My insurance plan doesn't cover mental health and I need a psychologist, what do I do?

Question

Hello,

I asked a question a few days ago in Answers about whether health insurance covers psychologists. I talked with Cigna (My health care provider through Healthy New York, the state's "affordable" insurance plan for the uninsured). They sent me a list of psychologists and after many calls, I was finally able to secure an appointment. Since then, I found out that Healthy New York does not offer coverage for mental health. I have been back and forth on the phone between Healthy NY and Cigna all morning. I'm willing to pay a higher preminum for psychological coverage, but both of them are saying there's nothing that can be done. I really need a psychologist, is there anything I can do? I'll provide details as they're needed.

Ironically enough, since the two people who replied are total douchebags who have nothing better to do with their lives, let me clarify: I was told by Cigna that the two exceptions under which I could get coverage are if I was in a substance abuse program or if I was detoxing. I could drink away my problems. But I know that won't help me. I can think rationally and clearly. That doesn't make me any less deserving of help. If anything, I'm more deserving. And a question to the second poster, why shouldn't I get help? I'm a 27 year old male, otherwise in perfect health, who is facing some emotional problems and needs to talk to a professional. I haven't used my health plan for anything else so far, and I've had it for nearly a year. This is the one time I need it, to justify the amount of money I'm paying into it every month.

Countrygirl, thanks for the suggestion, I'll look into it.

Mommy, unfortunately, it's not that easy. I got this plan under Healthy New York, which is meant to be an affordable plan offered by the state to cover the uninsured, whose jobs don't offer health insurance. There are multple plans I can choose from, meaning various HMO's. But this is the policy of Healthy NY. So I'll try to contact these other HMO's but if Healthy NY is only offering the most basic coverage, I don't think I can really do anything.

Mickey,

I manage a liquor store, and unfortunately, as you can probably assume, not a lot of liquor stores have health benefits, LOL.

Thanks everybody, this was very upsetting to me through the day, but seeing your thoughtful and informative responses make me feel better. Thanks so much, it means a lot.

Joules,

Thank you for the phone number, I will call them tomorrow.

Answer 1

Cigna should be separate from Healthy New York and Cigna IS the Mental Health coverage of state plans. So someone is giving you the runaround. However, why do you need a psychologist? The reason I ask that is this: Is it depression? Is it a traumatic experience? Did you have a head injury? In other words, is it something you can see a NEUROpsychologist for. If so, then the standard is that a NEUROpsychologist is NOT mental health, it is covered under Health/Medical because they test to arrive at a MEDICAL (not mental) diagnosis. If Cigna sent you the list then they do cover those psychologists. Stick with it until you get satisfaction. Cigna, like I said, is the mental health network offshoot of medical plans.

***ADDED NOTE:*** - Do you have an Employee Assistance Program (EAP) through work? If you do, seek out the EAP Program Coordinator. They can help you. I would say that your last resort is to find someone and set up a Payment Plan with the billing department (as long as you do that and you're paying "something - I think the lowest is $10/mo) on your bill then they can't sue you.

Answer 2

I suggest you to visit this web site where you can get quotes from different companies: http://INSUREQUOTE.INFO/index.html?src=2YAneygaT33n

RE :My insurance plan doesn't cover mental health and I need a psychologist, what do I do?
Hello,

I asked a question a few days ago in Answers about whether health insurance covers psychologists. I talked with Cigna (My health care provider through Healthy New York, the state's "affordable" insurance plan for the uninsured). They sent me a list of psychologists and after many calls, I was finally able to secure an appointment. Since then, I found out that Healthy New York does not offer coverage for mental health. I have been back and forth on the phone between Healthy NY and Cigna all morning. I'm willing to pay a higher preminum for psychological coverage, but both of them are saying there's nothing that can be done. I really need a psychologist, is there anything I can do? I'll provide details as they're needed.
Update: Ironically enough, since the two people who replied are total douchebags who have nothing better to do with their lives, let me clarify: I was told by Cigna that the two exceptions under which I could get coverage are if I was in a substance abuse program or if I was detoxing. I could drink away my problems. But I know that won't help me. I can think rationally and clearly. That doesn't make me any less deserving of help. If anything, I'm more deserving. And a question to the second poster, why shouldn't I get help? I'm a 27 year old male, otherwise in perfect health, who is facing some emotional problems and needs to talk to a professional. I haven't used my health plan for anything else so far, and I've had it for nearly a year. This is the one time I need it, to justify the amount of money I'm paying into it every month.
Update 2: Countrygirl, thanks for the suggestion, I'll look into it.

