Ask MetaFilter questions tagged with Depression and insurance

PCP, EPOs, PHD ABD, SSRIs, halp!

Anonymous — Tue, 09 Apr 2013 18:43:48 -0800

I am an ABD grad student dealing with significant situational depression. My therapist has recommended I seek out a prescription for an SSRI (antidepressant). My insurance situation is a bit complex -- I'm on the university's faculty EPO plan, but don't have a primary care physician relationship established. Trying to sort out the right order of operations for making sure I get coverage, and get timely access to care. For the last 5+ years, I have been a grad student, on university funding and using my university's student health insurance, which more or less covers the student health center on campus, and referrals from there to specialists. Last fall, I was hired as a one-year-term contract lecturer in my department, which is technically a faculty position. As a result, I elected to join the university's faculty EPO, which is a "you must go in-network, and you must get a referral from your in-network PCP to make an appointment with a specialist" plan. I've been paying for talk therapy out-of-pocket because my (very good) therapist does not accept insurance. I'm generally fairly healthy and have not yet established a relationship with a PCP, because I knew at the start this would be a time-limited arrangement and I'd be moving on after a year, and have not had any significant medical problems.

Recently, things have been very hard at work, and I've been feeling very depressed. My therapist has suggested that I look into antidepressants, and I agree that this is the right next step for me. My therapist is a Ph.D, not a Psy.D, and so can't proscribe anything. Since she's not in my insurance network, she can't refer me to anyone directly. I don't have a primary care physician. I'm not sure who to contact next. I'm not sure if student health services at my university is in-network for my EPO, and even if they are, I'm not sure how to set up a non-urgent-care type appointment with someone over there. It doesn't seem appropriate to try and convince an urgent care provider, either on campus or off, to proscribe SSRIs (if they even would, which I doubt). I'm not sure who to contact where to untangle this mess, and the utterly lethargic, unmotivated way I'm feeling isn't helping.

I realize nobody here can give me the answers, but who should I be reaching out to in order to get the answers without inadvertently shooting myself in the foot re: coverage/reimbursement? If you've been in a similar situation, how did you resolve it?

I don't want to post my insurance provider or the student health insurance provider to avoid de-anonymizing myself, but if it's important to know I will follow up with the mods.

Help us get rid of this house!

Anonymous — Tue, 02 Oct 2012 06:58:20 -0800

We have an old, unlived in house that is disintegrating. We need help fixing it up, emptying the junk out of it and selling it. We are overwhelmed and find it hard to face this problem. Advice needed. I am asking this for my parents. They are both retired.

They own a large Victorian house at the end of a suburban dead end street in upstate New York. It hasn’t been lived in for about two years. My parents are both suffering from various illnesses and disabilities, and have not been able to list the house or even get it ready to be sold. It is full of furniture and junk. It is slowly disintegrating. Part of the roof inside is falling in, and there is a hole in the cellar wall into the space beneath the porch where an animal must have dug through. Both of them are very overwhelmed with the prospect of dealing with this house, and I want to help them if I can.

As problems tend to do, this one is coming to a head now. For some reason the water has been turned off. My father suspects that there was some sort of water leak and therefore the city shut the water down. My parents received no notification of any problems. If the water does not get turned on and the pipes fixed before winter, there is a possibility that the pipes will freeze and that will result in a much bigger problem.

My father does not want to let anyone know that the house is uninhabited, because that will cause them to lose insurance on the house. It will also start the ball rolling on a lot of paperwork, fines and possible work on the house by order of the city. I suspect the city already knows that no one is living there. They must notice that no electricity and water is being used. But they have not sent any notices to my parents about it.

My parents see the situation with the house as a huge, enormous problem that they can’t even begin to solve and don’t want to even face. Depression plays a big part in it. They want to salvage many items from this house, but won’t face even going over there to start that process. I had a conversation with my father today about the house. As a result of his depression he tends to catastrophize things. He is also under a lot of stress lately dealing with various other issues. I tried to help him list all the things we need to do to solve this problem but every time I ask him a question he says, “I don’t know.” I am not a homeowner and I am unfamiliar with how a lot of this works.

We live only 10 minutes away from it. They are thinking of going to Florida in a couple of weeks for a month or so. They may not go if this house can’t be dealt with. My parents do have a fair amount of money to throw at this, but they aren’t super rich. They have paid to have the yard kept up in the summer and the snow plowed in the winter.

I’d like advice to handle the situation with the house. Maybe a list of steps to take to get the water turned on, the pipes fixed, the junk removed (with their items salvaged), the house fixed up and listed for sale. If the steps involved are too much for them, I even thought that a sort of “project manager” could come on board to help manage taking care of the problem.

