Medicaid Therapist in Fort Myers & Cape Coral, FL

Living Well Counseling accepts Florida Medicaid on a case-by-case basis, and clients with active Medicaid coverage pay $0 per session. We see Medicaid clients in person at our Fort Myers office and our Cape Coral office, and by secure telehealth anywhere in Florida. Our Medicaid capacity is limited, so we cannot promise a spot before we talk, but we will tell you on the first call whether we can take you on. We are not currently in network with Sunshine Health. Call (239) 940-7025 with your plan card in hand and we will check your coverage before anything is booked.

Coverage

Florida Medicaid, accepted case by case. Not in network with Sunshine Health; credentialing in progress.

Your cost

$0 per session while your Medicaid coverage is active

Format

In person in Fort Myers and Cape Coral, and by telehealth throughout Florida

Referral

Not required by us. If your plan requires one, we tell you when we verify your benefits.

Without Medicaid

$175 per 50-minute session. No sliding scale. The Living Well Mission funds therapy scholarships for those who qualify.

First step

Call or send a message with the plan name and member ID on your card. We respond within one business day.

What Medicaid Covers for Mental Health in Florida

Florida Medicaid covers outpatient mental health care, including individual therapy, family therapy and psychiatric care, when it is medically necessary. "Medically necessary" is the plan's term for care that treats a diagnosed condition and follows a treatment plan. That is what therapy already is, so it is not a hurdle for most people. Your therapist documents it as part of normal care.

Most people with Florida Medicaid are enrolled in a managed-care plan through the Statewide Medicaid Managed Care program, which is overseen by the Agency for Health Care Administration. The plan, not the state, pays the claim, keeps the provider list and decides whether a referral is needed. Sunshine Health is one of those plans. Children are often covered through Florida KidCare, which includes Medicaid for children. Whichever plan you have, the name on your card is the name we need when you call.

Medicaid eligibility is not permanent. The Department of Children and Families reviews it on a schedule, and coverage can end if a renewal is missed. Coverage has to be active on the day of each session for the plan to pay. That is why we verify before your first appointment and again if anything changes.

Why We Say "Case by Case"

Medicaid works differently from commercial insurance, and the number of Medicaid clients we can see at one time is limited. When you call, we check three things: whether your specific plan is one we can bill, whether a clinician who can see you has an opening, and whether your coverage is active. If all three are yes, we book you. If any of them is no, we say so on the same call and tell you what else might work, rather than putting you on a list and leaving you to wait.

We would rather be straightforward about this than promise something we cannot deliver.

Sunshine Health: Where Things Stand

We are not currently in network with Sunshine Health, and credentialing is in progress. That means we cannot yet bill Sunshine Health for your sessions. If you are a Sunshine Health member, call anyway. We will tell you where things stand, and if we still cannot bill your plan we will talk through your options, including telehealth and private pay. This page will be updated when that changes.

How to Check That Your Coverage Is Active

• Look at your plan card. It should show the name of your managed-care plan and your member ID. Many people also have the gold Florida Medicaid card. Bring both if you have them.
• Call member services at the number on the back of the card, or sign in to your plan's member portal, and confirm that your coverage is active and that behavioral health is included.
• Check your renewal date in your Florida benefits account with the Department of Children and Families, and open any mail about renewal promptly.
• Tell us if you changed plans. We verify against the plan you are enrolled in today, not the one on an old card.

We do this check for you before the first session. Having the card handy when you call makes it faster.

What a Session Costs With Medicaid

Nothing. Clients with active Florida Medicaid coverage pay $0 per session at Living Well Counseling, in the office or by telehealth. There is no copay and no deductible to meet.

If your coverage lapses, sessions can no longer be billed to Medicaid. We would talk with you before that affected anything. Nobody is surprised by a bill.

Who You Will See

Every clinician at Living Well lists Medicaid among the plans they accept, including our registered interns, who work under direct licensed supervision. Because Medicaid capacity is limited, we match Medicaid clients with the clinician who can take your plan, has an opening and has the right training for what you are working on. If you have a preference, say so and we will do our best. You can browse the full team before you call.

Psychiatric medication management, by telehealth for adults 18 and older, is available on the same case-by-case basis.

What to Bring to the First Appointment

• Your managed-care plan card, and your Florida Medicaid card if you have one.
• A photo ID.
• A referral or authorization, if your plan required one. We will have told you when we verified your benefits.
• A list of any medications you take now, with doses.
• If the appointment is for a child, the parent or legal guardian who completes the paperwork.
• The questions you want answered. Writing them down beforehand means nothing gets lost once the conversation starts.

Intake paperwork is sent in advance, so the first session is not spent on forms.

If You Are Not Eligible, or Coverage Ends

Without insurance, a 50-minute session is $175. We do not offer a sliding scale for therapy. If cost is a barrier, our nonprofit partner, The Living Well Mission, funds therapy scholarships for people who qualify. Ask about it when you call.

If you lost Medicaid and now have a Marketplace or employer plan, we are in network with Aetna, Florida Blue and BCBS, Cigna, UnitedHealthcare and Optum, TRICARE, Medicare, Lee Health, VA Community Care and CHAMPVA. If you have both Medicare and Medicaid, tell us about both when you call, so we bill them in the right order.

Getting Started

1. Call (239) 940-7025 or send us a message. Say you have Florida Medicaid and name the plan on your card.
2. We check your plan, our capacity and that your coverage is active, and we give you the answer on that call or within one business day.
3. You are matched with a clinician and scheduled, in the office or by telehealth. Intake paperwork arrives before the appointment.

Frequently Asked Questions

Further Reading

• Agency for Health Care Administration: Florida Medicaid (AHCA)
• Statewide Medicaid Managed Care: plans and enrollment (AHCA)
• Sunshine Health: member resources (Sunshine Health)
• Substance Abuse and Mental Health Services Administration: Mental Health (SAMHSA)

Available at our Fort Myers office, our Cape Coral office, and by telehealth throughout Florida.