[rainbow8]

I got to my session and the first thing T says is that she talked to my insurance and that I have 6 more sessions until January!!! I thought they changed it so there is an unlimited number of sessions, but apparently not. This is Blue Cross/Blue Shield. They gave me 10 more sessions, but that started 4 weeks ago.

You can imagine that didn't make me feel too good. T. said we'd work it out. Ha! Not with my H so much against therapy. She said to call insurance and see what I can find out.

I cried when I got to my car and then called. I got a slightly more optimistic answer. T has to pre cert, like she did for the extra 10 sessions and insurance gets to approve or deny it. They wouldn't tell me on what grounds they would do so. I know T tried to make it sound bad. Said PTSD which she really believes I have, and depression.

So, I called her AND emailed already with my news. I feel a little better but it's still a shock that they don't cover mental health sessions indefinitely like I thought I read somewhere.

As far as my session, no hand holding, but we talked about it, and my past, and how my wires get crossed. I felt a little distant, maybe because of the insurance problem. She thought EMDR next time would be a good idea. I felt good that I was perfectly honest with her, though! I told her exactly how I felt last session, and no, she won't hold me. Hugs when I leave, or holding my hands, are okay, though I didn't want a hug. So at least I know what her boundaries are.

[zooropa]

that would definitely have thrown me off, too, rainbow.
I thought like you did that insurance companies couldn't limit mental health treatment like that, but maybe it varies depending on the insurance or by state or something?

rainbow depending on where you live, you may be covered under the mental health parity law. It says the insurance must pay the same for mental health as for physical issues. If your T says you are depressed, that's considered a biologically based condition, and should be paid the same way as any physical illness.
Good luck with this.

[WePow]

Rainbow, my BCBS also has a 10 session pre-approval req. I hate it. But I also have PTSD and DID, so my T has not yet had a problem with that part - except when insurance didn't do things right and that messed up some stuff that we worked out. Anyway, so far things are still OK. I have only 5 sessions left before they make him re-app again. And T was thinking of going to 2 sessions per week again since I was feeling too SU this past 5 days and called him 3 times. Hope my experience helps put your mind at ease a bit.

Mental health parity is not as clear cut as it sounds, sadly. I dealt with this last year when my insurance company would not cover 2 therapy visits a week, but would approve 1. Insurance companies are definitely still allowed to limit mental health coverage under lots of circumstances!

Rainbow, luckily it sounds like your T just needs to deal with calling BCBS on her end and that should solve the issue. I am sorry this is so stressful...I know I was a sobbing, tearful mess last year when my insurance was a wreck.

For anyone else interested, www.nami.org is a good place to start to find more info...you can find a number for your local nami organization. The person at mine was very nice and helpful last year when I called re: mental health parity info.

[googley]

Rainbow- It depends on a couple of things. First, it comes into affect when the policy terms are re-negotiated. Also if you are insured under private insurance, this does not affect you. The other ways it may not affect you is if you are getting insurance from your employer and they have less than 50 employees or it increases cost more than 1%. URGH!!!! That really pisses me off. So these are the situations where you may not actually get the parity law applied to your situation.

I hope that this all gets sorted out for you and you are able to get the sessions you need.

[sunrise]

Rainbow, good for you for not letting the insurance thing ruin your session. I can see it could throw things off a lot. I'm glad your T raised that issue first so then you could get past it and do some good work. My T also likes to do the business type things first so then the rest of the session is for the sharing and feeling, and doesn't have to be interrupted at the end by concerns over insurance and payment, etc. (I always hand him his check at the beginning of the session.)

Originally Posted by rainbow8

I felt good that I was perfectly honest with her

That must feel so good. How quickly you have gotten to this point with your T.

[elliemay]

and the real kicker is - you are paying for that session to talk about how to pay for the sessions.

I try to talk to my T about insurance stuff on the phone and keep the session sort of "money free".

It's just too stressful.

BCBS is especially stingy about mental health.

[peaches100]

Hi Rainbow,

Don't worry about Blue Cross/Blue Shield. I have it too, and they just issue sessions in groups of 10. As long as you still need therapy and your t can justify it, BCBS should continue to approve your sessions. I've had weekly sessions all year with BCBS. My t just has to resubmit some info and a new request every time our sessions run out. I keep track and usually remind my t when we only have 2 or 3 left, so she can get the request in, because BCBS takes about 2 weeks to respond.

I'm glad you were able to talk so honestly with your t! It's good too that she let you know what kind of touch she permits and where her boundaries are. She seems like such a straighforward, caring person.

[rainbow8]

Thanks for all the responses.

zoo, apparently BCBS can do what it likes.

Calista, I remember that information from a past thread about the parity laws, but I'm not sure if it applies in my area or not. My insurance says they do not cover unlimited sessions. Thanks for bringing it to my attention again, though.

WePow, yes it's 10 sessions at a time after the first 20. I just hope the person I talked to was correct, and not the one T talked to who said "no more than 6" until January. Since you and Peaches also have BCBS, I feel hopeful about it now, as long as they accept the diagnoses my T has given.

traction, I'm sorry you had a hard time with insurance too. Thanks for the information.

googley, thank you. I hope it gets worked out too!

sunrise, I would have rather T brought it up at the end because I think it affected me adversely. I thought I had only 6 sessions left, and I had to put that awful thought aside so I wouldn't waste the whole session! You're right that I managed to do that. I've been honest with T from day 1, but some things I'm telling her that I wasn't going to.

elliemay, my T did let me stay 15 minutes extra to make up for the time we spent talking about insurance. I'm not sure if she did that consciously or not, but it was nice.

peaches, I know you've had concerns about the insurance too, at times, so I feel relieved that you also have BCBS and it worked out. I assume my T misunderstood or talked to someone who was uninformed about the policy. The woman I talked to basically said what you did.

I'm still depressed but I don't think it's about the insurance. I started another thread about it.

[Amazonmom]

My insurance will require a status update every 20 sessions. Since I am bipolar and PTSD it is easy for me to get approved. My employer before Mental Health Parity would only pay for 25 sessions a year no matter what you had. Now I guess people with mental health issues are running into the same issues people with physical health issues have with insurance.