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ForeverLonelyGirl
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Default Oct 27, 2014 at 04:06 PM
  #1
I just happened to click on the help section here and "find a therapist". I wrote an email, as directed, to the therapist seeking info, etc. I gave my email address and phone number. I thought I might get an email first but got a call from the therapist's office. Not upset with PC for anything, just the whole mental health care system has utterly failed as we all know.

The first thing she asked of course is what kind of insurance I had. I told her the name of the company, which is through medicare part D. I finally had to tell her it was medicare Part D and she said, "Oh no we don't take that!" Like it was something horrible and I was ridiculous for asking. However they take medicaid? That makes no sense to me. Why would someone take medicaid and not medicare? Also, I asked if they had a sliding scale, which has been suggested to me here a few times. Oh no, we couldn't do that!

So, "Sorry we couldn't help you"...This just makes my blood boil. The last time I called my insurance company looking for a therapist it ended the same way basically except they suggested the mental health center which is worse than having no therapy. It is ridiculous that I cannot even get mental health care at all and I am on disability for a mental illness. Hellooo...what is wrong with this picture!!!!???

Sometimes I feel like I just woke up in a bad dream in some kind of crazy alternate reality, some really vile dystopia.
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JoeS21
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Default Oct 27, 2014 at 06:57 PM
  #2
In my experience, it seems as though once a person is disabled by a mental health issue, they often times can no longer get mental health treatment. Practically no one take Medicare, SSDI income frequently doesn't even cover the rent (so forget self pay), and the therapists who do take Medicare have months long wait lines and are often (maybe practically always) really bad at their jobs.

I WISH THIS WERE ONLY MY OPINION but it's said over and over. I post it here so people know they are not alone, and so that maybe someone capable of fixing this will read it.
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ForeverLonelyGirl
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Angry Oct 27, 2014 at 09:11 PM
  #3
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Originally Posted by JoeS21 View Post
I WISH THIS WERE ONLY MY OPINION but it's said over and over. I post it here so people know they are not alone, and so that maybe someone capable of fixing this will read it.
Oh Joe, I think truer words have NOT been said. It's a travesty for sure. I registered an official complaint with my insurance company about the high co-pays. I'm sure it will go all the way to the top. Smmh...The last therapist I saw that took medicare had a constipated face look. I never went back to her. I spilled my guts, poured my heart out. Which only brought it all to the surface and basically she said, "Well, so when do you want to come back?" And "did you pay at the front?" She may as well also have said, "And don't let the door kick you in the butt on your way out!"

Wow, my attitude is foul. Once again, I feel like I fell into some dark dystopian universe lately, down the rabbit hole. I guess the only hope for us is self reliance and self help books. I hope there is a special place in hell reserved for the people with money that make these decisions in regard to our so called care.
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Default Oct 27, 2014 at 11:03 PM
  #4
I go to a university psych group/ I have Medicaid.
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Default Oct 27, 2014 at 11:26 PM
  #5
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I go to a university psych group/ I have Medicaid.
I've been told that I make too much to get medicaid. I'm rich!
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Default Oct 28, 2014 at 01:08 AM
  #6
Okay .. the disability your receiving .. is it SSDI ( I am assuming) then you are given Medicare part A and B ...and typically qualify for drug coverage.

Part A covers your inpatient hospital things
Part B is what pays for Doctor visits and Therapy
Part D is what helps cover your costs of medications

Once you meet your yearly deductible Mental health now pays at 65%

I honestly would not go by what T's you find on here, Call ones that are close to you and ask. I had no problem find many T's that accept medicare and I live in a very small town.

My T visits cost me 20.00 after medicare pays there portion..

I hope this helps

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Default Oct 28, 2014 at 09:33 AM
  #7
Wow i couldn't find any closer than like 45 mins from me!
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ForeverLonelyGirl
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Default Oct 28, 2014 at 10:48 AM
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Originally Posted by ~Christina View Post
Okay .. the disability your receiving .. is it SSDI ( I am assuming) then you are given Medicare part A and B ...and typically qualify for drug coverage.

