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Have you had trouble getting mental health services for yourself or your family? Have you had successes? Tell us! Whether you’re an individual living with a mood disorder or a friend or family member, we’d like to help you share your story with the Care for Your Mind community.
I have insurance through my husband. We have a 35% share of costs that we cannot meet for me to get a psychiatrist’s care, which is not covered. My primary care is covered, but my primary care physician can’t treat me because she said it would be a disservice since she isn’t a psychiatrist.
I am on disability. I am a prisoner of my bipolar depression a lot of the time. I have been practicing self-care and had been taking medication regularly for the last 10 years, until I got married a couple years ago.
Since my husband has a job, I don’t qualify for help. I have paid my taxes and worked since I was 17, but there is not enough money at the end of the month for basic necessities.
I have come to accept it, but I don’t approve, and it has almost cost me my marriage. Now I know why we feel so alone, but we are not alone and we do learn to live with this!
Back in 1996, when I was struck with postpartum psychosis, there was still a separation of mental health insurance coverage and medical insurance coverage. This separation was devastating to my and my husband’s financial situation. It also exacerbated my condition.
After two hospitalizations, my lifetime mental health insurance benefit reached its maximum. The lifetime maximum for mental health coverage was considerably less than the maximum benefit for medical coverage. The question of why the diagnosis of postpartum psychosis was not considered a medical condition puzzled me. Here I was having to take prescription medication to stabilize me and help me get better, yet my insurance was telling me I did not have a medical condition.
How could this be happening? I anguished over my dilemma. I needed medical care yet I could not afford my medicine and visits to the medical professionals. I had insurance coverage but had never had to use it for anything other then my pregnancies. When I was in a crisis and needed the medical insurance, I discovered how limited the insurance coverage was for mental health.
My husband and I had to use our lifetime savings to pay for the medical expenses. We began the process of appealing the insurance company’s decision of not recognizing postpartum psychosis as a medical condition. My doctor recognized it as a medical condition, supporting us in our appeal process. But the process would involve hiring an attorney—additional costs, as well as additional stress and anxiety for me. I struggled with what to do as I did not feel recovered enough to take on the huge task of fighting an insurance company.
Our saving grace was when the contractor changed at my husband’s job. This enabled us to have new insurance coverage hence a new life-time maximum for mental health conditions. I was so thankful, but it should not have taken an employer change to get the insurance coverage needed. I would learn that such discrimination between medical and mental health coverage occurred for years.
Thankfully, later in 1996, the Mental Health Parity Act was passed. The Act required equal coverage with respect to aggregate lifetime and annual dollar limits for mental health benefits. Although this Act did not help me during my initial onset of postpartum psychosis, it would help me later in my recovery.
The question of why the insurance company did not recognize that postpartum psychosis was a medical condition remains unanswered for me. My hope is that we can eliminate the stigma often associated with mental health and continue to conduct more research supporting the fact that you can not separate mental health from physical health.
As of late, I have found that more and more psychiatrists are collectively dropping Medicare patients. This is and will become a big problem for individuals on disability for mental illness, and for society as a whole.
This issue hits far too close to home. I was with a psychiatrist for 10 years who stopped accepting Medicare, while still accepting other forms of insurance, so now I am under the care of a nurse practitioner who doesn’t have nearly the expertise as a doctor of psychiatry.
There are not enough state-mandated resources to handle all of the mentally disabled individuals without the help of private psychiatric practitioners. There should be laws put in place that require all psychiatrists who accept insurance to accept at least a certain percentage of Medicare recipients. Otherwise, there will be many individuals that WILL fall through the cracks.
People on Medicare disability for mental illness need the best and brightest more than other patients, otherwise they would not be on disability for mental illness. Furthermore, if they do not get that premium health care, they most likely will be on disability for life, putting an obvious burden on themselves, as well as society as a whole.
I was diagnosed with bipolar disorder after having my second son. As a nurse, I know how critical care is for the mentally ill. Well, my experience has not been very positive.
When I was first diagnosed, it took a year to get in to a psychiatrist and I was treated by my nurse midwife until then. Finding a psychiatrist in a rural area that is covered by whatever insurance I had at the time was the problem. I once drove 2 hours for all my appointments because the only provider with an opening that carried my insurance was 2 hours away. That lasted a year and that wonderful psychiatrist retired.
My latest experience is with a provider 45 minutes away. First, let me explain that I have literally thousands of dollars in medical bills due to mental illness, even though I am normally covered by a healthcare insurance. That’s just in copays, out-of-pocket, and anything that goes over the mental health benefits coverage, which is minimal, I must say. I am a registered nurse—I should be able to pay my medical bills and feed my children!
Finally, when I recently had a two-month gap in coverage, my current psychiatrist refused to refill my medications without seeing me. (I couldn’t get in to see him because I have to pay $200 up front for an appointment because of past-due medical bills.) That didn’t matter to him. It seems to me that he had written me off as the stereotypical noncompliant bipolar.
When I finally got my tax returns and was able to go in, I was an emotional mess and I was angry. I clearly let him know the situation and that I felt he had let me down in our care partnership. I haven’t been back to see him, but I believe he now sees me in a different light. I work hard to take my medications, remain stable, and be a good nurse and mother to my children and I would just like it to be a LITTLE less hard to do that.
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- Caroline HeeJeon Gale, Learning to Live with Bipolar Disorder
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- Jennifer, Despite VA Benefits and Disability Coverage, Jennifer Struggles to Get the Care She Needs
- AJ French, Mental Health Advocate Launches Suicide Prevention Campaign While in Flight
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