Disclaimer: This page is for informational purposes only and does not constitute medical advice. Please consult with a qualified healthcare professional for personalized guidance.
Insurance
Does Medicaid Cover Therapy in West Virginia?
Yes, Medicaid covers mental health therapy in WV. Here's what's covered, how to access services, and what to expect.
The short answer: Yes, Medicaid covers mental health therapy in West Virginia.
But there’s more to know about what’s covered, how to access services, and what to expect. This guide breaks it down.
What Medicaid covers in West Virginia
West Virginia Medicaid covers a wide range of mental health and substance use services:
Outpatient therapy:
- Individual counseling
- Group therapy
- Family therapy
Psychiatric services:
- Psychiatric evaluation
- Medication management
- Follow-up appointments
Crisis services:
- Crisis stabilization
- Mobile crisis teams
- 24-hour crisis lines
Substance use treatment:
- Medication-assisted treatment (MAT)
- Counseling
- Residential treatment
Children’s services:
- Individual therapy
- Family therapy
- School-based services
- Psychiatric evaluation
Other services:
- Case management
- Peer support
- Day programs
Do you need a referral?
For community mental health centers: No. You can call and schedule directly.
For private therapists: It depends. Some require a referral from your primary care doctor. Some don’t. Call and ask.
How to find a provider that takes Medicaid
Community mental health centers are your best bet. They’re required to accept Medicaid and serve anyone who needs help, regardless of insurance.
Southern Highlands is the community mental health center serving Mercer, McDowell, and Wyoming counties. They accept all Medicaid plans.
Private therapists are hit or miss. Many don’t take Medicaid because the reimbursement rates are low. But some do. You’ll need to call and ask.
To find providers:
- Call the mental health center directly
- Use the West Virginia Medicaid provider directory
- Ask your primary care doctor for recommendations
What if you don’t have Medicaid but think you might qualify?
West Virginia expanded Medicaid under the Affordable Care Act. More people qualify than you might think.
You might qualify if:
- Your income is below 138% of the federal poverty level (about $20,783/year for an individual, $35,632/year for a family of three in 2026)
- You’re pregnant
- You have a disability
- You’re a parent or caretaker
How to apply:
- Online at wvinroads.org
- By phone: 1-877-716-1212
- In person at your local DHHR office
The application process can take a few weeks. If you need help right away, call a community mental health center. They can see you while your application is pending and work out payment later.
What if you have Medicaid but it’s not WV Medicaid?
If you have Medicaid from another state and you’ve moved to West Virginia, you’ll need to apply for WV Medicaid. Your out-of-state Medicaid won’t work here.
Are there any costs with Medicaid?
For mental health services, there are usually no copays if you’re seeing a community mental health center.
Some private providers might charge a small copay ($1-5), but it’s rare for mental health services.
Medications might have small copays ($1-3 per prescription), depending on your Medicaid plan.
What if you don’t have insurance at all?
No insurance doesn’t mean no options.
Community mental health centers offer a sliding fee scale based on what you can afford. You’ll need to show proof of income, but no one is turned away because they can’t pay.
Free resources:
- Crisis lines (free)
- Support groups (often free)
- Some community programs
What if you have private insurance instead of Medicaid?
Most community mental health centers accept all insurances, including private plans. They also accept Medicare.
If you have private insurance, call and verify they take your plan. Bring your insurance card to your first appointment.
How many therapy sessions does Medicaid cover?
There’s no set limit. Medicaid covers as many sessions as are medically necessary.
If you need weekly therapy for six months, Medicaid will cover it. If you need therapy for a year, Medicaid will cover that too.
The therapist will work with you to determine how often you need to be seen.
What if you need medication?
Medicaid covers psychiatric medications. You’ll need to see a psychiatrist or psychiatric nurse practitioner to get a prescription.
Most psychiatric medications have small copays ($1-3). Some are free.
If a medication isn’t covered, your doctor can request a prior authorization or switch you to a similar medication that is covered.
What about substance use treatment?
Medicaid covers substance use treatment, including:
- Medication-assisted treatment (Suboxone, Vivitrol)
- Outpatient counseling
- Residential treatment
- Detox services
MAT programs are covered. You won’t pay out of pocket for Suboxone or Vivitrol if you have Medicaid.
What if you’re on a waiting list?
In rural West Virginia, waitlists are common. If you call and they can’t get you in right away:
- Ask to be put on a cancellation list
- Ask if they have telehealth appointments available sooner
- If you’re in crisis, ask about walk-in crisis services
Crisis services don’t have waitlists. If you’re in immediate need, you can walk in or call the crisis line.
Frequently Asked Questions
Does Medicaid cover telehealth therapy?
Yes. Medicaid covers telehealth for mental health services in West Virginia.
Can I see a therapist without my parents knowing if I’m on their Medicaid?
If you’re 14 or older in West Virginia, you can consent to your own mental health treatment. The therapist won’t share information with your parents unless you’re in danger.
What if I lose my Medicaid coverage?
If you lose Medicaid, talk to your therapist or the clinic. They can help you figure out other options, like sliding scale fees or reapplying for Medicaid.
Does Medicaid cover therapy for children?
Yes. Medicaid covers mental health services for children, including therapy, psychiatric evaluation, and medication management.
Can I choose my own therapist?
You can choose any therapist who accepts Medicaid. At a community mental health center, you’ll be assigned a therapist, but you can request a different one if it’s not a good fit.
If you have Medicaid and need mental health services in Southern West Virginia, you can call Southern Highlands to schedule an appointment. They accept all Medicaid plans and serve Mercer, McDowell, and Wyoming counties. No referral needed.