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Does Insurance Cover Psychiatry in Texas? What Most Plans Require

  • Writer: Moe | Scarlet Plus
    Moe | Scarlet Plus
  • 4 days ago
  • 4 min read

Finding the right psychiatrist is hard enough. Worrying about how to pay for it just adds to the stress. We see this anxiety every day at our clinic. You finally decide to get help, but then you freeze. Will this cost a fortune? Does my plan even count mental health as "real" health?


The short answer is usually yes. Most major insurance plans in Texas cover psychiatry. However, the details like deductibles, copays, and referrals can feel like a maze. This guide will walk you through exactly what to expect so you can focus on feeling better, not fighting with billing departments.


Logos of health insurance companies: Optum, Aetna, United Healthcare, BlueCross BlueShield, Oscar, Oxford, Medicare, Medicaid, and Cigna on a teal gradient.
Major insurance providers like Optum, Aetna, United Healthcare, BlueCross BlueShield, Oscar, Oxford, Medicare, Medicaid, and Cigna are shown, often offering coverage for psychiatry in Texas.

The Short Answer: Yes, But It Depends on "Parity"

Decades ago, insurance companies could legally treat mental health differently than physical health. They could charge you double for a therapy visit or set strict limits on how many times you could see a doctor. That changed with federal and state laws.


The Mental Health Parity and Addiction Equity Act (MHPAEA) is a federal law that changed the game. It says that large group health plans cannot put more restrictions on mental health benefits than they do on medical or surgical benefits. Texas took this a step further with House Bill 10, which aligns state law with these federal protections.


In plain English? If your plan has a $30 copay for a cardiologist, they generally cannot charge you $100 for a psychiatrist. If they don't require prior authorization for a routine check-up, they shouldn't require it for a routine mental health evaluation.


Accepted Insurance Plans at Adelson Behavioral & Mental Health

We believe high-quality psychiatric care should be accessible. That is why we accept a wide range of insurance plans. If you live in Arlington, Dallas, Fort Worth, or Mansfield, or anywhere in Texas for telehealth, we likely work with your provider.


We currently accept:

  • Optum

  • Aetna

  • UnitedHealthcare

  • BlueCross BlueShield

  • Oscar

  • Oxford

  • Cigna

  • Medicare

  • Medicaid


A Note on Medicare and Medicaid:

Many private practices do not accept these government plans, but we do. Texas Medicaid (including STAR and CHIP) covers a wide range of mental health services, including therapy and medication management. Medicare also covers outpatient psychiatry, often with the same 20% coinsurance you pay for other doctors.


Common Requirements You Might Face

Even though "coverage" exists, it does not always mean "free." Here are three terms you need to understand before your first appointment.


1. Deductibles

This is the amount you pay out-of-pocket before your insurance kicks in. If you have a high-deductible plan, you might have to pay the full cost of your first few visits until you hit that limit.


2. Referrals (HMO vs. PPO)

  • PPO Plans: You can usually book an appointment with us directly. No permission slip needed.

  • HMO Plans: These often require a referral from your primary care doctor (PCP) first. If you skip this step, the insurance company might refuse to pay the bill.


3. Prior Authorization

Some insurance plans want to "approve" the treatment before you get it. This is less common for a basic evaluation but more common for specific medications or intensive treatments. We handle the paperwork for this on our end, but it can sometimes cause a slight delay.


Telehealth vs. In-Person Coverage

Since 2020, the rules for Telehealth have improved drastically. In Texas, state-regulated plans are generally required to cover telehealth visits the same way they cover in-person visits.

  • In-Person: We see patients at our clinics in Arlington, Dallas, Fort Worth, and Mansfield.

  • Telehealth: We can see patients from anywhere in Texas via secure video calls.


Whether you are sitting in our office or your living room, your insurance benefits usually remain the same. This is huge for patients in rural areas or those with busy work schedules who can't drive across the Metroplex.

How to Check Your Specific Coverage

Do not guess. The only way to be 100% sure is to ask. Call the number on the back of your insurance card. When you get a representative on the line, ask these four specific questions:

  1. "Do I have mental health benefits for outpatient psychiatry?"

  2. "Is Adelson Behavioral & Mental Health in-network for my plan?"

  3. "Do I have a deductible I need to meet first?"

  4. "Do I need a referral from my primary care doctor?"

What if You Don't Have Insurance?

If you are uninsured or if we are out-of-network for your specific plan, you still have options. We offer self-pay rates for evaluations and follow-ups. While we know paying out-of-pocket is not ideal, it ensures you get the care you need without waiting for insurance approvals.

We Are Here to Help

Navigating insurance is frustrating. We get it. But do not let the paperwork stop you from getting support. At Adelson Behavioral & Mental Health, our administrative team is experienced in working with Optum, BCBS, Medicaid, and others. We do our best to verify your benefits so you aren't hit with surprise bills.


If you are ready to start, we are ready to listen.

Contact us today to schedule your evaluation in the DFW area or via Telehealth.

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