MytTherapist dropped my insurance plan

I've been seeing my therapist for exactly two years. She recently opted out of medicare so that another client could get reimbursed by her insurance, which resulted in her being dropped from MY insurance, bc she has to accept medicare in order to see me.

Basically they made a mistake and didn't notice what she had done for a year, but now they noticed and called to tell her she cant see any of her client with my insurance anymore.

So she EMAILED me and basically said;

"Sorry I made a mistake in opting out of your insurance, I wish I could have seen you in person to tell you, but unfortunately that's not possible, if you want to continue with me it will be $120 a session. Think about it and let me know."

But I'm on SSDI- there's no way I could begin to afford $120 a session once a week (and I've been going twice a week for the two years I've been seeing her.)

Is this typical for a therapist to do? Bump the price up completely out of reach for long term clients and say pay this or goodbye? I feel like shes doing this bc she knows I cant pay it, and its a way to get rid of me.

I don't know what to do.

I'm sorry, I think this is utterly appalling behaviour on her part.

Oh I am so sorry this is happening to you. I wouldn't take it personal. Doctors make mistakes like this all the time. I know it happened to me once with a Doctor the office personal didn't renew the doctor's contract with the ins I had, so they basically told me the same thing it would be a 200 dollar office visit. There was no way I could pay. Sorry but I think you will just have to find a T that takes your ins. It's sad because you feel like you have to start all over. We will still be here for you no matter what. Hope that makes you feel a bit better, Sorry it is all I can do. I wish you the best.

Could have at least called!

The insurance maze is so confusing right now that these mistakes get made and they are not in any way personal. Still, it's a huge blow to be faced with losing your therapist after two years. One would very naturally hope for something more personal than an email.

Seeing there's not anything much you can do to change this situation, the most important thing you can do is start searching for a new therapist. If I was in this situation, I'd call my therapist's office and civilly ask them if they could provide me with a list of three or four other therapists who handle my particular kind of problem. This could save you a lot of time.

If they won't do that, well, maybe you're better off with a new therapist even if you have to struggle to find the right one. But even if they do help you, it's okay to start with a new therapist. Sometimes we just want to stay in our comfort zone with someone we feel safe with and when that happens we can stop making progress. Moving on to a new therapist would shake me up and make me feel uncomfortable for a while, but maybe it would trigger progress.

A few years ago, my doc suddenly decided to retire. Suddenly. No referrals. I received a form letter in the mail. It felt devastating. I did, fortunately, get to go in for an informal chat and we all ended up with hugs and a little teary eyed. The doc and his receptionist felt pretty bad about the whole thing, too.

It took three months to find someone new and that turned out a lot better than I thought it would. A completely new approach helped me. Explaining myself again made me really take a look at myself in a new way. While the new doc and I figured each other out, we had conflict for about a month, didn't feel comfortable at all. But, now, it's a relationship with a lot of trust. That taught me that getting kicked out into the cold world can be a good thing.

I sometimes see the retired doc and his receptionist around town and we have friendly conversations. They look so much better, ten years younger. It made me realize how stressed they'd been about things. The receptionist told me ALL the stress had come from dealing with insurance companies and the problem of some patients' insurance not covering that particular practice. Makes me not want to feel anger at any practice or person that makes mistakes with insurance coverage.

Hang in there. Hope you find a good therapist quickly.

So sorry, InRealLife. Alas, some professionals' offices are no longer accepting Medicare patients, since Medicare does not reimburse very well. (I think I have it right that the problem is that Medicare is your insurance.)I agree, though, that your therapist should have handled this matter better, since the two of you had worked together for so long. At least she could have recommended some new therapists if you couldn't afford her at her regular fee of $120 a session. (And how many people could?!)

That said, I don't think that would be the way she would try to get rid of a patient. You just got caught up in her boo-boo. Insurance is even confusing for them.

As Snake Charmer said, these things can work out for the best. A new therapist might even have a new approach which will be better than what the old one was using.

What a buzzard. I'd email her and tell her exactly how you feel.

Personally, I would have offered each of the effected clients a free or very reduced cost session to explain the problem and offer them a list of referrals. She could have also offered clients the option of paying whatever she was being reimbursed by Medicaid. Medicaid only pays a negotiated portion to the therapist's usually fee.

IMHO, she handled the situation very unprofessionally.

liz, I was thinking she should have offered a reduced rate, too, at least to help with closure/termination and to offer some suggestions for other therapists.

InRealLife, I hope your next therapist will have a better handle on how to be a professional.

I had a few sessions covered by my university's insurance plan. However, I found out I had one left between my psychiatrist and psychologist for the next several months. I would have to start paying (half or less the regular cost, but financially we're not doing so good). Anyway, my psychologist told me that the last covered session wouldn't be our last. In fact, she saw me for free so we could wrap up and figure out what I would do (I am now seeing a therapist for less than $10 per session). I hadn't seen her for that long either (an appointment less than once a month for less than a year).

In short, as lizardlady said, I think a free or reduced rate session should have been offered. Maybe not a full session, maybe less than half an hour, but at least time to wrap things up and see what options you have.

