[franki_j]

OK so my T is very expensive ($225/session) and doesn't take insurance, but she is very good at what she does and a researcher at a top university. The only way I am able to afford her is that my parents help me out, b/c they happen to have money. However, I myself am not rich at all. I am in grad school and living off student loans.
So for example, my T's office is in a pretty posh place, and I am pretty sure all her other clients live around the area (based on something she said once), whereas I commute more than an hour to see her. And she knows that I don't have a lot of money.
Anyways, I asked her for referrals for pdocs so I could get a scrip for Ambien, b/c I was going to someone else at Student Health who was awful. So she gave me the names of a couple pdocs whom she works with. I called two of them, one of whom didn't call me back. The second one I called (I had to mention my T's name, I think that's why she called me back) told me she charged $400/visit and didn't take insurance, then immediately asked me when I would like an appointment. I was so taken aback that I scheduled an appt, then had to call 20 mins. later and say I couldn't go b/c I couldn't afford it.
So I am feeling a little stupid now. Like, why would she give me the names of all these doctors I can't afford? I mean, I should have specified that I needed someone that takes my dad's insurance plan, but it still kind of bothered me, b/c she knows I get stressed about money. I do realize that she has a lot of wealthy clients who can probably afford to pay $400 per session, and so I guess she just referred me to those pdocs without thinking about my financial situation. I guess it just got me thinking, "Wow, most of T's clients are probably super wealthy," and also I wonder if she just thinks my parents will pay for my pdoc as well (they won't). I don't know, I guess it just bothered me, and plus, all my friends don't really have a lot of money, so I forget there are people out there that do have that kind of money. And some of those people are T's clients. I feel liek sometimes she forgets that I don't have a lot of money, but she also knows that I don't ask for any additional help from my parents. What do you all think? Am I just being too sensitive?

[unaluna]

The rich really are different. effin a, $400???!!! For effin ambien??? Pardonnez my effrançais!

[Dr.Muffin]

honestly, im not sure she really thought about it. all therapists have friends and colleagues in the field (and in related fields) to whom they refer. i bet her concern was referring you to someone good and the money didnt even cross her mind.

that could just be me projecting though! i know three psychiatrists who are really good at what they do and i would refer to them in a second....i have NO idea what they charge or whether or not they take insurance.

[Kacey2]

Can you see a family practice doctor for about $150.00 for a general appointment? I do agree that $400 is quite ridiculous to pay out of pocket. I hope you can find help that is affordable. It does seem like there is a whole other world of privilege out there. Just a word of caution and this is solely my experience. Please be careful with ambien. I have been on it continuously for 4 years and am addicted now. I can not sleep even a wink without it. I even have to take it to fall asleep for naps. I hope that you can get help and sleep soon!

[beautiful.mess]

Yeah.....uh, $400 is a lot. Esp if you just need a 'script for Ambien. That's just D-U-M-B they would charge that. No, you're not being overly sensitive.

Can she maybe refer you to someone who accepts insurance? Or maybe someone who isn't so off-the-charts expensive?

There is no shame in not having the money to pay for something you cannot afford, especially if that certain something is overpriced to begin with, ESPECIALLY if she knows you don't have money coming out the wazoo. But then again, if she DID in fact forget that point, I would not hesitate to kindly offer her a gentle reminder.

[beautiful.mess]

Originally Posted by Kacey2

Can you see a family practice doctor for about $150.00 for a general appointment? I do agree that $400 is quite ridiculous to pay out of pocket. I hope you can find help that is affordable. It does seem like there is a whole other world of privilege out there. Just a word of caution and this is solely my experience. Please be careful with ambien. I have been on it continuously for 4 years and am addicted now. I can not sleep even a wink without it. I even have to take it to fall asleep for naps. I hope that you can get help and sleep soon!

This is a good suggestion too.

[likewater]

I agree that she must not have realized the charge. Let her know , so ypu can get a more apropriate referral. I' m really poor, and this sort of thing happens to me all the time. No one realizes what they are doing to me. Prescribing me meds i can' t afford or drs i can' t afford until i find out and go back or call and tell them.

[franki_j]

Thanks guys! Now I don't feel so silly. Yeah, I will definetely let her know, esp. b/c she is going to ask about it next session, so I am gonna have to be like "Uuuh, no way i can afford to shell out $400!" lol. And yeah, I realize Ambien can be addicting, and I have a history of getting addicted to prescription pills, so maybe it is good I can learn to sleep without it.
I know that when I go to her office I see women coming out carrying Louis Vuitton or Longchamp bags or one time I saw a guy in a business suit, but I guess I didn't really think about it until now. Sometimes though I like that I am the one client she sees that doesn't have a lot of money b/c I think that my experiences are a lot different. Like I'll say something sometimes and i think she will get surprised but try and not show it lol. I really like her though, I don't think she is pretentious at all. Now I am wondering how her super wealthy, able to afford $400 medication, clients are like in session lol.

[Dr.Muffin]

the other thing you can do is get a provider list from the insurance company and see if you can find a psychiatrist on there. ive had clients print out that list and bring it in to see if i knew any of the names...

