Insurance and Mental Health Issues

by Jessica B. February 4th, 2015 | Mental Health
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painAlthough we would all like to believe that our health care is based on a series of decisions between ourselves and our doctors, the truth is that our health insurance company has a huge influence over what kind of treatment we receive and for how long. Many people are well aware of what kind of coverage they have when it comes to funding, but coverage for mental health issues can be extremely controversial and difficult to navigate. Here are some things to consider with an insurance plan.

1) Does your plan set a number of visits per illness? Many types of insurance set a time frame for treatment for common mental illnesses. Suffer from depression? That can get you 10-20 hours with a therapist. Suffer from OCD? That might mean 10 sessions. And if your practitioner feels you need more? This means they must submit information demonstrating why you need more to your insurance, which may mean revealing more information than you are comfortable with (obviously you need to discuss this with your practitioner first). Make sure you double check your policy for how they handle extension of treatments and how many sessions are allowed. If you or a family member has a history of mental illness, double check copays. Consider your ability to pay if your insurance company refuses treatment.

2) In-patient or outpatient – Different types of insurance cover in/out patient differently. Despite doctor recommendations, if your insurance prefers outpatient, that may all you will be able to get covered. If your practitioner is recommending something different, you can always speak with the center and try to get reduced rates and pay out of pocket.

3) Not in the best place – Like with many illnesses, you may not be in a place to negotiate or even talk to an insurance company if you are battling mental illness. If your doctor is saying you need in-patient hospitalization, chances are you are not in a place to fight with your insurance company about it. Make sure you have an advocate, a family member or a lawyer, who can help you push for the best service while you are getting the rest you need. If this is impossible, talk to your treating physician about the plan you should pursue.

Sadly, mental illness is not treated in a respectable way by most insurance companies, and that means that a lot of people end up not getting the treatment they need. They may also be saddled with debt because they had no choice.

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All health and medical information is provided for educational purposes and is not meant to replace the medical advice or treatment of your healthcare professional.