Payment for Services
If you are enrolled in Medicaid and meet the criteria for the specialty mental health and substance abuse services, the total cost of your authorized mental health or substance abuse treatment will be covered. If you are a Medicaid beneficiary with a deductible ("spend-down"), as determined by the Michigan Department of Health and Human Services (MDHHS), you may be responsible for the cost of a portion of your services.
- A charge shall be made to persons for services received.
- Rates charged for services will reflect the actual planned and expected cost of the particular service based on the estimated volume of service units and planned operating expenses for the services including distributed appropriate overhead costs for administration.
- The rate charged shall be determined at least annually.
- Charges to persons for services shall be based on their ability to pay as determined in accordance with Department of Community Health policies and schedules and Substance Abuse Coordinating Agency policies and schedules.
- No resident of the Board's catchment area shall be denied services because of ability or inability to pay the full cost of services; a sliding fee determination is available.
- Ability to pay determinations shall be made on the basis of Monthly Liability as defined in Department of Community Health policies and schedules.
- Out of catchment area residents shall be accepted for non-crisis service only upon referral by their local community mental health program. An agreement that results in collection of the full cost of services shall be negotiated with the referring community health program.
Other Insurance Plans
Make sure you inform your local Community Mental Health of all the insurances that you are covered by as well as any changes to your insurance. The law states that if you are covered by another insurance plan they will be billed before any state funds are (including Medicaid), to cover the services provided to you. It is important that this information is current at all times.
- The Agency will identify and seek recovery of revenues from all liable third parties in order to use county, general fund and Medicaid revenues as the last resort.
- The Agency will develop the necessary certifications and accreditations and meet appropriate standards in order to qualify for various third party payments when it can be demonstrated that the amount of revenue to be realized justifies the cost of qualification.
- The Agency will continually explore opportunities for funding through grants from public and private sources when such grants support provision of services within the mission and fiscal capabilities of the Agency