Paying For Stuff/ Insurance

[scout86]

Partly this is because I'm curious, partly it's because I think it might be helpful to gather information together in one place.

We have people here from all over the world and from a wide variety of circumstances. Some countries have "socialized medicine", some don't. I'm guessing that there's a lot of variation, even between countries with socialized medicine.

So, for anyone who wants to chime in, how do you pay for therapy? What problems have you run into? How have you dealt with the problems? What are your ideas on better ways to do things? What questions would you like to ask on this topic?

In my case, I started out paying for therapy myself, because I didn't have insurance. My T has a sliding scale, which helped. (He was still second only to the house payment on my list of monthly expenses.)

As of a year ago, I have insurance. It's cheap and so far uncomplicated. I have no idea how long they're going to be willing to pay the bills. (He just had me fill on a DSM self assessment of some sort and that might give him enough excuses to keep me around a long time!) He never brings insurance up. I'm sort of scared to ask. I guess I'll cross the bridge if and when I come to it...

I know, at least in this country, insurance varies wildly. Mine is a state subsidized program for "the working poor". Mental health care only costs me the monthly premium. No co-pay, no deductible. The premium is slightly less than half of what I was paying at the bottom of his sliding scale, for one session. (Here in the US, we do things one extreme or the other, I guess.)

Anyone else?

 

[Glara]

My survivor has insurance through his employer. He said it only covers therapy once a week. He told me because I asked if he could increase his sessions. Now he's in the hospital but I don't for how long. That will depend on his insurance as well. I know in the the state I live in, we have Medicaid expansion which had been great for people getting the coverage they need even if they are not disabled and do t have children. At my job we have 27 openings and a whole new dept because of the expansion. The state he lives in doesn't have the Medicaid expansion and he'd be out of luck without employer insurance.

 

[digger]

I live in the UK and am having to use up savings to pay for a private therapist because the NHS service where I am is so shit. Insurance isn't the norm here.

 

[Anarchy]

There's a saying from those parsimonious souls, north of the border "He who pays the piper, calls the tune"

I only had relationship counselling, I paid, and I got to choose a T that we liked. not one that we were assigned.

I was reading the British "increasing access to psycho therapies" web site - i may be mistaken, but it looks like the training courses are only open to those already working in the British state sector; quacks, nurses and social workers.

When I was in Ireland, a visit to a GP cost between 40 and 60 euros (government employees and welfare recipients got in free). that meant you only went when you thought you really needed it, and you got in straight away. the receptionist was almost pleasant and the doctor was keen to please

In Britain it is potentially over 2 weeks to get a "free" appointment (it depends on area, there really is a postcode/ zip code lottery), the disincentive of having to pull money out of your pocket isn't there, so there are other disincentives; the receptionists are usually venomous the waiting room is packed with coughing and snivelling err individuals, you'll likely waste half a day, and the quacks usually can't wait to get you out of the door again.

The British appointment is "free" only in the sense that the NHS has already taken the money out of pay packets and from employers (raising the cost of employing people and so reducing the number of jobs).

The present Irish psychopa... sorry, prime minister, was promising "free" GP visits in Ireland. I hope the Irish people appreciate what that will mean in practice.

 

[Mit]

In my experience in the UK, it's a very mixed bag. Therapy through the NHS is limited. I was given just six sessions. The therapist wanted to refer me on to a psychologist, knowing that six sessions were insufficient, but this was turned down, I suspect because of very limited NHS resources.

I have also paid to see a therapist until I could no longer afford it.

Currently I am seeing a therapist through a charity that supports victims of sexual abuse. It's free, once a week for six months.

The only drawback (again in my own experience, not necessarily true in all cases) is that my therapist seems less experienced and qualified than her NHS counterparts. But at the very least it's someone to talk to.

 

[Deleted member 28986]

Any people in France on this forum? They're supposed to have amazing healthcare.

In 2013 I got private insurance, but despite the crappy insurance, I spent over $10,000 on healthcare that year, partly contributing to my bankruptcy. (This wasn't even mental healthcare.)

For the first seven months of 2014, I was just coping without insurance. I was paying out of pocket for what was essentially physical therapy, but it didn't break the bank at $30-40 per session. Really great trainer and a great price.

Then I got hooked into the new healthcare reform, and because I had no income, my coverage was free. No copay. My primary care provider is a pain to deal with and I feel like every visit is a negotiation to get what I want/need, but it's ok. It is what it is.

