Therapists are turning me away saying that they can't take anymore people with my insurance.

I have good private ppo insurance but the in-network therapists I've contacted have complained that my insurer doesn't pay well per client so they limit client intake from them.

I'm getting weary and concerned about myself. I need to see someone soon, I'm trying to get help but I'm being turned away over money when I have good private insurance.

I can't hold on for much longer, feel like giving up.

What should I do?

[doyoutrustme]

Can you go out of network?

I'm betting you have Cigna, yes?

[timentimeagain]

I was about to say that too...is it cigna?

[UnderRugSwept]

United Healthcare is also terrible as far as paying therapists.

I am sorry you are having this issue, rouge.

I can go out of network but that means paying a lot up front and hoping for reimbursement.

[guilloche]

I don't know if it will help, but have you tried calling the insurance company? Personally, I'd keep a list of all the therapists that are turning you away (maybe with date/time that you contacted them), and call up the insurance company and explain what's happening.

It seems really unfair that all the in-network providers are unwilling to take new clients, which could force you out of network, which has less reimbursement (making the insurance kind of pointless).

I don't know that they can do anything, but you might want to ask:
- Can they recommend any in-network providers that are accepting clients near you (they may genuinely not know, but it's good to ask)

- Do they have any rules around providers accepting clients? Maybe I'm just mean, but I'd want to report these Ts. They're taking up space on the provider list and getting the benefits of "advertising" with the insurance company, but not fulfilling their part of the bargain. It doesn't do anybody any good if your insurance company has a list of 100 therapists in-network, but not one of them is taking new clients.

There is something that feels kind of unethical to me about this. It feels like, if a T doesn't like the reimbursement rates, they should not sign up to work with that insurance company. I'm sure this is a bad idea, but if I were in your shoes, part of me would want to sneak in to see a T, acting as if I didn't have insurance, or saying something like, "well, you're not on my insurance, so I'll just file out of network" (without telling them the company), and then after a couple months, saying "oh look at that! I didn't realize you ARE in-network after all! What great news! Guess I WILL be using my insurance!"

It sucks and is deceptive, but it's also deceptive to list yourself with an insurance company and then refuse to take people from that company, imho.

Good luck Rouge, and hang in there. I'm really sorry that it's so tough. Sadly, it's hard for a lot of us to find a good, competent therapist that we click with and that we can afford. I hope you find somebody soon...

[doyoutrustme]

Originally Posted by rouge198

I can go out of network but that means paying a lot up front and hoping got reimbursement.

Some that don't take insurance will give you a bill that you can submit for reimbursal. When that reimbursment comes in, you can pay.

This is how I do it, but I do admit I paid up front for a while before I established a therapeautic relationship. And theres the deductible. I am glad I did it though, I need therapy more than I need money. In the end it helped me get out of a hole I was in job-wise and I'm making a lot more than I did when I started.

[Petra5ed]

I also have insurance and very few take it, so I'm paying out of pocket. No one seems to care about mental health care in America.

[nottrustin]

Do you have Aetna insurance? Around here a lot of ts have stopped taken aetna because they worst reimbursement rate. Cigna is the second worse. My t is one of the few that does as she said by the time expenses are taken out they make very little.

As far as why they sign up to accept the insurance if the rate is so bad is because they currently have clients who have that insurance and don't want to turn away those people. Ply in our area several large employees offer aetna. So they accept a certain number of clients with it but they also know they need clients with better passing insurance to make a living themselves.

I agree with guilloche. Call your insurance provider and ask for a list of therapists in your area that are taking new patients. Sometimes you can access that list online. If you do call them, I would definitely mention that the providers you're calling are telling you that they aren't accepting any more patients with your insurance.

I don't have private insurance anymore, but when I did, I also had a good PPO plan. It was excellent for medical care and had good psychiatric inpatient coverage, but its payment for psychiatric outpatient care was awful.

Another option sometimes is to go through a mental health care "agency". They're not as nice to go to as a private provider. They usually don't let you choose your own therapist. I went to two different ones at times when I had the PPO, though, and got a good therapist.