Also, advice on how to help them (and me) face this problem and not feel totally intimidated by it would also be welcome. I know this is a big problem with many parts. I apologize for that, but would appreciate at least some help starting to fix it.

[Side note: I am talking to my father about seeing a doctor and/or therapist to get his depression under control. He is not easily persuaded but we are working on it.]

If you have any questions you can reach me at getridofthishouse@gmail.com.

In the shadow of the valley.

Anonymous — Mon, 10 Sep 2012 19:08:02 -0800

Major depressive episodes and individual (USA) insurance repercussions. Should I let my psychologist submit this? California, USA. I've just been to see a new psychologist for a first visit today. My initial impressions are quite positive; I could see myself developing a very fruitful and trusting relationship with him over time.

At the end of the session, he offered a diagnosis of mild clinical depression. He asked my psychiatrist to revisit my existing citalopram prescription (from 10mg) and said that he wished to see me twice a week on an open-ended basis. He doesn't see me as having a lifelong (chronic) depression problem, but it is presently very significant and he wants to get me stable in order to achieve longer-term health.

Because my insurance only covers 20 visits a year for outpatient therapy, he asked if he could submit a diagnosis of a Major Depressive Episode in order to qualify me for unlimited sessions under the Mental Health Parity Act. He said it was ultimately up to me if I wanted to pay out-of-pocket after the 20 sessions if I didn't want that on my record.

At the moment, I'm covered under an HMO, but my company isn't doing well, and I can conceive of a future date where I might have to pay for individual insurance. Shall I allow him to process that diagnosis (thus gaining access to more therapy for free), or pay out-of-pocket and keep my record clean for the future?

(I don't know how my psychiatrist classified our prior sessions to my insurance company, but I went in with a panic/anxiety disorder two years ago and I've been on my citalopram regimen ever since. I have nothing else on my record.)

Neurostar TMS therapy (depression)?

isoman2kx — Fri, 19 Aug 2011 19:59:44 -0800

Neurostar TMS therapy (depression)? I'm pretty depressed about things in general and have been for a while. The anti-depressants I'm on seem to be doing not very much, but yet I've tried a lot of them. It's a very long story, but I want help... I don't want to feel like this at night. I'm tired of my current life, I'm tired of my chronic neck pain, I'm tired of my chronic depression, I'm tired about my school situation. Everything.

My psychiatrist and I have talked frequently about different combos of anti-depressants and such, and even TMS. The problem with Neurostar TMS therapy is it's expensive as **** (I believe my psychiatrist quoted $10000 to $12000) and insurances haven't figured out what to do with it coverage wise; thus, they are reluctant to reimburse you anything until you've emptied your checking account and appealed their denial 40 times. We don't have the money, but I'm slowly losing hope for not being depressed and would almost sell my soul for it now.

I have United Healthcare (Value Options is their mental health branch), and was wondering if anyone in the Houston area has tried this treatment for depression and how was your battle with your insurance like if so?

Or if anyone knows anyone in the Houston area, I'd really really appreciate if you could ask them.

-Travis

How to get counseling while unemployed?

Anonymous — Wed, 20 Oct 2010 08:58:42 -0800

How can I seek treatment for possible depression while I'm unemployed? I am concerned that I may be depressed. I know I have self-esteem issues, and I struggle with procrastination. I think these things are affecting my motivation, and I'd like to deal with them.

However, I am unemployed, and have no health insurance that would help pay for counseling or meds, if I get prescribed any.

I live in a rural area in southern California. I do have unemployment insurance, but it just barely covers my expenses, so I cannot afford much out-of-pocket.

How can I find some help with this?

Temp e-mail: trapped.in.socal@gmail.com

Can I get individual health insurance with mental health coverage?

Anonymous — Mon, 19 Apr 2010 23:52:51 -0800

Can I buy individual insurance with mental health coverage with a pre-existing condition? I work for a small employer who reimburses employees for individual health insurance. My current health insurance policy has an exclusion on mental health coverage because it was/is a pre-existing condition. (I'm in the United States.)

I currently see a psychiatrist every few months, see a therapist weekly, and pay for prescriptions, all out of pocket.

Is it possible to get a policy that includes mental health coverage, given that I am currently receiving treatment for depression?

I have seen vague references to pre-existing conditions in articles about health care reform, but am unclear on the details. Will things be different a year from now?

Thanks.

Insert worried question about U.S. health insurance here.

