Will Your New Insurance Plan Do a Better Job Covering Your Mental Health Care?

Gretchen is optimistic that hers will.

The federal government is in shutdown mode but the health insurance marketplaces are open for business. People with mood disorders and their families have the opportunity to explore the pros and cons of different insurance plans that become effective in January 2014. Mental health care must be covered, but will the different levels of plans pay for the services you need? What will you need to pay for yourself?

Gretchen, who lives with a mental health condition, is hopeful that her new insurance will cover her preferred therapist and psychiatrist. Here’s her story and her thoughts about mental health advocacy.

My health insurance has been inadequate
I have been very fortunate to have found a therapist and psychiatrist that communicate with each other. They work together as advocates for me when I have been unable to do this for myself. My challenge has been being able to afford such good care.

Because of my diagnosis, my employment has not always been consistent. And currently, neither are covered under a healthcare plan. Both of these factors have added to the challenge of finding adequate mental health care. As a result, I have paid my mental health expenses out of my own pocket and with the constant help of concerned family members dedicated to my wellness.

The promise of the ACA
With the Affordable Care Act coming into place this fall, I am optimistic that I might find the coverage that may help me in this challenge. After looking through the links provided through the CFYM website and the information provided by the federal government, it has become clear to be me how important this opportunity will be for many people who struggle with mental health issues.

Our organizations need to reach out to their constituencies
I want to see access to this information in a prominent place within organizations such as DBSA. Illinois received $27 million in federal money to inform community organizations on the ACA, and Gov. Quinn distributed it to 44 different groups. Looking through the list of organizations, there seemed to be a missed opportunity in reaching those who struggle with mental illness and the families who care for them. Go beyond posting information on your websites. Send informed people to local support group meetings with appropriate and helpful information about mental health care and insurance under the ACA.

I feel this would be an excellent chance for organizations such as DBSA to significantly help a target audience who often receives secondary status in the issue of adequate healthcare. Being informed is the first crucial step.

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2 comments
Sandydawn
Sandydawn

I am having a problem getting my mental health company to approve visits with my therapist for PTST.  We have been working together for 3 years and the "memory" sessions have changed my life.  Other therapists wanted me to take drugs and do yoga but this man actually started a series of sessions where I was encouraged to remember these childhood abuses and work through them.  My life began to get better.  I got a part time job, started getting out of bed and taking care of my home and wasnt depressed on a daily basis.  Best of all, someone was there to work through the memory flashes so I didnt have to go to a hospital.

A few months ago my mental health provider started denying these visits.  I had been seeing him 5 times a week for 45 minutes.  They immediately cut the sessions to 2 a week and required i spend time filling out a how do i feel form for 15 minutes of it. The provider told them this level of work couldnt be terminated like that without harm to me.  They said I wasnt suicidal and seemed to be doing great so no and by November cut it down to one a week.  They claim that they aren't denying care anymore than they would medically.  That they dont see a reason for the care even though I still am on effexor and ativan and was hospitalized in April for stoke symptoms due to the stress this all caused.  The key here seems to be they dont agree with PTSD treatment or Exposure therapy to work through the past.  They just find it neccessary to maintain my life.

As a result, I have a 30 thousand dollar psychologist bill, as I couldnt stop treatment.  I quite my part time job out of depression and gained 25 lbs.  I dont see where parity will help.

The Eyes
The Eyes

“Don’t give up on your dreams, or your dreams will give up on you.” - John Wooden If you don’t follow your dreams, then who will? Got any dreams you’ve been neglecting lately? If so…what can you do to start realising them, beginning TODAY? NEVER LET GO OF YOUR DREAMS

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