Mommy, unfortunately, it's not that easy. I got this plan under Healthy New York, which is meant to be an affordable plan offered by the state to cover the uninsured, whose jobs don't offer health insurance. There are multple plans I can choose from, meaning various HMO's. But this is the policy of Healthy NY. So I'll try to contact these other HMO's but if Healthy NY is only offering the most basic coverage, I don't think I can really do anything.
Update 3: Mickey,

I manage a liquor store, and unfortunately, as you can probably assume, not a lot of liquor stores have health benefits, LOL.
Update 4: Thanks everybody, this was very upsetting to me through the day, but seeing your thoughtful and informative responses make me feel better. Thanks so much, it means a lot.
Update 5: Joules,

Thank you for the phone number, I will call them tomorrow.
Follow 12 answers

Answer 3

Yes they cover it. I would assume you do not have access to group health insurance then? You aren't going to save money by using insurance to see a doctor for mental health. Health insurance is only worth it when something catastrophic happens. You SHOULD have it for that reason... if you get hurt or get hospitalized and are looking at thousands of dollars in medical bills that will bankrupt you. You don't get health insurance so you can see a shrink for $20 instead of $75. Also.. have you ever been treated for mental health in the past? You can be turned down for health insurance because of this, or if you're lucky they'll tack on a rider saying they insure you for everything except mental health. It is considered a pre-existing condition, like diabetes or something.

Answer 4

Most of the time when a service is denied, you've got very few options.

What most insurers say is "go get the treatment, then appeal." This isn't a great option - yeah, you get the treatment, but you can also get stuck with the bill, and they can tag your file with a preexisting condition so if later they do start covering it....you get the idea.

Sometimes if you can get your GP to refer you rather than a self-referral, specialists can be covered, but not always. For example, sometimes they'll cover treatment for post-partum depression but not "standard" depression, or vice versa. As always, companies are also more willing to cover pharmacology than therapy, but will sometimes cover both in tandem.

The next thing I would do is to see your GP, which should be covered. Some GPs are even willing to prescribe things like antidepressants if they feel they're warranted, but even if they're not willing to prescribe a good doc will try and help you get the help you need.

Answer 5

I didn't read thru all the smart *** answers, but alot of places have a fee for service scale, or there are other agencies they may help.

I'm going to look and see if I can find any other info for you.

Here is the link to NAMI- the mental health organization in NY State. And below is a help number to get information.

Helpline 1-800-950-3228 (NY only)

I'm sorry I don't have more information for you, but there is a start. NAMI usually can help you find assistance.

Answer 6

wow, that is terrible. Here in Canada I can go see a therapist at the community mental health for free.. I even got my kid into child therapy for free (turned out I was concerned about nothing)... but I didn't have to pay a dime. Don't you have any offices like that where the government pays their wages and it is free to the public (all you have to do is run your problems by an intake worker and they accept or deny you... but they always accept)? Nothing like that?

The other thing I'd suggest is to get better covered and don't tell the company why. Once a company knows they will pay out, they dont' want you to use them, lol. That is what they are there for, but you need to increase your coverage or get a new plan with a different company... you may have to wait 3 months for it to kick in... but don't tell them why you want a premium package... make it sound like you want it just in case..

I don't know if that will help. I heard the states has terrbile health care.. like you even have to pay to get treated in a hospital and stuff!!

Answer 7

I work for 3 psychologists in the midwest. Their full fee is $125/hour, but they will provide a sliding scale if you ask. Sometimes people prefer not to file insurance (even when they have mental health coverage), so it is not on their records anywhere.

Good luck

Answer 8

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Answer 9

There are some mental health clinics that are usually low-cost, that are often funded by the county. Try calling the health department in your area for some direction.

Answer 10

If you search around you will probably find one that will take you on a slidind scale.So say you bring a certain amount of money a month they go by what you make and that is how you are charged.If it gets to bad try a county that you live in and they have people that can assist in your crisis.Hope you know that what ever it is you are going threw that there is nothing that God does not see or hear.Prayer does amazing things for people.