Anonymous — Wed, 30 Sep 2009 18:54:34 -0800

Best U.S. insurance company for a pre-existing condition (depression) - advice please! Yet another question about U.S. health insurance. I'd like to have some basic health insurance that's not tied to an employer - I'm unemployed and don't know when I'll find work. The catch is that I have a pre-existing condition (well, two - chronic unipolar depression, and ADHD, both of which I've had since my teens). It means for me (at least) that I go through periods of unemployment, including right now. My coverage (under my ex-husband's plan) is about to end, and I'm panicking. AskMe has been invaluable about the topic, but I'd love some actual 'I have x company, and they're good/bad/good enough' testimonials. I've seen Tonik mentioned a few times on here and will be looking into them, although they don't cover mental health.

I'm primarily looking for basic physical health coverage (i.e. catastrophic, so that if I get hit by a truck I have *some* kind of coverage). While I'd love to have a plan to include mental health, I know that's going to be hard to find. I'm worried about even finding any basic physical coverage considering the pre-existing condition thing. I'm on medication (Zoloft and Adderall - prescribed through a psychiatrist covered by ex-husband's coverage) and am otherwise healthy (a few minor surgeries as a kid) in my mid-30's. The past year has been hell (for a number of reasons - let's start with divorce, death of a parent and losing my job), but hopefully qualifying for insurance won't be...impossible (she says, crossing her fingers hopefully).

I'm in California, a permanent resident (if it helps) and am willing to look around for community therapists etc. and already go to the local NAMI affilated support group, do the 'exercise, eat right' etc. etc. thing and have a therapist I'm willing to pay out of pocket for - and maybe get the meds via Walmart etc., if I have to. What I want is the basic coverage, since waiting for the folks in Washington to decide on health insurance is NOT an option. Basically, is there a way to have the physical insurance and mental health insurance be separate? When do I have to tell them about my mental health history?

Has anyone had any experience trying to get group insurance via things like the Freelancer's Union or AIGA? I'm a designer, and I'm open to suggestions. What about going through an individual insurance broker - any good experiences? Any advice is appreciated. I'm going through all the info I can find (on AskMe and elsewhere) and really appreciate any help, as my head is spinning and I'm worried to death.

What happened to PMI?

GatorFan2000 — Mon, 06 Apr 2009 09:50:14 -0800

Why hasn't private mortgage insurance (PMI) softened the blow of the real estate implosion? You can't turn on the TV these days without hearing about the mortgage implosion. People are walking away from their severely depreciated homes and leaving the banks scrambling to make up for the shortfall between the remaining mortgage balance and the current home value. One thing I don't understand however, is why private mortgage insurance hasn't softened the blow. Isn't it supposed to make the lender whole if the homebuyer walks away and stops paying? I know you are no longer obligated to pay it after you have 20% equity in your home, but I'm assuming most of the subprime borrowers defaulting on their loans had exotic mortgages that did not require them to put down large down payments (if any). I'm hoping someone knowledgeable in the mortgage industry can shed some light on this.

How to get treatment for depression without income or health insurance?

jnnla — Wed, 18 Mar 2009 16:14:14 -0800

I suspect I am suffering from Depression and I have no health insurance or current source of income - how do I get help? Three months ago I quit my high-paying job due to extreme job dissatisfaction, and with the job, I also lost my employee sponsored health care. I have since missed the deadline to file for COBRA (I live in California).

As a result I am currently unemployed (by choice) and without health care. I am 26 years old and am extremely fit and healthy physically (gym 3x at least per week), but mentally I suspect that I am suffering from depression.

I was diagnosed with depression as an 18 year old, but overcame it and within a year and a half became happy and healthy again.

Within the last two years, however, I have felt "flat," and I feel the familiar pangs of depression - a general all-encompassing apathy, constant anxiety and intrusive negative thoughts, as well as the random urge to cry or hole myself away in my bed. My omnipresent negative emotions and worries, I feel, prevent me from reaching my potential. These feelings partly led to my decision to quit my job, which was only exacerbating my condition. I committed to take time off for a few months to work on personal projects, explore other possible career paths, and to try to handle my negative feelings. I have saved up money (quickly running out) in order to facilitate this plan.

I would like to see a therapist and get a diagnosis, as well as schedule regular therapy sessions. In my normal state I am a very vibrant and social person, who has a zest and love for life - and I would very much like to have that person back and get him working again...but I feel I need treatment.

QUESTION:
So...what is an unemployed person without health insurance to do? How do I go about getting help? I can afford CHEAP health insurance for a few months (100-150 dollars per month). I have looked into Tonik, and am going to give them a call but it is unclear to me whether they have mental health coverage - furthermore, should I be mentioning my condition when calling health insurance companies or will that get me denied or put me in a waiting period for treatment? I assume my options are to see a therapist of my choice out of pocket or to buy health insurance and have them foot the bill for an in-network shrink. In the meantime are there any free or state-sponsored options I can look into? Any help on the matter would be greatly appreciated!

