Insurance hassles

29 May

My hub is starting a new job soon. That’s the good news. He’s been pretty unhappy at his current job and finally found a new one, and so far the people there have been very nice. Even though he hasn’t even started yet!

So the bad news? The mental health benefits on the new insurance suuuuuuuuuuuuuuuck. When possible, we always go for a PPO (or POS), in order to go out-of-network when needed. Because of my chronic illnesses, we want to have the potential to pick our doctors when we need to, even though it costs us a fortune to have PPO insurance. At his present job, we have the PPO and the mental health insurance is pretty good. In network, it’s covered after the deductible is met, though as I have said before, finding a therapist in-network is near-to-impossible. Out-of-network, it’s covered 80% after the deductible is met, though it’s only 80% of what they feel is an appropriate amount. So in my case it’s about 69% coverage. Not horrible, though our deductible was hella high for me for some reason. And fortunately, no cap on the number of visits. The worst part is actually getting reimbursed. Sending in the paperwork is a pain in the ass, and when they actually receive it (the last time I had to send it 3 times), it takes them forever to process it and even waaaay longer to send the reimbursement check.

New insurance…ugh. The first five visits are covered (post deductible) for out-of-network at 80% (of what they feel is fair for our area), then visits 6-30 are covered at 65% of what they feel is fair. Visits 31 and past? 50% of what they feel is fair. WTF. This is how we try to care for the people who are actively seeking help? Instead of praising them for trying, we get nothing but punishment. And these coverages? Pretty close to equal whether is in or out-of-network. Assholes. Of course, there will still be the reimbursement issue to deal with. *sigh*

I should be grateful because I know there are people who need and want help who do not have any mental health coverage, and who therefore cannot afford to get it. Or even people who have insurance but cannot afford (or are not able) to go out-of-network to find a provider. I am grateful. But that doesn’t mean I can’t be frustrated at the new issues I’ll have to deal with on the new insurance.

I still remind myself every single night how grateful I am for the insurance coverage we do have, and for the opportunity to work with T every other week. What bothers me is how companies–insurance and/or employers–treat people with mental health needs. By making it difficult for providers to work with insurance companies, we are telling people they are not worthy of mental health services. By making mental health insurance difficult to obtain, use, and/or pay for, we are telling people they are not worthy of mental health services. We all have mental health just like we all have physical health. We should have the opportunity to be healthier mentally just like we have the opportunity to be healthier physically.


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