[token451]

What problems have you all run into with insurance as far as switching providers, getting coverage, retaining coverage, getting meds/therapists covered, etc?

[Disorder7]

I just found out my insurance may not cover Ambilify. I have to wait 24-72 hours while they decide. Meanwhile, I have nothing to take for bipolar. Nice.

[Curious651]

sometimes the doc has to go through an approval situation. As for getting coverage I would not tell them the dx unless have to. Depending on your situation you should be fine. Most cannot prevent for mental health due to law, but we all know how that goes. As for all the rest, it is to general of a question to answer. To many variables.

[~Christina]

There is an Insurance and Finances forum here on PC.

That might help you see ways our members have overcome hurdles finding proper treatment.

It can be a nightmare.

[token451]

I was asking because I went with my husband to look over adding me onto his insurance through his work. They just changed the policy this year and no longer ask questions that would completely disqualify anyone who has even has a referral to a psychiatrist, been diagnosed with any of a host of mental illnesses, along with a list of general medical issues. I can get on with this one without having to disclose but it is a new policy with my husband's work so I'm not sure how most other companies work. It's mainly for future reference since we are planning on moving and that would require switching companies. Thank you for letting me know about the Insurance forum, I'll be sure to check it out.

I'm with an HMO, so it's very straightforward. If a provider prescribes from the formulary, it's covered, so there's no guessing. If it's a test or referral, it's covered as long as it's someone in the network. If it's self-referral, I just go to whoever is in the network and choose someone. If it requires pre-approval, I just need my primary care or pdoc to write an order.

On the downside, it's an HMO. But at least I can go to one place and get everything done. Some of the providers are sucky, but some are fantastic. I guess you get that everywhere in health care.

[Victoria'smom]

look at your husband's preferred drug list usually you have to go through that before the company lets you have prior authorized ones. Even then you have a formula. Look at the members book it should tell you how many psychiatric and therapy appointment's you can have in one year. It'll say if they cover intensive out patient, partial hospitalizations, exc.

Then you flip to the providers and see if there's any treatment/crisis/psych hospital. If not do cold calls to your local treatment center/crisis/psych hospital. When you find one you like go back to the providers book and start calling the psychiatrists and therapists to see if they're accepting clients, still take your insurance, as about a 15 min face to face (how much that would cost) and what hospital/crisis center they are affiliated. Put a star next to the ones that are willing to do face to face interviews for cheap. Color in the stars for drs affiliated with your chosen treatment Center. Call and set up a 15 min appointment with all of them because you may not like the first one. You can always cancel but it's hard to get in. Make sure they will work with your GP and therapist.

Find GP following above steps (make sure GP is willing to share with psychiatrist and other specailists)

Repeat all steps for each of your specialists BEFORE transferring insurance.