What am I eligible for?
Your eligibility for programs and services may vary based on a number of factors including your age, your health insurance coverage, prior authorization requirements for therapy and psychiatric visits, and your ability to pay. Connecticut has a variety of resources for teens and young adults to access mental healthcare including Access Health CT for finding which health insurance plans you qualify for, the DSS Husky Hotline (1-855-805-4325) for Husky Health recipients, the Mental Health Waiver program for folks looking for person-centered planning and individualized recovery plans, and Local Mental Health Authorities that offer a variety of mental health and community support services.
If I’m under 18?
In CT, if you are under 18 you can receive services through Child Guidance. They can assess you, provide individual, group, or family therapy, and can help coordinate all the services you or your family may need.
Child Guidance will accept people with private insurance or public insurance such as Medicaid. If you don’t have insurance, they charge using a sliding-fee scale based on your family’s income. You may be able to pay around $30/visit, which is equivalent to some people’s co-pay.
If I have private insurance?
If you have private insurance, take a look at the policy (or ask the company to send it to you) and find out what mental health benefits are covered, what the co-pay is, whether you need a doctor’s referral, and whether you need the insurance company to “pre-authorize” services. Then take a look at the insurance company’s online list of mental health providers that they work with. Look for someone local who is “in-network”—it’s usually cheaper than out of network.
“The insurance companies will work with you if you work with them. The issue is they’re not always as generous as you’d like them to be.”
“When I’ve had to search for providers, I’ll find all the providers that are along bus routes or that are walking distance from where I live or from where I work. Then I’ll go through the information and highlight different specialties they have that are relevant to me, and I’ll pick 3-6 that I am absolutely sure that I want to try and I’ll try them. If those don’t work out, I’ll move to the next.”
If I qualify for public assistance?
If you or your family have a low income, you may qualify for coverage under Medicaid. In CT, there are several Medicaid programs known as HUSKY.
HUSKY D is Medicaid for low-income adults.
HUSKY A covers children and their caregivers, as well as pregnant women.
HUSKY B (aka the Children’s Health Insurance Program) covers uninsured children up to age 19 in somewhat higher income families, sometimes with cost-sharing depending on the income level.
HUSKY C is for people with disabilities, including mental illness.
Note: There are other entitlement programs, for people, if you have a developmental disability. A social worker can help you figure out what you qualify for. If you’re not sure, apply anyway! If you don’t qualify for them, then you don’t qualify for them, but you won’t know until you apply.
In Connecticut, people who qualify for public assistance can receive outpatient and inpatient services, case management, and wraparound care, including young adult services focused on people ages 18-25, from the Department of Mental Health and Addiction Services (DMHAS).
“When I applied for HUSKY-D, it took me five months to get approved, and I had to make a lot of phone calls to make sure my case was moving along and not getting lost in the piles of paperwork. But now, I don’t have any copays because I have Medicaid for low income adults.”
If I’m undocumented?
If you are undocumented, you can still get mental health services and pay “out of pocket” (cash). Look for agencies that charge based on a “sliding fee scale,” which means they will charge you more or less based on your income. You may be able to pay around $30/visit, which is equivalent to some people’s co-pay.
In Connecticut, people who are undocumented can receive outpatient and inpatient services, case management, and wraparound care, including young adult services focused on people ages 18-25, from the Department of Mental Health and Addiction Services (DMHAS).
If I’m going to pay cash?
Many therapists do not participate with any insurance companies, because it’s easier for them to charge you directly and let you deal with getting reimbursed. Expect to pay around $100-150/visit. Your insurance may later reimburse you up to 80% of the cost.
Always get a printout from the therapist showing the date of service, service received, with all info and codes filled out, indicating that you paid. You can submit that document to your insurance company for reimbursement. Make sure you keep a copy in case they lose it!
Private vs. public insurance?
Ironically, if you qualify for public assistance, you are probably eligible for a lot more mental health services than if you have private insurance. The state Department of Mental Health and Addiction Services (DMHAS, pronounced “deemuss”) offers “wraparound” services such as young adult programs, case management, peer support, supported housing, supported education, and supported employment for people with a mental illness.
If you have private insurance through your family, a social worker might advise you to get off their insurance especially before you turn 18, so you can qualify for the public programs.
During 2014, the state Department of Children and Families is working on designing an integrated behavioral health plan for ages 0-18 that is supposed to provide the same level of care no matter what kind of insurance you have.