Psycho-Babble Psychology Thread 770126

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Health coverage for treatment--YOU CAN HELP!

Posted by gardenergirl on July 17, 2007, at 13:47:51

My health insurance has limitations on coverage for mental health treatment, specifically, a cap on visits and lower reimbursement levels. However, physical diseases and disorders are covered without these limitations. So I get 20 visits per year, and these are split up between any MH provider I see, in my case, a T, a pdoc, and a marriage counselor. If I didn't have access to a T and a pdoc through school, I'd either get significantly fewer sessions over the year, or I'd have to pay a heck of a lot of money for sessions that were covered, but then weren't covered because I'd reached my limit. However, there aren't any caps on number of visits to my doctor, and if I see a GP, an OB/GYN, a dermatologist, etc. none of those visits "count against" visits with the others. How is this fair?

This is legal in my state and in many states which do not have full mental health parity laws. It sure feels like discrimination against those with mental disorders, to me. Against me, even.

So I've written to my senators to urge them to support S. 558, the Mental Health Parity Act of 2007. This issue has been introduced in Congress each year, but has never passed. Passing this bill would close the loopholes that allow insurance companies to set arbitrary limits on mental health coverage (number of visits, total cap per year, reduced reimbursement, higher copays, etc.) so that coverage for mental and physical disorders are comparable.

If you are a US citizen and you are interested in letting your Senators know your views about this, you can go to http://capwiz.com/nami/issues/alert/?alertid=9939486
to get more information and to send an email straight to your legislators. The NAMI site has a pre-written email for you to send. You can edit it as you like. You can also go to http://www.senate.gov/general/contact_information/senators_cfm.cfm
to email your Senator via their own webforms, though you'll have to write the letter yourself.

I'm passionate about this issue, and I fully support it. I realize that others may not for various reasons, and I respect that. I think it can be empowering to voice your opinions to Congress, and I encourage you to do so regardless of which way you lean on this issue.

Thanks,

gg

 

Re: Health coverage for treatment--YOU CAN HELP!

Posted by LadyBug on July 17, 2007, at 15:10:43

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

I'd love to see this be changed! I have 25 visits a year not even half of what I need and when things are difficult like they are now, I need to go more than once a week. I will follow the link and do what I can. I agree with what you said about having a cap on the number of visits you can have per year. Why is this? It's not fair to someone like me that suffers from depression that is on going and always will be.

I would love to see some changes but without people doing what the can to change this, it probably won't ever change.
Under my not yet ex-husband's insurance I can go to unlimited visits once the 300 dollar deductable is met. I have a co payment of 20 bucks, I don't think that is too bad.
LadyBug

 

I did my part. Thanks for the link. (nm) » gardenergirl

Posted by annierose on July 17, 2007, at 16:31:44

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

 

Re: Health coverage for treatment--YOU CAN HELP!

Posted by tofuemmy on July 17, 2007, at 17:40:14

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

And in lots of states where they HAVE passed parity laws - they only cover certain illnesses. Most qualify it by specifying "biologically based" illnesss. So, this would include depression, for instance, but exclude PSTD. That REALLY ticks me off. So, make sure you know what your primary diagnosis is, and make sure it's on the list!

em

 

Re: Health coverage for treatment--YOU CAN HELP!

Posted by TherapyGirl on July 17, 2007, at 18:22:34

In reply to Re: Health coverage for treatment--YOU CAN HELP!, posted by tofuemmy on July 17, 2007, at 17:40:14

My state just passed a parity bill. And they did limit it to 9 specific conditions, but PTSD was one of them. We have a lot of military here and I wonder if that's why PTSD made the list.

The really interesting thing is that states that have passed the parity bills have not seen the rise in insurance costs that was predicted. Imagine that -- treating mental illness is actually cheaper than not treating it. Who knew?

 

Re: Health coverage for treatment--YOU CAN HELP!

Posted by Abby Cunningham on July 17, 2007, at 22:37:09

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

Thanks gardenergirl. My state has no parity law yet, but I am fortunate enough to have parity with my HMO provider. Blue Cross/Blue Shield lets me have as many therapy visits as I need; but skimps on medication allowances. Fortunately my doctor has always been able to override their decisions.

 

Re: Health coverage for treatment--YOU CAN HELP! » gardenergirl

Posted by OzLand on July 17, 2007, at 22:54:21

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

It isn't fair, and this is why our Govenor in IL and legislature at least made some effort toward mental health parity. This year we went from 30 sessions per year to 60 sessions per year.

I remember, however, when I had a BCBS $1million dollar policy for mental health services and used to go for long term treatment inpatient and outpatient. This was some 25 years ago. Once managed care got into the picture, then mental health benefits suffered more than others.

 

Re: Health coverage for treatment--YOU CAN HELP!

Posted by B2chica on July 18, 2007, at 7:48:00

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

Thanks GG....i chimed in...now if they'll only listen.
although i'm lucky enough to not have a cap on visits...this is SO important to me. because i kept hearing of others that had this problem. a few years ago, i don't know where i'd be if there was a 'cap' on my visits. at one point i was seeing my T three times a week! and sometimes that wasn't enough for me! but BECAUSE i was able to see him that often with only my copay...i'm alive...and now have a BEAUTIFUL little girl. i know for a fact that would have NEVER happened had it not been for him.
i truly don't believe i would have made it through that time without seeing the T i did as often as i did. so much fear and anger...

you know it's just so stupid. there's a stigma of seeing a T anyway, that if you do go you go because you REALLY need one! then they limit you?? i mean...like someone said, theres no limits on GP or ob's ..etc., why then on MH practitioners?
both conditions call for professional help.

something REALLY needs to change...NOW.

thanks again gg.
b2c.

 

Re: Health coverage for treatment--YOU CAN HELP!

Posted by gardenergirl on July 18, 2007, at 23:33:00

In reply to Health coverage for treatment--YOU CAN HELP!, posted by gardenergirl on July 17, 2007, at 13:47:51

Thanks everyone! Just a quick message to say thanks. Lots of interesting comments here, and I plan to get back to them as soon as I can.

Way to go!

gg


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