It sounds like you go to a clinic rather than a private practice? If that is the case, I would make an appointment with the clinic director and state your case and see if some accommodation can be made for you so you can continue seeing your therapist. The rate is what is charged if you do not have insurance they use and some people pay that out-of-pocket because they do not have or want to use their insurance. It is very unfortunate that she cannot see you in person to discuss the problem but it sounds like she is constrained by her clinic's/others' rules about her job. She may not have personally decided to drop Medicare, as another person has said, who-pays-for-what and how is rapidly changing and Medicare is often being dropped by other mental health therapists/clinics too.

It has taken a grueling two years just to begin to trust this T...it would be next to impossible with anyone else...I can be a lot to deal with, and I simply don't trust easily. I've never had anything more than a superficial relationship with all my other T's. I couldn't bear to start over, I'd rather just not go.

But I called my insurance. Took two phone calls and they agreed to do whatever they need in order to keep paying my therapist, that they dont want an interruption in my care. So they are really stepping up. But my THERAPIST is another matter. I feel like she threw me under the bus, and I feel betrayed and I dont know if I want to keep seeing her now. I cant even explain the sense of betrayal I'm feeling.

No, she is private practice and she makes her own rates and sets her own rules/policies. She did the medicare opt out by herself.

THATS WHAT I WAS THINKING, TOO. Her rate is $120, but my insurance paid her $95 a session on 2013, but this year dropped to $75 a session.

I don't understand why she couldn't at least keep the rate at $75, but no, she was very adamant that I pay the $120 and if I couldn't, then to let her know when I could afford it and shed make me an appointment.

It just feels very cold to me.

At any rate my insurance has a loophole to continue paying her, but I feel so betrayed by her right now.

I expected something like this, and I'm very confused why she didn't. I meet with her today to discuss it, though. I want to hear her explanation before I tell her my insurance will still pay her.

Since when do other insurance companies say they won't be involved with a provider that accepts medicare? That in itself is insane.....what does it matter to them if a provider offers services to someone on medicare or any other insurance coverage.....they should only be concerned about whether the provider accepts their coverage or not.

What it sounds to me like your provider didn't want to continue receiving the much reduces rates that medicare pays for coverage & that was probably more the reason why they dropped medicare. I had one private T where I lived before that dropped medicare also because she needed the higher rate coverage to live on after her divorce & dropped all the medicare patients/clients who chose NOT to pay the higher rate that she wanted.....she wasn't that great in the first place, so it didn't really matter to me.

However, my last psychologist & pdoc in Calif before I left chose which of their clients on medicare they were willing to continue with (those who had been with them for more than a certain number of years)....but wouldn't take any NEW patients on medicare......that sounded like the most reasonable way IMO of handling it.

So it does come down to the fact that the T does make the choices. I understand how you feel about her also.....if she would end up being willing to work with you & accept medicare for your coverage. I know that medicare refuses to pay over a certain reduced amount & then we pay an even smaller reduced amount lower than that, so even paying the reduced amount that medicare pays would be a problem IMO.

I don't think that the T's choices are specifically against YOU....but I think they are made for her own personal benefit & don't take her clients into consideration.....no one in specific, but any client who falls within that situation....& you just happened to be one of those who did.

I know it stinks.....& I know the feeling of not being able to find anyone else....but I know from my own experience that this last psychologist I found is one of the best in all the 20 years.....so we never know.....& this one in in a community mental health provider group which I wouldn't have even considered in Calif....but much better than any private provider...both her & my DBT group leader are better than any of the other psychologists I have ever had......have been so excited to learn what they have to offer.....so you never know what might be out there even if you feel you are better off with none.

Eskie, I am on SSI-I have medicare/medi-cal. My insurance company specifically contracts with medicare/medi-cal. When my t opted out of accepting medicare, she became ineligible to be a provider for an insurance company that exclusively handles medicare/medi-cal.

Yes she has definitely been upset by the reduced fees of medicare.medi-cal and has refused to accept any new patients with that insurance, but she only has 5 clients with this insurance, and most of them have cash co-pays (I'm the only one who doesnt.)

I just think its interesting..on monday she told me if I stopped coming to therapy I would die, that I would self destruct.

On the following Saturday she sends me an email that basically says "sorry I can never see you again unless you cough up $120, $45 more than what I've been accepting from your insurance. I understand it will be next to impossible for you to come up with this, and I'm so sorry it had to happen to this way."

It just feels very cold and clinical very uncaring, very..money hungry, when she never really struck me that way before.

UGH.....that sounds manipulative to me. I think out of spite....I would find another BETTER T just to PROVE HER WRONG. I hate it when people do things like that to me. Like you....it would destroy my trust in them that's for sure.....& I would definitely make a point of telling her what I think....but then that's always been something I do has been to tell people what I think when I feel hurt by them.

I definitely understand why you feel the way you feel.....I know that I would feel the same way & would never (even if I had the money) pay someone like that for any kind of treatment. She would have to do a lot of explaining to talk her way out of the feelings that kind of situation would create & then I doubt that I would ever trust her again.