[ScarletPimpernel]

My T and I knew it would happen, but it doesn't make it less painful...

My insurance has denied more sessions with my T.

I am crushed. I can't lose her. I know I "shouldn't" be so dependant on her, but I am. She's 1 of 2 people who are safe to me. My "thoughts" are definitely bad right now... But I'm trying to hold it together because she means so much to me and I don't want to put any extra pressure on her.

The only hope I have is that I do get to appeal, I do have my Pdoc's and primary's support, and my T has promised not to leave me.

This is killing me!

[Wren_]

Ugh so sorry to read this is happening ... is there anyway that you and your T can work things out so you could continue somehow paying out of pocket? I know you don't want to put extra pressure on your T but if you are really struggling with your thoughts right now please let your T know and keep talking about this with her

I hope something will work out for you

[HazelGirl]

Definitely talk to your T and see if you can work something out.

Your T will go through the appeal discussion with insurance (unless he's already had that discussion with them). Try not to panic quite yet. Generally they will go with the therapist unless you don't have a solid Axis I diagnosis.

Why did you and your T predict this would happen? Is it just routine for your insurance to automatically deny? Some are just doofuses that way. My insurance actually used to call and speak to my T every so many months, and I don't know what he said, but they never denied more sessions. (I don't think they even bother to check with him anymore after all these years. They just automatically approve.)

[ScarletPimpernel]

Originally Posted by 1914sierra

Your T will go through the appeal discussion with insurance (unless he's already had that discussion with them). Try not to panic quite yet. Generally they will go with the therapist unless you don't have a solid Axis I diagnosis.

Why did you and your T predict this would happen? Is it just routine for your insurance to automatically deny? Some are just doofuses that way. My insurance actually used to call and speak to my T every so many months, and I don't know what he said, but they never denied more sessions. (I don't think they even bother to check with him anymore after all these years. They just automatically approve.)

We both just found out about the denial today

Both me and my T are going to try to appeal. I've already fax a letter to a senator and wrote a letter to the director of the department of health care services. I also have an advocacy number I'm going to call tomorrow.

I have Medi-Cal (California's medicaid). They typically only approve 16 sessions a year for therapy for adults. Medi-Cal did give me 32 sessions... But for my disorders, that is like 1/8th the time I need. So my T and I were prepared for a denial...but we just kept hoping for the best.

My diagnoses are MDD, BPD, and GAD. I definitely meet their criteria. I also have the support of my psychiatrist and probably my primary doctor.

Medi-Cal wants me to seek assisstance through other avenues in the community. The problem is, I have. Nothing exists for me

[dark_sweetie]

((((((scarlet)))))))

I hope you can appeal successfully.

[ScarletPimpernel]

Originally Posted by tigergirl

Ugh so sorry to read this is happening ... is there anyway that you and your T can work things out so you could continue somehow paying out of pocket? I know you don't want to put extra pressure on your T but if you are really struggling with your thoughts right now please let your T know and keep talking about this with her

I hope something will work out for you

Originally Posted by HazelGirl

Definitely talk to your T and see if you can work something out.

My T basically knows how I'm feeling. I broke down on her once before over the fear of losing her, so now that the fear is more real, she realizes I'm going to be a wreak. I emailed her back right after she emailed me about the denial. I asked her for additional support and reassurance this week. She told me I can write or call her whenever I want to (she never allows that).

I'm so lucky to have her. I CAN'T LOSE HER!!!!!!

I will fight this... but if I lose, and l lose her...I'm done. This is my last attempt to save myself...and I have no more energy to fail and try again.

[RTerroni]

WOW, I know this is hard, I remember that when I went on medical assistance that I knew that I would have to say goodbye to my Therapist at the time, I know it's hard and I unfortunately will have to do the same thing to my current Therapist in 2 weeks (since she is leaving the practice I am currently at) but as I said to someone on my bi-weekly conference call tonight (which is mostly about sports broadcasting but we also discuss personal things) "All good things must come to an end".

[HazelGirl]

There's no way your T can reduce her fee or help you out in some way?

[ScarletPimpernel]

Originally Posted by HazelGirl

There's no way your T can reduce her fee or help you out in some way?

Maybe. She refuses to discuss that with me. I think she's trying to keep money out of the relationship until there's no other choice.

She knows I will pay her if I have to. But she also knows I can't afford much. I receive SSI as my only source of income. So if I paid her the normal hourly rate...I would be spending 70% of my income on therapy

I'm pretty sure we could work something out though.... I just have an extreme fear of abandonment and rejection (I have BPD...) and this is PAINFUL!!!

I know she will always be apart of my life in someway or another (until one of us dies ), but I need someone who is physically present...tangible...touchable...real.

I don't mean to whine, and I know there are still many possibilities ahead... Just wish I could avoid such situations... I guess this is a character building exercise???

[tinyrabbit]

This is so unfair - I really hope you can figure something out.

[BrokenGirl22]

No advice, but I know how you feel. I hope things work out for you.

[AllyIsHopeful]

Originally Posted by ScarletPimpernel

Maybe. She refuses to discuss that with me. I think she's trying to keep money out of the relationship until there's no other choice.

I know how this feels. My situation was I would no longer be able to use my mom's insurance due to reaching the federal age limit, so I would be without insurance for at least a month and wasn't sure if I'd be able to afford any of the plans accepted by my T. She also refused to discuss the solutions and only reassured me that she was not going anywhere.

This situation was distressing because I was really making progress and didn't want to mess it up or lose that connection. But it did get better and everything worked out just fine in the end. You will find a solution and you're T will help you.

I'm sorry you are experiencing this though because it's a crummy feeling.

[Wren_]

My T basically knows how I'm feeling. I broke down on her once before over the fear of losing her, so now that the fear is more real, she realizes I'm going to be a wreak. I emailed her back right after she emailed me about the denial. I asked her for additional support and reassurance this week. She told me I can write or call her whenever I want to (she never allows that).

I'm so lucky to have her. I CAN'T LOSE HER!!!!!!

I will fight this... but if I lose, and l lose her...I'm done. This is my last attempt to save myself...and I have no more energy to fail and try again.

It really sounds like your T is doing her best to make sure you know she is there with you as much as she can be and wants something to work out so that you can keep working together ... and that her plan isn't to lose you ... I'm glad she is giving you the extra support right now and hope that you can both keep exploring ways to make this work out somehow

I can also hear how scared you are ... and am glad you are going to keep fighting to keep your T

[ScarletPimpernel]

Thank you all for all the support!

I actually have a positive update!!!

I contacted an advocacy group and they took on my case and they believe they have enough documentation to win my case! In fact, they contacted my insurance and got them to continue to pay for sessions until the decision about the appeal is made. So I at least have my T for a little longer...YAY!!!!!!!!!!!!!

Still scared about everything, but at least there is definitely a light at the end of the tunnel.

Oh, that's a relief. Keeping my fingers crossed for a successful appeal.

[Jordy]

that's great news! I'm so happy for you and hope everything will work out...

When reading threads like this I am so grateful for the health system in my country as I will never have this situation.