Originally Posted by guilloche

I don't know if it will help, but have you tried calling the insurance company? Personally, I'd keep a list of all the therapists that are turning you away (maybe with date/time that you contacted them), and call up the insurance company and explain what's happening.

It seems really unfair that all the in-network providers are unwilling to take new clients, which could force you out of network, which has less reimbursement (making the insurance kind of pointless).

I don't know that they can do anything, but you might want to ask:
- Can they recommend any in-network providers that are accepting clients near you (they may genuinely not know, but it's good to ask)

- Do they have any rules around providers accepting clients? Maybe I'm just mean, but I'd want to report these Ts. They're taking up space on the provider list and getting the benefits of "advertising" with the insurance company, but not fulfilling their part of the bargain. It doesn't do anybody any good if your insurance company has a list of 100 therapists in-network, but not one of them is taking new clients.

There is something that feels kind of unethical to me about this. It feels like, if a T doesn't like the reimbursement rates, they should not sign up to work with that insurance company. I'm sure this is a bad idea, but if I were in your shoes, part of me would want to sneak in to see a T, acting as if I didn't have insurance, or saying something like, "well, you're not on my insurance, so I'll just file out of network" (without telling them the company), and then after a couple months, saying "oh look at that! I didn't realize you ARE in-network after all! What great news! Guess I WILL be using my insurance!"

It sucks and is deceptive, but it's also deceptive to list yourself with an insurance company and then refuse to take people from that company, imho.

Good luck Rouge, and hang in there. I'm really sorry that it's so tough. Sadly, it's hard for a lot of us to find a good, competent therapist that we click with and that we can afford. I hope you find somebody soon...

I found all of the therapists who've turned me away by calling my insurance provider a few weeks ago and asking for a list of in network providers who are currently accepting patients.

I took your advice and gave the names of the providers who've turned me away to my insurance company today. The representative I spoke with said that what the therapists are doing is wrong.

I've expanded my search for therapists to include a large near by city and am really hoping that I'll find someone because I feel like I'm in crisis because I can't seem to find the help I need.

Originally Posted by doyoutrustme

Some that don't take insurance will give you a bill that you can submit for reimbursal. When that reimbursment comes in, you can pay.

This is how I do it, but I do admit I paid up front for a while before I established a therapeautic relationship. And theres the deductible. I am glad I did it though, I need therapy more than I need money. In the end it helped me get out of a hole I was in job-wise and I'm making a lot more than I did when I started.

Unfortunately I keep happening upon therapists who want full payment at the time of service.

Originally Posted by Petra5ed

I also have insurance and very few take it, so I'm paying out of pocket. No one seems to care about mental health care in America.

You're so right, no one cares. Funny though how mental illness is the scapegoat for mass murder and other depraved behavior that's inconsistent with most MIs but no one is interested in helping those who they incorrectly identify as at the greatest risk of harming others. You would think they'd throw tons of money at us. Guess we only matter when they need to explain away the behavior of depraved criminals.

Originally Posted by nottrustin

Do you have Aetna insurance? Around here a lot of ts have stopped taken aetna because they worst reimbursement rate. Cigna is the second worse. My t is one of the few that does as she said by the time expenses are taken out they make very little.

As far as why they sign up to accept the insurance if the rate is so bad is because they currently have clients who have that insurance and don't want to turn away those people. Ply in our area several large employees offer aetna. So they accept a certain number of clients with it but they also know they need clients with better passing insurance to make a living themselves.

I don't have Aetna but insurer seems to be terrible in my area.

Thank you for helping me understand why therapists join panels they aren't satisfied with.

Originally Posted by jo_thorne

I agree with guilloche. Call your insurance provider and ask for a list of therapists in your area that are taking new patients. Sometimes you can access that list online. If you do call them, I would definitely mention that the providers you're calling are telling you that they aren't accepting any more patients with your insurance.

I don't have private insurance anymore, but when I did, I also had a good PPO plan. It was excellent for medical care and had good psychiatric inpatient coverage, but its payment for psychiatric outpatient care was awful.

Another option sometimes is to go through a mental health care "agency". They're not as nice to go to as a private provider. They usually don't let you choose your own therapist. I went to two different ones at times when I had the PPO, though, and got a good therapist.

