Mental Health Insurance

Updated on September 05, 2012
L.O. asks from North Platte, NE
7 answers

I'm wanting to take my son to see a counselor or at least go on ADHD meds. But all those things are classified under Mental Health and you will get charged full price to see a doctor for any of these things. We currently have Medical Health Insurance through my husbands work but they don't offer Mental Health Insurance. Any advice? I thought about dropping him from our Medical Health Ins and trying to get Medicaid but the risk there is how long it takes to get Medicaid my son would be without insurance that could be several months. The other concern is what would then happen if we started him on meds and then all the sudden made to much money to be on Medicaid through pay raises etc. Any thoughts? Do you know of any private mental health insurance companies out there? I just don't want to be paying $200 a month at least in just one doctor expense.

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J.W.

answers from St. Louis on

Psychiatrists are sometimes covered under specialist and not mental health because there are visits required by law to write the prescriptions since a lot of the meds are controlled substances.

I had a three month lapse going between insurance companies and had to pay my psychiatrist out of pocket, it was only 70 dollars and you only have to see them every 3 to 6 months. You don't have to have a doctor's visit to get your monthly script.

Just thought I would warn you though the meds themselves are pricey if they are not covered by your insurance.

I have to ask, is this the son who killed the Guinea pig? He needed help months ago and you didn't because it wasn't covered?

4 moms found this helpful

N.G.

answers from Dallas on

Are you absolutely positive that it's not covered? I have never had a health insurance plan that did not cover psychiatry, counseling, etc.

I've never heard of a policy created solely for mental health. A lot of providers are quite reasonable for cash-paying patients. We paid cash for our marriage counselor, and it was only $35/visit.

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M.S.

answers from Washington DC on

I would ask his pediatrician's office for their advice. They might have the ins and outs.

1 mom found this helpful

M.B.

answers from Tampa on

Call your insurance provider and ask them.

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S.S.

answers from Colorado Springs on

A great place to ask about insurance issues, and mental health should be covered, is Family Voices.

PTI Nebraska is the Family Voices State Affiliate Organization and the F2F in Nebraska.

PTI Nebraska 6805 Grover
Omaha, NE 68106
Phone: ###-###-#### · Fax: ###-###-#### · Toll-Free: (888) 490-9233

Primary Contact(s): Nina Baker ###-###-####
Bridget Cannon-Hale ###-###-####

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E.A.

answers from Erie on

You can list medical expenses you have incurred in the non-insured months when you sign up for medicaid, and they will pay them. At least, that's how it works in PA. I never waited very long for coverage, certainly not several months.
You will update your info every 6 months and are required to notify them any time there is a change in your information, like salary amounts, change of address, change in bank accounts or other assets. You should be able to find the income limits online at your state government's website.

Your other choice is to do what I did for myself, find a community mental health organization who can charge you on a sliding scale. I pay for my own meds and get free counseling and regular check ups by a Psychiatrist to tweak my meds. If/when we make more money, I will pay a small fee for these services depending on our income. Just google your city+mental health services.

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G.B.

answers from Oklahoma City on

I think you need to call the insurance provider. It may be that if the primary doc refers the child that they will cover it. It is medical care and I don't see how any insurance company can not cover it. That's like saying they cover all health problems but have selected to not cover any health issue that is related to the heart.

I think that if a primary care doc says they need to see someone they have to follow through. It's a medical need. Maybe not therapy or something but for medication I don't think they could do that.

Look in your area for a free or low income mental health clinic. You will need to see a psychologist that is qualified to evaluate for a diagnosis to receive medication from a psychiatrist. They just won't see anyone who wants to put their kids on meds. They have to have a doc's evaluation that is qualified to make that determination.

If you have a teaching medical college nearby call them and find out if they have children's services. They should have a pediatric mental health department. That department could do evaluations and also have a psychiatrist on staff.

We took my grandson to a psychologist for evaluations this past spring then also went to OU Health Science Center this summer to the Pediatric mental health department. He did evaluations and is now on meds.

We didn't have to pay anything for any of his care. The state medical card covered it. If you do start making more money then you just pay a portion that is based on income in a lot of places. You can always find out through the insurance provider when you call them. It might be that he just didn't sign up for the mental health part when he did his plan this year.

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