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Insurance And Other Ways to Pay for Help

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There are different ways to cover the costs of therapy and other behavioral health services. Here’s an overview of options, including health insurance and direct payment methods.

 

Health Insurance

Many employer-provided health insurance plans cover mental health services, including therapy for children and teens. The details, like copayments, deductibles, and whether a provider is in-network or out-of-network, depend on the specific plan.

Plans bought through the Health Insurance Marketplace (HealthSourceRI.com) include mental health coverage. It’s important to review each plan carefully to understand what behavioral health services are covered.

Medicaid is available to families based on income and family size. There are no citizenship requirements for children or pregnant people*. You can find income eligibility guidelines here. Starting January 1, 2024, all children in Rhode Island who qualify for Medicaid received 12 months of continuous coverage, regardless of any changes in their situation.

  • Katie Beckett Pathway:This program helps children with long-term disabilities or complex medical needs qualify for Medicaid even if their family’s income is above the usual limits. The child’s income and resources are the only things considered when determining eligibility. This allows children to be cared for at home instead of in an institution.
  • RIte Care and RIte Share Programs: Children and families eligible for Medicaid in Rhode Island will receive coverage through one of these programs:
    • RIte Care: Rhode Island’s Medicaid managed care program for families with children, pregnant women, and children under age 19. Families can choose from three health plans: Neighborhood Health Plan of Rhode Island, Tufts Health Public Plans, and UnitedHealthcare Community Plan.
    • RIte Share: This program helps pay for an employer’s health insurance plan. The state covers all or part of the cost of the employee's health insurance, and Medicaid covers any services not included in the employer’s plan.

How to Apply for Medicaid

Families with children can apply for health coverage in different ways:

  • Online: Visit HealthyRhode.ri.gov to apply for Medicaid and other state benefits using the customer portal. For help using the portal, go here.
  • By Phone: Call the RI Department of Human Services (DHS) Call Center at 1 (855) 697-4347.
  • In-Person: Submit an application in person by putting a paper application in any secure drop boxes located at all DHS regional offices. In addition to the availability of in-person services at regional offices, you may seek application assistance and support through outreach vendors.
  • By Mail: You can print out a DHS-2 Application, fill it out, and mail it in.

For more information, you can contact the RI Department of Human Services (DHS) Call Center: 1 (855) 697-4347.


Direct Payment Options

  1. Self-Pay and Out-of-Pocket Payment Paying for therapy directly can give you more choices when selecting therapists or services that might not be covered by insurance or are out of network.
    • Cost: The cost of therapy varies depending on the type of therapy, the therapist’s qualifications, and how often you have sessions. Typical fees can range from $100 to $250 per session or more.
  2. Sliding Scale Fees Many therapists offer sliding scale fees, which means they adjust the cost based on your income. This makes therapy more affordable for families who might struggle to pay full price. It’s a good idea to ask your therapist if they offer this option.
  3. Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) HSAs and FSAs allow you to use pre-tax money to pay for medical expenses, including therapy. This can help lower the overall cost of care. Check with your employer to see if these accounts are available through your payroll.

 

Community Resources and Assistance Programs

  • Low-Cost or Free Services: Some non-profits offer free or low-cost mental health services for children and teens. Local community health centers, family service organizations, and mental health-focused non-profits may provide individual therapy, group therapy, or support groups.
  • Support at School: Many schools have counselors, psychologists, or social workers who can offer mental health support to students. These services are usually free for families.
  • DCYF Support and Response Unit (SRU): The Department of Children, Youth & Families (DCYF) offers various services to support children with behavioral health needs and their families. You can reach the Support and Response Unit by dialing 1-888-RI-FAMLY or 1-888-743-2659. Learn more about support services.

Steps to Determine Coverage and Costs

  1. Contact Your Insurance Provider
    • Verification: Call your insurance company to check if they cover mental health services, including specific therapies and providers.
    • Details: Ask about copayments, deductibles, if prior authorization is needed, and which providers are in-network.
  2. Consult with Providers
    • Billing Information: Talk to therapists or mental health professionals directly to understand their billing practices and whether they accept your insurance.
    • Payment Plans: If you're paying out of pocket, ask about payment plans or sliding scale fees to make therapy more affordable.