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Anonymous37913
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Default Dec 28, 2011 at 08:00 PM
  #1
I lost my job in July and have been treated for trauma, anxiety and PTSD since then by my T, requiring 2 to 3 visits per week. I have been paying COBRA to continue my medical benefits and have been lucky to have a plan that allows for unlimited T visits. (Several times prior, I've had to discontinue therapy when the allotted number of visits ran out.)

Today, when I called my prior employer to confirm the new COBRA rate for 2012, I was advised by the that they are changing plans effective immediately to a different insurance provider. (They just sent out notices yesterday.) My T has not been accepted by this provider and I will have to find a new T. Also, since I've had this provider before, I do know that it does not provide for unlimited T visits that I so desperately need.

It looks like tomorrow and Friday will be the last visits with the best T that I've ever had. He asked me today what I am planning to do. Emotionally, I am not in a good place. I guess I will seek counseling under the new plan but I am unhappy that I will have to start from scratch. It will take a lot of motivation to find and start over with a new T. I've asked my current T if he could recommend someone. He is going to try to once again sign up with my new provider though that could take some and is not guaranteed. I don't know what else to do.
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Default Dec 29, 2011 at 01:46 AM
  #2
The provider doesn't set the visit limits, the employer does. So even if you had this provider before you may have a different benefit package. Mental health parity may have changed the visit limits on the new plan. Keep your chin up and keep fighting.

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Default Dec 29, 2011 at 01:18 PM
  #3
Too, I would ask your T to work with you to get your T accepted and then use the number of sessions alloted, maybe saving a bit more money up (in that six months or so) so you could continue beyond; T may charge $125 an hour from insurance or self-pay individuals but insurance pays T less than that; see if you can negotiate with T to pay less, what insurance pays, when you are on the self-pay portion?

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Default Dec 29, 2011 at 03:07 PM
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Okay, here's an update. I emailed my prior employer and requested data on the new plan choices. The least expensive plan will cost $70 more per month and has a $500 annual deductible. The summary page does not indicate if there is a limit on the number of mental health visits though the cost for each visit will double to $40. That means that, at most, I might afford one visit per week. There are no out of plan provisions. Other costs are increased also including MD visit co-pays and Rx copays.

Also, I called my current insurance provider and was advised to go to their website for info. Unfortunately, that company does not offer individual policies in my state. There were several referrals to companies that do offer individual coverage. The individual coverage closest to what I currently have was twice the cost of my COBRA payment. There was one affordable brand of insurance but it did not include mental health coverage.

It looks like the Friday will be my last therapy session until I have a new job. I have decided to spend the increased free time job hunting. I know of no 12-step program that can help me with PTSD issues. But, I will need a place to talk and socialize and will select a program for those purposes. Instead of therapy, I will invest time and money on self-help books and free articles on the internet. I hope I find a job soon.
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Default Dec 29, 2011 at 04:34 PM
  #5
I am so sorry this is happening. I've been where you are and gotten sick because of it. I hope that the health care mess in the U.S. gets straightened out soon because it is causing real hell for lots and lots of people. It disgusts me that the richest nation on earth lets its own people suffer this way.

Hang in there. Please come back regularly and post how you are doing.
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Default Dec 31, 2011 at 07:41 PM
  #6
Sorry, I am in the same boat!
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Default Jan 07, 2012 at 06:05 AM
  #7
My T did a little research. Turns out, my new HMO has a transitional care option for patients like me who are in desperate situations and cannot immediately change Ts. The option allows me to see my current T for 60 days and be covered by my new insurance even though my T is not a participant in my new plan. T also advised that it is possible to apply for an indefinite extension past the 60 days in urgent cases like mine. Of course, such an extension would need to be approved by the HMO.

This is really a blessing because i am in really bad shape and needed an emergency appointment. I could not go a week without seeing the T without getting seriously depressed. So, please make a note of it, there is such thing as "transitional care" provisions that will not require you to change Ts even though your insurance provider has changed.
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Default Jan 07, 2012 at 08:33 AM
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Also note that PsychCentral has a discount Prescription Card. it's not insurance but if you have to pay cash it will reduce your cost by quite a bit. It takes 50% off of my Adderall at Walgreens. be careful though because some places say they accept it but they don't adjust the price at all. Ask the price before and the price after.

Also, you can get your meds through the Candian Pharmacy. The link is NorthwestPharmacy.com I used them for two years and never had a problem with my meds at all. 100% genuine. The catch is that they can take up to 3 weeks to come, so you need to order in advance.

