[Martina]

I got a new job - which I'm GREATFUL for - don't get me wrong. But the insurance that came with it has been anything BUT a benefit.

My psych nurse - and all psych nurses, for that matter, are not in-network. But they allowed me to see her out-of-network and just pay 100% while I was meeting my deductible - no difference anyways while meeting deductible.

When I talked to the insurance behavioral health people in April, they gave me the name of a psychiatrist who WAS in-network.

I just called today to get pre-authorized to get an appointment with him.

Guess what. The lady on the phone today tells me......HE'S NOT IN-NETWORK. And she's not even sure if there IS a psychiatrist in my town that is in network. Period.

She'll have to check on it and "call me back later."

Why is it so much of a mess every time I try to get help for this illness? And never for medical? When I very first tried to get help for my mental crap back in 2006, I went through so much $#%&)# it was unbearable, from the insurance company, from the bad therapists, it was insane. How do they expect you to get help when you have to jump through so many hoops just to get it?

Oh, and that's just for the meds. They're forcing me to split meds from therapy. I then called my EAP people (Employee Assistance Program) - a totally different company - and they sent me to VOICEMAIL. At 11:30 in the morning on a Tuesday!! Lovely. At least they assessed me first and I wasn't in crisis. But still.

Any of you had issues with insurance?

[shaggy dog]

Hi Martina, I'm sorry you are having so much difficulty getting the help you deserve. I hope that when the lady on the phone gets back to you she has good information. It sounds like you could really use a break. Hang in there, shaggy

If you keep on getting the runaround, I would seriously consider filing a complaint with the insurance commissioner.

[Martina]

Oh, this is funny. So, I call them back, and they refer me to a different psychiatrist, telling me that he is now the ONE AND ONLY psychiatrist in-network in my area.

HE IS A CHILD PSYCHIATRIST. Who, they say, also sees adults. But I'm sorry, if you have an adult medical issue, DO YOU SEE A PEDIATRICIAN FOR IT? Not only that, but he is the ONLY child psychiatrist in town, and booked solid until OCTOBER.

I am just DONE.

Then the insurance calls back - a different lady this time - and tells me that the first psychiatrist, who they told me was NOT in network, well, now I can see him. Ok....what does that mean. First I couldn't, now I can? I hadn't even told them yet that this other guy was a child psychiatrist.

It's just a huge run-around.

I don't know what to do. Part of me is just DONE dealing with the insurance and wants to just give up, and pay the extra out-of-network prices to see my psych nurse. But part of me just can't afford that!

I did call the other psychiatrist, not the child one but the one they disallowed and then allowed, and left a message. In his voicemail he said he returns calls after 6:00 PM. We'll see how far out he's booked.

Why is it always such a mess?

I went through similar hassles the first time I tried to get help back in 2006, and it was BECAUSE of the hassles that I gave up on getting help at all. Took me 2 years to force myself back to treatment, and that nearly killed me - had three suicide attempts in one summer before I got stabilized.

If people had to jump through this many hoops to get medical care, there would be uproars. Why is it okay for us?

I'm failing myself. In the hospital I made it my mission to do away with all this crap. To create a system that is easier. LONG story....I had this huge dream. I've not followed through on that dream. Someday.

[tears_of_a_clown]

I don't believe that insurance companies have any particular interest in you using services that they will have to pay for. Many insurance companies can't establish networks in many areas because they are not willing to pay anything close to what would be a UCR for the service. It is one of the most horrible aspects of our mental health "system." Good luck navigating it, I hope you have better success than I.

Originally Posted by Martina

I got a new job - which I'm GREATFUL for - don't get me wrong. But the insurance that came with it has been anything BUT a benefit.

My psych nurse - and all psych nurses, for that matter, are not in-network. But they allowed me to see her out-of-network and just pay 100% while I was meeting my deductible - no difference anyways while meeting deductible.

When I talked to the insurance behavioral health people in April, they gave me the name of a psychiatrist who WAS in-network.

I just called today to get pre-authorized to get an appointment with him.

Guess what. The lady on the phone today tells me......HE'S NOT IN-NETWORK. And she's not even sure if there IS a psychiatrist in my town that is in network. Period.

She'll have to check on it and "call me back later."

Why is it so much of a mess every time I try to get help for this illness? And never for medical? When I very first tried to get help for my mental crap back in 2006, I went through so much $#%&)# it was unbearable, from the insurance company, from the bad therapists, it was insane. How do they expect you to get help when you have to jump through so many hoops just to get it?

Oh, and that's just for the meds. They're forcing me to split meds from therapy. I then called my EAP people (Employee Assistance Program) - a totally different company - and they sent me to VOICEMAIL. At 11:30 in the morning on a Tuesday!! Lovely. At least they assessed me first and I wasn't in crisis. But still.

Any of you had issues with insurance?

[Perna]

What a crummy medical plan and/or small town? Can you complain to the company owners, suggest they look around for a better plan? I'm in a good metropolitan area so never had that problem of too few practitioners (other than dermatologist who are too busy doing botox because it makes more money for them than serious skin problems).

I would see if you could find a psychiatrist (do you have hospitals nearby, especially a university teaching one?) and then see if you could ram them down the idiot insurance's throat?

[AAAAA]

I’m so sorry, dealing with insurance companies is the worst! Our insurance used to be so good, and now it’s just crap. Like I have any control over the anesthesiologist, we live in a very small area, there is ONE! My doctor used to be excellent in dealing with them, now he cannot even get through to speak to a medical professional on staff. He’s dealing with “the high school drop out that answers the phone that doesn’t know the difference between an aspirin and an ativan.” He’s so fed up that he’s just said “I’m sorry, but this is something you’re going to have to appeal on your own.”

The thing I’ve learned in the past five years is that you just have to keep jumping through the hoops, the insurance companies are just too big for the average Joe to fight with. There isn’t even an option for us to speak to a specialist anymore. You call the 800 number, leave a message and if they’re inclined, they’ll send you the paperwork to appeal their decision.

i briefly had HMOs at one point. all i can say is thank God i wasn't sick then! they were the absolute worst. if there is any possible way you can buy your own private insurance i'd do it--even if you have to sacrifice bigtime elsewhere. having options of doctors is a necessity if you have serious health issues.