Using Maryland Medicaid for mental health care: what to know

If you have Maryland Medicaid, you may be surprised that your HealthChoice health plan isn’t the one that handles most mental health care. Here’s how it works and what it means for you.

Your health plan and your mental health care are managed separately

Maryland Medicaid covers primary behavioral health care, such as care for mild depression or anxiety from your primary care provider, through your HealthChoice managed care plan. Specialty behavioral health services, like therapy and psychiatric care from a behavioral health practice, are “carved out” and managed by Carelon Behavioral Health on behalf of Maryland Medicaid.

What that means for you

• You can come to us directly. No referral from your primary care provider is needed for therapy or medication management.
• Some services need approval first. When approval from Carelon is required, our office requests it. You don’t have to.
• Most behavioral health medications are covered through Maryland Medicaid’s fee-for-service pharmacy program rather than your health plan.
• Your HealthChoice card still matters. Bring it to intake so our office can confirm your coverage.

ABA therapy works the same way

ABA therapy for Medicaid members under 21 is also managed by Carelon, and it always requires approval before sessions begin. Read our guide to getting started with ABA.

Commercial insurance

If you have commercial insurance instead, participation varies by plan. Our office verifies your coverage and explains any costs before your first appointment.

Questions about your coverage?

Call (443) 824-4842, Monday through Friday, 9:00 a.m. to 5:00 p.m. See our insurance page for more.

This article is general information, not medical advice. For questions about your own care, talk with your clinician. In a crisis, call or text 988, or call 911 in an emergency.

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