I located the providers who've been turning me away through calling my insurer and visiting their website.

What is an agency and how to I find one?

You can try doing a web search for "mental health services YOURCOUNTYNAME county" and see what comes up. You can also usually call United Way at 211 and ask who people with no insurance in your city/county can see. Sometimes it will be a county health center, sometimes it will be a non-profit agency, and sometimes it will be a for-profit agency that contracts with the county to provide services for the uninsured.

A web search for "YOURSTATE department of health and human services mental health care" should also turn up something.

These providers may have also been listed in your insurer's list or they may not.

I hope you find something. I would think that your insurer is obligated to give you at least ONE name of a provider that is currently accepting new patients with your insurance. Otherwise, they're not exactly "providing", are they? Sounds horribly frustrating.

Originally Posted by jo_thorne

You can try doing a web search for "mental health services YOURCOUNTYNAME county" and see what comes up. You can also usually call United Way at 211 and ask who people with no insurance in your city/county can see. Sometimes it will be a county health center, sometimes it will be a non-profit agency, and sometimes it will be a for-profit agency that contracts with the county to provide services for the uninsured.

A web search for "YOURSTATE department of health and human services mental health care" should also turn up something.

These providers may have also been listed in your insurer's list or they may not.

I hope you find something. I would think that your insurer is obligated to give you at least ONE name of a provider that is currently accepting new patients with your insurance. Otherwise, they're not exactly "providing", are they? Sounds horribly frustrating.

My insurer sent me two names, each are too far from where I live. I'm not picky at all, I just need the provider to be accepting patients, less than 50 miles away, skilled in working with people like me and assertive.

[Lauliza]

I've never heard of limiting the amount of clients with a certain insurance. Either they accept it or they don't. I think what these therapists are doing is very wrong. I don't have any great advice but I do hope you get the help you need.

Originally Posted by Lauliza

I've never heard of limiting the amount of clients with a certain insurance. Either they accept it or they don't. I think what these therapists are doing is very wrong. I don't have any great advice but I do hope you get the help you need.

Thank you, Lauliza my insurer says they're doing something wrong as well. I filed a formal complaint. I still have no one to see for help.

[ThisWayOut]

Correct me if I'm wrong, but doesn't having a ppo mean you can see an out of network provider but have a higher copay? At least, that how it works with mine. I can see anyone, but if I pick someone out of network, I have to pay $45a session instead of $40. I did speak to one t who wanted payment for sessions up front, but most I had checked with only requested the copay at time of service.
Just a thought, but it might open up more options for you.

Originally Posted by ThisWayOut

Correct me if I'm wrong, but doesn't having a ppo mean you can see an out of network provider but have a higher copay? At least, that how it works with mine. I can see anyone, but if I pick someone out of network, I have to pay $45a session instead of $40. I did speak to one t who wanted payment for sessions up front, but most I had checked with only requested the copay at time of service.
Just a thought, but it might open up more options for you.

Yes, I can go out of network and my insurer pays 70% but the issue with that is that where I live therapists will take payment in full from me up front then I have to ask my insurance company for reimbursement. I would happily pay $40 or $45 for out of network but where I live the going full fee is around $125. I'm early career and won't have $125 once a week to give until I'm reimbursed by my insurer. Where I used to live ppo was how you're describing it but where I am now it means an expensive up front payment then reimbursement.

I shared an update on my other thread but want to be sure I thank everyone here too. My insurance company found a therapist for me and I saw her tonight. I also filed a grievance against the in network therapists who turned me away due to my insurer.

Thank you all for listening to me and suggesting solutions. I had been planning to give up and you all saved my life by encouraging me to keep looking for help. Thank you.

[LittleBird42]

Just an observation - I'm from Australia, and visits to T are covered (90% paid back to you) under our national Medicare that is provided to all citizens. I can't believe some of the stuff I read on here - that you are turned away due to insurance stuff. It seems to me a complete lack of duty of care. My T does get a 'kick back' from Medicare; but I've gone through some hard times and he's let me accumulate over $1000 in fees, as it wouldn't stop him treating me. Lucky, because I've improved, been able to keep a job, and have been able to pay him back!

I'm glad you've found a T. How was your first session?