How Are Services Paid For

How Are Services Paid For?

Updated 11/3/09

Michigan law requires people who receive mental health services to pay for those services if they can. Following are some questions you might have about how we determine what you must pay.

Do I have to pay for public mental health services?

Yes, if you, your minor child, or your husband or wife receive services. You may not have to pay if you have Medicaid.

How much will I have to pay?

It may depend on your income—as much as you can afford and still meet needed living expenses.

We first consider any insurance benefits you may have. Some insurances may pay the whole cost of service. Medicaid pays the whole cost for many mental health services.

You will never have to pay more than the cost of the services.

How is the amount determined?

There are three ways to determine the amount you must pay:

By using an income chart, based on how much you pay on your state taxable income for the following services:

Adult psychiatric hospital and crisis residential services of less than 61 days

All adult outpatient services

Any services provided to your minor child

For all other services, your total financial circumstance is considered by

Adding together all money you receive

Adding together the value of some of your assets, such as property you own and money you have in the bank

And then subtracting all necessary expenses such as personal debts, food, clothing, shelter, medical expenses, taxes, insurance, transportation, child support, and education.

If you have Medicaid, it is likely you will not have to pay anything.

Is there a limit to what I must pay for my husband or wife or child?

Under certain conditions you are required to pay for 730 days of hospital or residential services after which only your husband or wife can be charged.

You will not have to pay for more than a combined total of 18 years for 2 or more of your minor children.

What you must do…

Provide us with all information we need to figure out how much you can afford to pay

Provide us with information about any health insurance that may cover services. Please bring your insurance card(s) with you

Pay the amount we determine you can afford, up to:

Your co-insurance and/or deductible

The cost of the services

Or your ability to pay, whichever is lowest

How are you protected?

You can ask our office for a new determination if your finances change and you feel that you cannot make payments.

The law requires that we automatically set a new amount you must pay each year, if you or family members still receive services.

You can also ask for a review of your determination if you do not agree with the amount you are asked to pay

You can discuss your situation with our reimbursement specialist if you are having problems with your payments.

What if I still feel that I can't pay the amount you say I must pay?

After finding out how much we determine you can pay, you can ask for an administrative hearing. This request for a hearing must be a written request and must be sent to our office within 30 days of the original fee determination.

If you still believe this amount is more than you can pay, you can take your case to the Newaygo County Probate Court.

Is the information I provide confidential?

Yes, all information will be held in strict confidence.

You may be asked to sign a form that will allow us to give medical information to your insurance company.

What if I still have questions about making payments or how my ability to pay was figured?

You can contact our reimbursement specialist at 231-689-7330 or 1-800-968-7330

Your rights

If you are denied a service, or if you are told that you are not eligible for a service, you have the right to a second opinion. If you wish to receive a second opinion, you must put your request in writing to

Executive Director

Newaygo County Mental Health

1049 Newell, PO Box 867

White Cloud MI 49349

If you need help in writing this request, please call our office of recipient rights, 231-689-7330, or toll-free, 1-800-968-7330 and ask for the recipient rights officer.

Other rights

When you are scheduled for your first appointment, you will receive a booklet, Your Rights. This booklet spells out any rights you have as our customer. These include

To have information about you kept private

To have person-centered treatment planning

To agree with the services you are receiving

To choose or change your counselor

To complain about any problem with our services by calling our recipient rights officer at 231-689-7330. If this call is long-distance for you, you may call 1-800-968-7330.

A fee schedule is available upon request.

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