insurance problems

[GardenOfSimple]

We (I saw "we" because I'm only seventeen, and my mom deals with all that stuff) were having problems with the insurance covering therapy sessions. My coverage would only get us all the way through June. They I'd have ONE session from July through December for this year. (My mom had said that if she had to, she'd pay for it, but I told her I wouldn't go then -- she told me that I'd have to be either i/p or o/p then. grrr... ) But, the insurance ended up granting me more sessions. This is more than what the plan allows. They did this last year, too. I guess the reason is because they say its "medically necessary." But, it was a hassle to be able to get more sessions. I feel guilty that my mom has to go through this. And, I'm also not so sure HOW many sessions I have left. I had suggested to my mom that I go every other week, but she said that Mindy (t) didn't think I was ready for that. So, I don't know what's gonna happen.

But, I also wanted to know how much most insurances cover? I think some people say that we have good insurance, but others say otherwise. I don't think I really know what I'm talking about, huh???

Oh... also, with them saying its medically necessary, that means that they HAVE to cover it???? (Just thought about that now...) Or is that not true? Could they just refuse to cover it??? I guess I just don't want my parents to have to pay for my sessions. They pay ten dollars now per session, which isn't bad (I think... again I don't know...)

So... yeah....
Sorry for BORING you...
Lotsa :love,

[chablis]

your mom is to be praised and congradulated on her work with the insurance co!!!!!!!!! my in surance covers a total of ******** visits a year, those visits split between an MD and a counselor, not an eating disorder specialist, i have to pay for myself.. big thanks for fighting the system, please thank your mom chablis

[GardenOfSimple]

the numbers thing, for one....
but also... I know that my md sessions are seperate from the t sessions in coverage. We haven't had trouble with the md stuff (to my knowledge... but my mom usually doesn't tell me about insurance stuff... I kinda overheard this time...). But, I only go once a month, anyway for that...
oh... and I meant that I suggested that I go only every other week... not every week. (that's what Mindy said she doesn't think I'm ready for.)

[isobel]

jamie~
a ten dollar payment for your therapist from you insurance company is actually really reasonable. i used to pay thirty five and then my insurance changed and i was suppose to pay fifty five but my t lowered her rates for me. i would assume the regular session price is probably similar because we live in the same area more or less. most t's charge between ninety and a hundred dollars an hour and more if you are seeing someone in chicago. my insurance company now covers fifty two visits but the one before (which was cheaper) only covered twenty visits. i also had to call and get more sessions for medical necessity. it is kind of a hassle making the phone calls but it really isn't that bad.

my comment would be that if you can work through some of these things now, it will be much better than waiting. also, do you feel comfortable only seeing your t every other week? i see mine twice a week and i hate how much money i have to spend on seeing her but i know i am better off in the long run seeing her that much. but, if you feel ok seeing her every other week, i think you have done this stuff long enough to make that type of decision. but it is worthwhile to keep going for ten dollars a week if you think it is helping or even if you just remotely think it could help you more.

i understand how you are worried about the cost. but many t's will work with you or your parents about fees if insurance runs out. and, you could always go to one of those ANAD groups...they are free :sarcasm. actually, i am trying another one and i hope it works out.

and, my guess would be that your doctor/md appointments are covered under a totally different fee structure than your t appointments.

:love isobel