Part A covers your inpatient hospital things
Part B is what pays for Doctor visits and Therapy
Part D is what helps cover your costs of medications

Once you meet your yearly deductible Mental health now pays at 65%

I honestly would not go by what T's you find on here, Call ones that are close to you and ask. I had no problem find many T's that accept medicare and I live in a very small town.

My T visits cost me 20.00 after medicare pays there portion..

I hope this helps
The therapist that was referred from here was very close to my home so I got excited about it. I had a long talk with my insurance company and no matter what, I have to pay a $40 copay and that is just too much for my budget. I could go maybe once in a while. I do know how my insurance works.
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Default Oct 28, 2014 at 04:07 PM
  #9
Oh I hope you weren't offened when I broke it down. Some people are confused, I'm glad you are not. I hope you can find a way to access more services.

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Default Oct 28, 2014 at 04:11 PM
  #10
Don't give up. I finally found one for $20 each visit but can only go twice a month
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ForeverLonelyGirl
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Default Oct 28, 2014 at 05:39 PM
  #11
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Don't give up. I finally found one for $20 each visit but can only go twice a month
Thanks. I guess I have no choice. I am not sure what giving up would look like since the way I live is pretty much like I have already. Hmm. Sorry hate to sound pathetic and in my own pity party...

Oh how I wish I could just really tie one on, cannot drink since my brain is so damaged from klonopin, it really has a strange and warped effect on me. Just to have one nice drink would be awesome!

Seriously I am a little afraid to even try calling another therapist. What happened to the therapists with sliding scales? From what I have been told from other sources, once you have medicare you don't qualify for other programs....then there is just nothing for me out there because a $40 copayment is not an option for me to pursue. Maybe changing my insurance company for part D would be another choice to get a lower copay.
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ForeverLonelyGirl
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Default Oct 28, 2014 at 05:40 PM
  #12
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Oh I hope you weren't offened when I broke it down. Some people are confused, I'm glad you are not. I hope you can find a way to access more services.
No problem, I appreciate you trying to help.
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Default Oct 29, 2014 at 08:02 AM
  #13
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Originally Posted by ForeverLonelyGirl View Post
Seriously I am a little afraid to even try calling another therapist. What happened to the therapists with sliding scales? From what I have been told from other sources, once you have medicare you don't qualify for other programs....then there is just nothing for me out there because a $40 copayment is not an option for me to pursue. Maybe changing my insurance company for part D would be another choice to get a lower copay.
Medicare part D is for prescription insurance coverage only. Part B is the only medicare insurance coverage for outpatient providers.

I cannot remember if you said you qualified or not for the state medicaid program, if have not considered or applied, this can be very helpful to consider; forgive me if you have already tried to get this coverage.

Also if it might be an option to consider, if affordable, of getting a medicare supplement / medicare companion plan, that will pick up 100% after medicare part B pays their portion of approved amounts. They allow for unlimited visits. The plans vary by state and company though in their cost and whether you signed up for them when you immediately got medicare; if not immediate, there is a penalty with a slightly higher premium. I am currently paying $112 a month, and initially it seems more expensive but when it picks up 100% of the coinsurances/copays of Part B, it pays for itself in the long run cutting out of pocket costs because all am paying is the insurance premium; it picks all the coinsurances for all my providers including my mental health ones, and can see them whenever. The rates may be more or less in your state, check the insurance provider websites for quotes, if this might be an option.

I do hope you find a therapist and solution soon. Hang in there meanwhile.

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Last edited by Fresia; Oct 29, 2014 at 08:18 AM..
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ForeverLonelyGirl
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Default Oct 29, 2014 at 01:42 PM
  #14
My insurance company does cover md visits with a copay and specialists are a $45 copay, therapists are $40. The medication coverage is fair for my every day meds, some have high copays that are not my regular meds. I am not eligible for medicaid.
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