[nannypat]

Originally Posted by Dr.Muffin

the other thing you can do is get a provider list from the insurance company and see if you can find a psychiatrist on there. ive had clients print out that list and bring it in to see if i knew any of the names...

This is what I had to do. There is no way I can see anyone that doesn't take my insurance which I pay big bucks for every month. There is a tendency starting around here for some not to take insurance. They won't be seeing me. I'm just making it now.

Actually, for an initial appointment with a psychiatrist, at least in this neck of the country, the usual rate is around $375, so the $400 doesn't actually seem all that out of line for an initial appointment. But if all you are needing is something for sleep, a family doctor should be able to help you for much, much less. If you really want to see a psychiatrist though, you need to get your parents' provider list and work off of that. Your T can probably make some recommendation from that list. If not, it will at least narrow it down a bit for you.

[unaluna]

In grad school - aren't there student health services available?

just because someone dresses well doesn't mean they are wealthy...ya know you can buy excellent names at thrift shops.

don't worry about the $$ difference. everyone has issues...i have seen dr's where i was the poorest & where i was among the richest...either way i wore what i wore. jeans, shorts, my same old crappy shirts etc. i am who i am...don't like it well then sucks to be you. i am not worried about what the other people think...they don't like it, don't look.

those "rich" people have issues too...some much worse than mine...& $$ doesn't buy you ethics or values or standards..it just buys you things.
i lost a friend who i knew for over 6 years & i counted as a good one because i challenged her on her crappy treatment of another friend...that friend wasn't perky. i dared to question that. i questioned why her issues made everyone else's views wrong. she decided i wasn't worth being friends with...& did it in a classless manner...they have more $$ than god...doesn't mean that they don't have issues...(she could keep a t busy for a loooong time) just $$.

don't fret over the $$ issue. go to a gp...ask for a script there or search the parents plan book. t's forget or don't know who charges what..no one keeps track of another dr's charges...

good luck!

stumpy

[Dr.Muffin]

Originally Posted by hankster

In grad school - aren't there student health services available?

when i was in grad school, my student health center was crap. they were only useful if i had, say, a sinus infection.

and those of us in the doctoral program couldnt go to the counseling center because we were the damn interns there!

we got screwed.

[franki_j]

Originally Posted by Dr.Muffin

when i was in grad school, my student health center was crap. they were only useful if i had, say, a sinus infection.

and those of us in the doctoral program couldnt go to the counseling center because we were the damn interns there!

we got screwed.

Exactly! The woman at Student Health who was prescribing me Ambien tried to get me to see a different therapist, then told me I was driving people away with my stress, THEN tried to prescribe me Klonopin, which I kept telling her repeatedly I didn't want. So I refuse to go back to Student Health ever again.

[likewater]

You are funny wondering what wealthy people talk about in therapy. Probably issues are the same, but they don' t have the added stress of not being able to pay for treatment or meds. Also maybe their always afraid of losing their money or whether their friends really like them for their personalities or just for their money. Or maybe they can' t really afford those accesdories. And they' re living beyond their means. Like the wife is thousands of dollars in debt and doesnt know how to tell husband. Yeah. And the guy with the business suit and briefcase lost his job, but hasnt told anyone not even his T. Their lives aren' t that happy - perfect or they wouldn' t be going to therapy.

[franki_j]

I'm not saying that people with money don't have problems. I'm just saying that going to my T's office and hearing how much the Pdoc was charging, I am reminded about socioeconomic differences in our society and that there are people that have a lot of money. And I think that based on things like socioeconomic status, people's problems do tend to vary.
I live in a city where the well-off and not-so-well off areas are pretty stratified, so when I go to my T's office, which is in a very well-off area, the differences b/w my neighborhood (mostly Latino immigrant population) and hers are very apparent to me. And I guess the whole thing with the pdoc's rate made me think about that even more.

[Elana05]

Hi franki,

I can relate to your post because I worry about the money too. I remember having to tell prospective T's that I just couldn't afford it. I went back and forth trying to decide if I should see a psychopharm. or just go to my doctor for meds. In the end I decided on the psychopharm. because I knew he would know a lot more than my regular GP and be able to tailor meds to my needs based on what was or wasn't working over time. I just don't think the GP's know much about antidepressant medications / sleep meds etc. $400 does seem awfully high - I consider $200 per session to be the upper limit. Maybe that is just for a 1st appointment, but still...
Maybe you might want to be honest with your T and just explain that you can't afford that kind of fee and can she recommend anyone else. My phychopharm. is also in a posh neighborhood and he charges $150, so I am sure you can find someone in that price-range. (Are you in the States?) Maybe you can find someone who advertises with Psychology Today Online - I think they have a pretty big database. Good luck.

If you're just looking for Ambien, couldn't you go to a physician who accepts your dad's insurance? Do you have a regular physician? I get alprazolam from my physician, and he prescribed it long before I went into therapy. Seems like you would only need to see a pdoc if they were going to evaluate you for appropriate meds. Just my thoughts. Hope this all works out for you.

[likewater]

Yeah. Therapista want to refer us to psychiatrist for meds, but its cheaper for me to get them from family dr. Hopefully that could work