I'm very happy with my therapist, who I can see once weekly. I want to ask about doing multiple treatments at once (?) because 50 minutes of therapy every seven days seems like putting a Band-Aid on a gushing wound.

I'm also pretty happy with my physical healthcare, but getting my doc to prescribe something, no matter how harmless, is an exercise in patience. Glad I'm learning grounding exercises. LOL.

I'll still be spending a chunk of change on non-covered services this year, but overall I am very happy with my health coverage right now, and I encourage those who need the service to take advantage of it. Your own health comes first.

 

[sun seeker]

In Canada there is socialized medicine, but it seems to be done differently from Great Britain. I've never heard of rigid limits to length of therapy, though that could just be in this region and others can correct me on this. Almost everyone here has basic medical insurance for a premium which is calculated according to income. This covers therapy through Mental Health for anyone with a mental health diagnosis. It also covers psychiatrists. What you get under that umbrella is the luck of the draw. Some are very good, some are lousy. They are way, way backed up. Recently one of the workers in a nearby town told me they were getting something like twenty new requests per week, with three people available to cover them (or something close to that, I could be remembering wrong). In cities there is more choice while in rural areas you take what you get, and may have to wait a while for it, though I haven't heard of waits going into years like some people are having in England.

Then there is free counseling offered through community service societies, and that is available to anyone. Again I have never heard of this being time-limited. Again though, it's the luck of the draw. For some reason I can't fathom, in my area these societies seem to have a tendency to hire a lot of art therapists, more than any other specialty. Clinical psychologists I have not seen represented at all, for instance. Whether that's about pay scale or prejudice, I don't know.

Then there are private therapists for those who can afford them. Some of them may take private insurance. And then, at least where I live, there are a whole host of alternative practitioners from Reiki to massage therapists to hypnotherapists. That's probably true anywhere, but they seem to congregate around here especially.

That's my impression of the scene, but it's a huge country and each province handles medical care somewhat differently.

 

[theotherside]

I pay out of pocket but fingers crossed insurance will cover..

 

[Deleted member 12723]

In the US, Southern California, I have paid for therapy once a week on a sliding scale which was very affordable for me. Now I have Kaiser and I have to pay for my own medical insurance with sixty dollars co pay a visit to a therapist, psychiatrist, and doctor visits. So I am glad that I do not have to go very often.

 

[City Slicker]

In Canada we have 'socialized' medicine.

Therapy for adults with anyone except a Psychiatrist is not covered. There are hospital based programs that offer basic 'adjustment' type 'counselling' to get you patched up and back out there and are limited in what they offer - also if you are in an isolated area of the country you are pretty much out of luck for access. They do not offer long term therapy.

There are many community programs to assist people based on 'issue' type for example, programs to assist survivors of sexual assault, violence prevention, anger management programs and while they do an amazing job they are not equipped to provide 'general' therapy let alone long term PTSD therapy.

If you have third party insurance benefits through employment you can get a therapist from a 'regulated' profession such as a psychologist or MSW social worker and you can choose your own. However, there are financial caps on the number of sessions you can get from your insurance company - usually $1000 or 6 sessions. You pay the therapist and you submit your receipts to your insurer.

When I saw a therapist briefly a few years ago, I capped out at 6 sessions before I was even able to begin to articulate specific goals for therapy. I took additional work to pay for the sessions. It got to where I was working close to 16 hours a day most days. I was relieved when that part was over.

Therapists can offer sliding scales and many do but the going rate here for a 'regulated professional' for long term therapy starts at about $150 per session. You are certainly free to negotiate the rate from there with the therapist.

Cheaper sessions can be had with students from various professions but they will not be covered on any insurance.

 

[scout86]

So far, to be honest, this sounds pretty awful! Everywhere.

The idea that who you get is sort of "luck of the draw", I guess is sort of inevitable. But I really believe that it's important to have the right combination of people, so there kind of needs to be a way to try again, if the first T doesn't work out. (I got REALLY lucky!)

I THINK, but am not sure, that there are programs in the US that will help out if you are the "right kind of survivor". But I think you actually have to qualify and a lot of people will fall through the cracks.

 

[Hope4Now]

I pay a FORTUNE for health insurance, plus have a $4000 deductible annually, but I only have to pay $20 per session with my therapist and have unlimited sessions. So...not too bad, especially given that my spouse and one of my children are also in psychotherapy. I have to pay the psychiatrist out of pocket ($200/30 minutes) because he is not in the network. Also have to pay out of pocket for all alternative medicine that is not physical therapy...so, massage, energy work, body work, etc.