New insurance and pre-existing conditions?

Anonymous — Thu, 12 Feb 2009 17:40:40 -0800

Pre-existing condition and new health insurance, what do I need to know? I suffer from depression. I was diagnosed in late 2005 and received treatment through the beginning of 2006, covered by the insurance plan from my full-time employer at the time.

Since leaving that job in early 2007, my coverage has been spotty and sporadic, using short term plans just so I wouldn't be totally bankrupted if I got cancer or something. I haven't been covered for the entirety of that time, however... there were gaps of varying lengths between renewals, the longest was probably two or three months. I don't get coverage through my current employer.

I recently signed up for a full-fledged plan, and it starts soon. I disclosed my original depression diagnosis, but what I didn't disclose is that I've been experiencing a pretty severe relapse on and off in recent months. The application didn't ask for that info in explicit terms, but it did ask how I would categorize my mental state over the last few months, and I responded with something to the effect of "mildly depressed" (it was multiple-choice). Any of these may have been the wrong things to do, but they're done already so that's not my question. In my defense, at the time I filled in the application I was actually doing okayish so "mildly depressed" seemed like a reasonable average.

Now I have a letter from the insurance company reminding me that there's a nine-month waiting period for pre-existing conditions, including conditions for which "a prudent layperson would have sought treatment" within six months before coverage. Obviously my original diagnosis falls outside that limitation... my relapse does not, but there's no documented evidence of it other than possibly the response I gave on the application.

So here's my question. If I want to seek treatment for my depression and get it covered under this plan, what should I know? For example, is it going to throw up red flags if make an appointment with a therapist within the first week of coverage? Does it matter that I had short-term coverage during most of this time, but opted not to use it? Or am I overanalyzing the situation entirely?

Thanks.

How do I get life insurance without disclosing the skeevy details of therapy?

Anonymous — Wed, 21 Feb 2007 19:40:43 -0800

Is there a way to get life insurance without the underwriter seeing the complete records of my two-plus years in therapy? There's nothing earth-shattering: Just a standard-issue case of depression and anxiety that, thanks to psychotherapy with a good shrink and a low dose of Lexapro, is now well under control. But the insurance company won't accept a letter from my doc saying simply that he treated me and that I have responded well. The rep assures me that only the underwriter will see the records of my treatment, and, like I said, there's nothing terribly shocking in there ... but it's intimate, personal stuff that I'd like to keep as private as possible. Any thoughts?

Depressed and uninsured. What now?

mostlymartha — Mon, 29 Jan 2007 11:31:47 -0800

I've finally acknowledged that I'm pretty seriously depressed. I don't have insurance and live in San Francisco. What should I do? After a tough weekend, I’m willing to (finally) admit that I’m depressed. I have been for at least a year, but that year was so filled with external difficulties that I was able to blame all the bad feelings on what was going on outside to avoid dealing with what was going on inside. I mean, my abusive, alcoholic father died, my fiance and I both spent a significant period of time unemployed (which led to some very scary, no money for food-type financial problems), and there have been some almost hilarious, Southern Gothic extended family issues. Those things are starting to resolve, but I’m feeling worse rather than better.

I have a history of anxiety and depression, so I don’t know why I’ve been so reluctant to call this particular emotional spade a spade. The last time I felt this bad was during my senior year in high school when I had a nice little nervous breakdown that almost resulted in hospitalization. I feel myself nearing that point again and I’d certainly like to avoid it.

When this happened in the past, I had insurance to pay for meds and counseling. Now I don’t and I don’t even know where to start looking for the help I know I need. I’m scared that this cycle of depression and panic attacks is going to take over my life again. What now? I live in San Francisco. What kind of resources are there and where do I start?

Now what?

Anonymous — Thu, 30 Mar 2006 10:55:19 -0800

Maybe I have a couple problems. The first one probably stems from the second. Insurance won't cover therapy or medication. Is there any place in Baltimore, MD that offers free or very low-cost assistance? Thank you.

Supplemental Mental Health Insurance in the U.S.

Anonymous — Sun, 19 Dec 2004 18:09:27 -0800

I am in search of supplemental mental health insurance (in the US). Does such a thing exist? I'm a full-time grad student about to lose my awesome COBRA benefits from my past job. I'm going on to my husband's plan, which has crappy mental health coverage (only 20 therapist visits a year vs. 45 with my last insurance). I need weekly visits, but there's no way to change the plan. I've googled for supplemental health insurance, but I mostly get sites for those on Medicare. I've checked several major insurance companies, but none have any specifics about their mental health coverage. Has anyone else dealt with this situation? Perhaps someone who works in the insurance industry can point me in the right direction?