Medicaid and Medicare Therapist in Wisconsin

Mental health services is an important piece of our wellbeing, therefore I strive to take insurance from a variety of networks so I can service everyone with different incomes. As the clinic grows, I plan to add more networks.

  • Intake Session (90 mins): $175

    Regular 55 mins session: $130

  • Medicaid (T-19),

    Chorus Community Health both Medicaid HMO and Marketplace, Medicare Part B

    United: Medicare, Medica, Medicaid, and commercial United.

    Please read below for more details about insurance.

    Pending insurance: Anthem Blue Cross Blue Shields, Tricare West.

  • I provide supervision for APSW in the state of Wisconsin. The rate is $130 per 1:1 supervision hour or $50 per group (minimum 3 per group).

  • (Updated 3/27/25)

    I am nearing capacity for case load. My only available slot is meeting once every other week on Saturday morning before 10am.

  • Insurance is very confusing. Please scroll below for more information that may be able to clarify some things for you.

Insurance can be very complicated. Below is a condensed understanding of how insurance works, so you can easily understand whether Narrative Therapy MKE can take your insurance, and if not, what you can do about it (if you so choose). I will also attempt to clarify some insurance words that come up a lot. Disclaimer that I am not an expert, just a social worker who have worked in the community for a long time, but I do hope that this will support you to make an informed decision about insurance.

All About Insurance

Insurance Lingo

Word

Copay: A fixed amount you pay for a coverage health care service after you’ve paid your deductible.

Deductibles: The amount you pay for covered health care services before your plan will start to pay.

Out of Pocket Max/Limit: The most you will pay for covered services in a plan year, which includes: deductibles, copays, and co-insurance for in network care and services. After reaching the max out of pocket cost, your plan will pay $100% of the costs of covered benefits.

Medically necessary: Health care services or supplies needed to diagnose or treat an illness, condition, disease or its symptoms and that meet accepted standards of medicine.

How this works in therapy:

If your deductible is $2000 for a single adult, then you will be responsible for paying the allowable fee for therapy ($130) until you’ve met that deductible (which can include other medical services), then your insurance will start to pay a percentage of the therapy fee.

For example, your copay is $20, your plan’s allowable cost per therapy session: $130

If you’ve met your deductible: You pay $20 at time of your therapy session.

If you haven’t met your deductible: You pay $130 at time of your therapy session.

Once you hit your out of pocket cost (example $5000) for the year which can include what you paid for other covered services including your therapy session, your plan will pay 100% of the rest of the covered therapy cost for the rest of the plan year.

In order to bill for therapy and use your insurance, I will need to make a DSM diagnosis. This diagnosis can change as I get to know you better. I also value maintaining space to have a discussion about what impact the diagnosis can have on you presently and in the future.

Source: Healthcare.gov

Specific Insurance Info

Please click on the logos below to be sent to the provider directory. Please note that due to specific thresholds for when an agency is eligible to be on the directory, Narrative Therapy MKE is NOT in the directories for ForwardHealth and Medicare at this time.

Medicare Part B, or Original Medicare, covers such services as: ambulance services, clinical research, durable medical equipment, and mental health services.

If you have Medicare Part B, or Original Medicare then Narrative Therapy MKE can take your insurance.

If you enrolled in a Medicare Advantage Plan (ie through a commercial plan Aetna, United), also known as Medicare Part C, it then REPLACES your Medicare Part B services. If you have an advantage plan, Narrative Therapy MKE, canNOT take your insurance because we are not yet paneled with any advantage plans.

What if I can’t find a therapist through Medicare or through my Medicare Advantage?

You are able to switch your Medicare Advantage to a different plan OR switch it back to Original Medicare and vice versa during open enrollment, which usually takes place in the fall.

Forward Health, also known as Badgercare, or Medicaid in the state of Wisconsin. It is for those who are low or limited income and meet eligibility for it.

Upon signing up for Forward Health you will be asked to choose a contracted HMO company (ie CCHP, United, Dean, Network Health etc). For some individuals, they can have instead “straight Medicaid” where the funder is directly through the state. If you have straight Medicaid, you can see any provider that is Medicaid approved including Narrative Therapy MKE.

But if you have a Medicaid HMO, you need to find in-network providers through that company. Narrative Therapy MKE is paneled with CCHP (see below) for Medicaid at this time.

What if I can’t find a therapist through my HMO?

If you are having difficulty finding a therapist through your HMO, you can choose a different HMO once a year - usually around your renewal. Please be aware that changing your HMO may affect other medical services such as your primary doctor no longer being in network.

Chorus Community Health Plan (CCHP) is both a Medicaid HMO AND a marketplace plan.

If you have either one of these plans, Narrative Therapy MKE can take your insurance.

What if I can’t find a therapist through CCHP?

You are able to change your HMO or marketplace plan once a year during annual review (for Medicaid) or open enrollment (for marketplace). Open enrollment usually happens in the fall. Again, please be mindful of how this will affect your other services.