Paying For Stuff/ Insurance

[City Slicker]

@sun seeker I had posted my reply then I saw your reply. Pretty much my experience too - especially the art therapists - I am not sure why that is - maybe it's the only mental health profession that uses the word 'therapist' making people feel they are actually getting some type of therapy ??

Canadian Association of Mental Health coverage here is time limited although if you are hospitalized you can get a longer term of 'aftercare' but you will not be able to do any meaningful type of therapy work. It's mostly CBT counselling to get you bandaged up and back out in the world. The Local Health Integration Network places a premium on how many new clients an organization is seeing, not so much on how many times that same individual is seen. There is quite a bit of pressure on health services to see more and more clients for less and less service.

Waiting lists in this province are crazy. You get priority if you get hospitalized. And you have to be in really rough shape to get hospitalized in my city.

 

[Casper1018]

I live in the US. We have a High Deductible insurance plan which means the first $6,000 is out of pocket, so I pay $70.55 per therapy session twice a week. After the deductible gets met, my co pay is $14.11/session.

 

[Friday]

I'm insured (Huzzah! Spent 9 years uninsured.)

Mental & Dental isn't covered... So it's out of pocket for both. Drats.

I go twice a month @ $120 per hour. He'd like me twice a week at a min, but $240 is really more than I can afford, anyway. Even before adding in $40 travel expense, each way, to get there. I multitask during the travel so I don't really count it. Shrug. I've had worse.

What I miss about kickass insurance (had it a time or three) were the 10% copays. OMFG. $7 massages. Done & done. LOL. Okay, also $12 counseling, but massage! Oy vey. Miss that one. One of the ironies of wealth: everything costs less.

 

[jaccat]

My first therapists I saw through my university students union. It was a free service they provided. One I'm very thankful for, but it was hit and miss who you got. My first T was a trainee, the second was amazing, but dropped out of the programme with no warning and no explanation.

I avoided going to the NHS for years. Eventually I did and they referred me to the local service, where I received 6 weeks of CBT. I requested therapy, what I got was CBT. Didn't scratch the surface.

I know in the UK the service you recieve depends on whereabouts you are, and so which service provider you deal with. I have a friend receiving therapy in another part of the country. She has got 6 weeks of actual therapy, and her therapist is trying to get her on a CBT programme too.

In the end I decided to go private and pay for mine. Fortunately my T has a sliding scale and I can afford it as long as I'm careful.

 

[Sighs]

Here in Australia we have arguably the best medical system in the world. (We complain about it all the time - the waiting lists, the "gap" fees, but compared to the rest of the world it is amazing!)

My vet has a VA Gold card. That means he is recognised as 100% disabled due to his service. He can go to any doctor or dentist for any reason, receive treatment, present his gold card and walk out having paid nothing out of pocket. He recently had minor surgery completely unrelated to any of his service injuries (mental or physical) and was not charged any gap fee at all by the surgeon, anesthetist or (private veterans) hospital. He pays a maximum of $7 per prescription regardless of the actual cost of his medicine and if his doctor writes a script for it he pays only the $7 for over the counter medicines as well.

I think if I wanted to get counselling through VA then because I am his de facto spouse I would be entitled to it free. I haven't followed up on this because I wouldn't want him to know that I felt so bad I needed counselling...

As a plain old civvy I could go to a GP and they could refer me to a psychologist and I think I would be entitled to government assistance with the cost for up to 10 sessions a year. I think the assistance would be about half the actual cost. Again, I haven't followed up on this because frankly money is so tight at the moment that I couldn't pay half the cost.

I also have private health insurance. I think they would contribute about a quarter of the cost of a psychology session (but you can't claim the government assistance and the private rebate for the same session...).

So, yeah, we don't have that much to complain about but the upshot is I still am not getting any counselling... Sigh!

 

[sun seeker]

I'm floored by a lot of this. Some of you are paying as much for therapy as I spend on groceries. I know, a good therapist probably took out some expensive student loans s/he is paying back, but still.

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".

I forgot to say that Canada has free therapy (something like 50 sessions) for victims of sexual assault. However, I have to wonder how anyone ever qualifies for it. You have to make an official report that is submitted to the province where it happened, not the province where you are now living. Not every province has a victims' assistance program, so that's some people struck off the list right there. Then, you have to get someone to corroborate what you are claiming. Huh? How many people have that? Is this supposed to be to save the government, which I will point out means the taxpayers, all two dollars and seventy-nine cents they would be wasting on the hypothetical person who would go so far as to make a false report?

Pretty much my experience too - especially the art therapists - I am not sure why that is - maybe it's the only mental health profession that uses the word 'therapist' making people feel they are actually getting some type of therapy ??

I don't know. Interesting you've noticed the same thing. I mean, it's probably great for some people, but it certainly isn't a cure-all.

From several people I've talked to, I get the impression that actual trauma therapy is very rare anywhere other than with a private therapist. Not unheard of though. There was a woman at a community service agency near here a while ago who did EMDR. I saw her a couple of times but we didn't click.

 

[Deleted member 28986]

@Sighs: There is no shame in needing counseling. Telling your vet you want/need counseling shows your strength, not weakness.

I don't know about Australia, but in the US, veterans in mental health treatment learn how much their families can be affected, and veterans are encouraged to involve their significant other: going to groups, couples therapy, and/or individual therapy. I know it's scary to say you need help, but maybe he will be more understanding than you expect :-).

You will be helping your household finances by using a government benefit that your spouse already paid dearly for. There's no need to pay for it again.

Hugs and condolences.

 

[scout86]

Has anyone had any luck getting an insurance company, the NHS, or any similar entity to change their mind and allow longer term therapy? How in the world can they expect to sort things like this out in such a short amount of time?

 

[Deleted member 28986]

@scout86: My (Obamacare) mental health coverage is unlimited. Almost. I can't change mental-health providers more than twice in a year, and my therapist now is booked such that he can only see me once a week. If he was more available, it would be covered.

My physical therapy (PT) was limited to six sessions a year (hahahaha), but my physical therapist wrote a long letter or something to the insurance company and they allowed more treatment.

I met a pain patient with severe debilitating pain with my exact same insurance. She said she could not get more than 6 PT visits a year, even after appealing. :-(

 

[Deleted member 28986]

It's concerning that when I get a certain amount of income again, my "free" health coverage will drop. If I paid out of pocket for the treatment I'm getting now, it would be a couple thousand bucks a month. Wow.

When that happens, I'm planning to get a full-coverage, no-deductible plan that is about $260/month.

Hooray.

—

EDIT: Some hospitals have a "charity" program. My physical therapist (who works out of an HMO-like hospital) said that if insurance denied her request for more sessions, I could apply to the charity program.

 

[scout86]

It's concerning that when I get a certain amount of income again, my "free" health coverage will drop.

Yes, this is kind of a weird aspect of the program. I have my own business and pay for my own insurance. My account told me last year that I could earn $3000 more a year, but no more than that or I'd lose eligibility for the program I'm under now. That's not likely to happen any time soon, but it's a worry that earning an extra $100, at some point, could cost me many times that in insurance. There HAS to be a better way to do this!