Health Clinics that offer an broad array of services. The CMH organizations in Kalamazoo and St. Joseph counties are among the 14 counties participating in the pilot project.
The new services include 24-hour crisis intervention; screening and diagnosis; outpatient therapy and substance-abuse services; coordination with physical care; targeted case management; follow-up services after a psychiatric inpatient stay; family support services, and enhanced programs for veterans.
The target audience for the Certified Community Behavoral Health Clinics are Medicaid and uninsured patients. But people with private insurance also can use the new program, and it’s especially advantageous for those with high deductibles and co-pays who feel they can’t afford the out-of-pocket costs.
4. See if your workplace has an Employee Assistance Program.
Many workplaces — especially large employers — have an Employee Assistance Program that offers free and confidential assessments, short-term counseling, referrals and follow-up services to workers with personal and/or work-related problems. The issues addressed by an EAP typically include substance abuse, stress, grief, trauma, family problems and mental-health disorders.
To find out if your workplace has an EAP, contact your human resources department or look in your employee handbook.
5. If the issue involves your child, check with his/her school or college.
Many Michigan elementary, middle and high schools are using their share of federal pandemic dollars to fund mental-health services within the school building. The counselors are typically paid by the district, which then bills insurance if the child has it and subsidizes the rest of the cost.
Meanwhile, colleges and universities typically have a counseling center that offers free services to their students.
6. Consider a university-based clinic that trains counselors.
Western Michigan University has several such clinics that are open to the public.
WMU’s Centers for Counseling and Psychological Services operate clinics in Kalamazoo and Grand Rapids that provide low-cost counseling services for children, adolescents and adults.
The clinics are staffed by graduate students studying to be therapists and supervised by faculty members who are professional counselors or psychologists. To schedule an appointment at the Kalamazoo clinic, call (269) 387-5105; the number for the Grand Rapids clinic is (616) 771-4171.
WMU also has a Behavoral Health Clinic on Oakland Drive that is open to the public. The clinic is affiliated with WMU’s specialty program in substance abuse treatment, although it is open to anyone experiencing mental-health difficulties. The clinic is staffed by licensed counselors as well as students in training.
Counseling services are offered at no cost to WMU Blue Cross Blue Shield PPO participants and their dependents. For more information, call 269-387-8230.
Need a psychiatrist? Pine Rest operates the Loeks Residency Center in Grand Rapids to train psychiatry residents, and that clinic is open to the public. “Working closely with faculty, second-year psychiatry residents provide psychiatric assessments, treatment and medication management,” the website says. To schedule an appointment, call (866) 852-4001.
7. Counseling services may be available through your religious congregation.
Church counseling services can take many forms, from a minister who offers a listening ear, to congregants who volunteer as counselors, to an actual counseling center staffed by licensed professionals.
Relying on a church for counseling services depends on the seriousness of the issue and the capabilities of those doing the counseling. Talking to a clergy member or volunteer may suffice in some circumstances, but people experiencing serious issues with mental illness, substance abuse and/or trauma should make sure they are talking to skilled, trained professionals.
8. Victims of sexual assault and/or domestic violence can get free counseling at the YWCA.
YWCA Kalamazoo offers free individual counseling for victims of sexual assault, domestic violence, and human trafficking, and also has a number of free support groups for survivors of both domestic violence and sexual assault.
The support group meetings are held in English and Spanish and childcare is available. Call (269) 385-3587 for more information.
9. Support groups can provide a terrific support system.
Support groups usually involve minimal out-of-pocket costs and can be tremendously helpful for people struggling with a range of issues, from substance abuse to grief to dealing with LGBTQ-plus issues.
There’s a long list of support groups in Southwest Michigan, and Psychology Today offers a directory in which you can search by city or ZIP Code.
10. Group therapy can be a lower-cost alternative to individual therapy.
People seeking a lower-cost option to individual therapy may want to consider group therapy, in which a therapist works with a group, often five to 15 people, dealing with similar issues.
Like more informal support groups, group therapy can provide a sense of community and offer a support system. Participants also can learn new strategies and gain perspective on their own issues. The downside: Potential personality clashes, lack of confidentiality and you need to be able to share in front of a group.
11. Teletherapy apps.
There’s been an explosion of teletherapy services, such as TalkSpace or Cerebral, in which counseling services are provided over the phone, online and/or via text.
The services typically have a monthly or weekly subscription rate and they do not bill insurance, although they may provide paperwork so that patients can seek insurance reimbursement.
The advantage: Teletherapy services typically charge less than traditional counselors because there are no brick-and-mortar expenses and the billing operations are minimal. Also, many patients find teletherapy more convenient, less intimidating and it’s great option for people in rural areas and/or who seek a counselor with a specific expertise or background.
The cons: Insurance coverage for e-therapy can depend upon the state where you live and the insurance that you have. Also, some people prefer seeing a therapist in person.
12. Some counseling agencies will provide financial assistance with counseling fees.
In the same way that hospitals have a fund for patients who need financial assistance, Pine Rest puts aside $2 million a year to subsidize costs for clients who need help in paying for services.
Other private agencies also may be willing to offer discounted fees in specific situations; it doesn’t hurt to ask.
And realize for people who can only afford a few therapy sessions, that may be enough.
“The research is clear that if you can get to five visits, you will have a statistically significant improvement in your behavioral health,” said Robert Nykamp, chief operating officer for Pine Rest Christian Mental Health Services, a nonprofit based in Grand Rapids whose service network includes southwest Michigan.
Indeed, for those who could afford therapy but question the value, that concern is misplaced, experts say.
“If you had a chronic condition like diabetes, you would pay for what it takes to be healthy,” said Susan Davis, a therapist with Family & Children Services in Kalamazoo. “We need to be like that with mental health.”
For people who view cost as a barrier to obtaining mental-health services, “there are lots of options out there to support people,” she said. “Yes, there is likely going to be a cost. But let’s figure out how we’re going to pay for it and get you healthy from all angles.”
This story is part of the Mental Wellness Project, a solutions-oriented journalism initiative covering mental health issues in southwest Michigan, created by the Southwest Michigan Journalism Collaborative. SWMJC is a group of 12 regional organizations dedicated to strengthening local journalism. For more info visit swmichjournalism.com.
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