[embarassed]

Hello,
I recently got a new job so now I'm trying to decide which health insurance plan to go with. I have the option of either choosing a PPO, EPO, or an HMO/POS plan. I'm thinking of choosing the HMO/POS plan. I've heard horror stories about HMOs but the PPO plan offered by employer doesn't seem to offer the greatest mental health benefits either. I was wondering which option was better if I want to see a therapist and use other mental health services. I've been taking medications but I definitely need to see a therapist too. Does anyone have any advice on which type of plan to choose if I want decent mental health coverage? Thanks.

[(JD)]

That's exactly why they offer more than one plan. Some people need some benefits while other people need other benefits. To try and put everything into one plan makes it very expensive and makes people pay for things they don't think they need. Look carefully at the offerings, co-pays and deductibles etc. A PPO requires the health care providers to be part of the plan usually, but is generally better overall coverage even if you go out of plan. Yet, as you noted, it might lack in mental health care. My PPO doesn't require any referral from another doctor.

The POS is a point of service plan. It does generally require a main doctor who you have to see for each referral you need (so it might be more money for those visits.) These doctors might help the bulk of patients and waiting might be a real issue (as well as booking in for an appointment.) While that probably won't be an issue with mental health professionals, it will be regarding physical health care.

I suggest you talk to your regular MD's office person who handles claims, and find out what they know of your particular plans of choice. You might also call the therapist's office of where you think you will go, and see what they say about the options. It could be it won't matter in the long run.

Best wishes.

[Perna]

The PPO is probably most expensive but also probably has the most flexibility as to who will honor it. You get to choose who you want as a doctor rather than having to fit into a plan or choose from an approved list. I would read the sections in the three plans as to what they cover for psychotherapy (often there's a "separate" book for that, ask your plans administrator at work) and their list of doctors, etc. It could come down to how big an area you live in; if you're in the "country" finding a therapist you like and can work with could be harder if there's not many to choose from one a list. If you're in a larger metropolitan area though, one of the less expensive plans might do fine.

[free2beme]

[embarassed]