Hope this helps,
Tara

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Originally Posted by unhappyguy View Post
My T did a little research. Turns out, my new HMO has a transitional care option for patients like me who are in desperate situations and cannot immediately change Ts. The option allows me to see my current T for 60 days and be covered by my new insurance even though my T is not a participant in my new plan. T also advised that it is possible to apply for an indefinite extension past the 60 days in urgent cases like mine. Of course, such an extension would need to be approved by the HMO.

This is really a blessing because i am in really bad shape and needed an emergency appointment. I could not go a week without seeing the T without getting seriously depressed. So, please make a note of it, there is such thing as "transitional care" provisions that will not require you to change Ts even though your insurance provider has changed.
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Default Jan 07, 2012 at 09:12 PM
  #9
You may be able to have your current T covered by the new plan under a provision called 'continuity of care'. That is, they recognize that a person cannot just quit therapy abruptly or change therapists abruptly. If they do this, they will cover you for a set number of visits, as a way of helping you with the change in benefits/coverage. If you are interested in this, call the new insurance company right away.

Good luck in all of your ventures!
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Default Jan 08, 2012 at 07:22 AM
  #10
Here's a good page reviewing PTSD self-help books?

http://ptsd.about.com/od/additionalr...elpwebsite.htm

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Default Jan 21, 2012 at 08:33 AM
  #11
Here we go again with my new HMO. My (former) employer changed insurance providers as of January 1st and my T was not a member of their panel. Thanks to a transitional care provision, I was able to continue seeing my T. (I am in really bad shape.) Yesterday, T advised that the new HMO will not cover him because he does not meet it's criteria - his degree is not accepted by the provider. He will appeal this decision but is not hopeful. I may have to find a new T and start over again in as little as a week's time and certainly by the end of the month unless the appeal is accepted. T did not seem optimistic. Next week I an scheduled to see a Pdoc; I really don't want to take meds but T says they may help stabilize my moods. When sessions with my current T end - and it appears they will because he does not have the degree needed to continue with the HMO - I will be more isolated than ever. I am not in a good frame of mind and my prior employer is doing all they can to prevent me from getting another job. My T indicates that I require long term outpatient care. I have been troubled since childhood. I have had many T's over the years, several gave up on me or used modalities that did not work for me. I am currently very seriously depressed. Bad luck continues to plague me despite my best efforts. I need a job and now I need a new T. The money is running out. I don't know how much worse things can get.
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Default Jan 21, 2012 at 12:56 PM
  #12
Unhappy guy, I'm sorry you are feeling so depressed and hopeless. Maybe I can throw out some other ideas, give you a little hope?

What is the difference between what you pay your T and what T accepts from an insurance company? I would come up with a plan for X number of sessions/months that I think it might be useful to see this T to get in a better place? Say, you want to be feeling less depressed and hopeless and have a job by July, six months?

Seeing T once a week for six months at a deficit of $50 (say, for example, she charges the insurance company $95 an hour but it only pays $65 and you pay $15 out of pocket for your portion), then you'd owe roughly $200 a month (you'd still pay T $15 or whatever you currently pay) times six months = $1200 by the time you got a job in July. You would agree to start paying T "back" at that time.

If you did not have a job, you would perhaps have to quit T and, paying T back at the same $15 a session would take 80 sessions, or another year and a half. It would be like you had taken out a student loan for a semester of school. However, if you did get a job, you could continuing paying the $15 each week, and at least another $15-$25 or more a session ($25 would pay T back within a year).

See if you can get a little excited about T and the opportunities the experience of psychotherapy affords instead of feeling bad about your situation. "Want" therapy instead of just feeling like you "need" it? Wanting to feel less depressed is a wonderful goal for six months and there are a whole lot of ways to work on that goal and "experimenting" with each you can think of to see if it helps you could be a great project? http://www.helpguide.org/mental/depression_tips.htm

Looking for a job can be just as educational and interesting a project? http://www.cdlponline.org/index.cfm?...D=1&storyID=15

Instead of looking at the problems in your way, try to look at where you want to go and why, what interests you and how you would like your life to go. It is much harder to steer a car, boat, other mode of transportation (self :-) that is not moving than if it is tooling along toward a destination. Look out beyond being depressed as if depression is just a chasm that has to be crossed; focus on how you are going to get across or go around or, if you have partially climbed down one side, remember that you will be climbing up that other side sooner than when you started!

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Default Jan 22, 2012 at 07:58 AM
  #13
Perna - Thanks for your suggestions. I am facing the most basic of struggles - living. I have given up on my life and have little to no hope. I am facing deep psychological issues that things like CBT have failed to treat. All I know are problems and I hate my life. I really don't like going to therapy at all and, in many ways, deeply resent it. Still, I am truly sick mentally. This T seems to be the only one who understands and recognises my problems. I might not be alive now if it were not for this T.
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