How to get basic outpatient mental health care when work-provided insurance does not cover it?
March 29, 2011 5:10 PM   Subscribe

How to get basic outpatient mental health care when work-provided insurance does not cover it?

Me: IT contractor working for Big Software company in Seattle. History of depression, which is currently very bad and interfering with my ability to work. Been off-meds for about 6 months (stopped seeing previous doctor due to an insurance changeover, thought I'd find a new doc soon, didn't get around to it), and like clockwork the dark train is rolling back into the station.

Insurance company: Says "Your standard health insurance plan does not cover outpatient mental health services. You cannot see a psychiatrist on this plan unless you pay for it yourself." Oddly enough, the plan does cover up to ten days of mental health hospitalization - just no outpatient care. The temp agency's previous insurance company did cover outpatient mental health in their plan, when they switched to a new provider they decided to drop that coverage. This was not mentioned in any of the documents I remember reading at the time.

Temp agency: Says "We cannot answer any questions about insurance coverage, you need to contact the insurance company directly, that's the end of what we have to say on the matter."

Uh . . help? Sinking pretty fast here. I had some help under "charity care" status when I was unemployed, but that involved standing in line outside at 6AM waiting to maybe see someone that day, it's not practical to try that while also trying to work. Are there sliding-scale or other services available to people who have insurance, but it's just really bad insurance? I don't believe I'm eligible for Medicare or anything like that.
posted by anonymous to Health & Fitness (8 answers total)
1) Talk to the insurance company directly, sometimes you can "trade in" hospitalization days for other types of mental health services.

2) Otherwise psychology training clinics are your best bet. I am a therapist-in-training in Pittsburgh at Duquesne University. Our cost is $2-20 for therapy (sliding scale based on income), $25 for psychiatry. You would likely be seeing clinical psychology doctoral students with hundreds of hours of experience. Our psychiatrist works pro bono for us once a month at this reduced rate. I see U of W does something similar, though I can't vouch for their prices exactly. But I imagine they would be fairly close to ours. You could also ask that clinic about other Seattle services, as training clinics tend to see a lot of uninsured folks in the community and so are more in the know about what's out there for not a lot of money.

Good luck to you! I'm glad you are taking care of yourself.
posted by amileighs at 5:34 PM on March 29, 2011

Sorry, I read too fast and didn't see that you already talked to your insurance company. It still might be worth calling back and asking another representative about a "trade in." I have heard of this practice more with regards to private practice psychologists getting 20 extra sessions for their clients, when their insurance only covers 30 per year, but its worth a shot. ::shrug::
posted by amileighs at 5:40 PM on March 29, 2011

Your local university is often the best bet and the University of Washington has long been noted for its compassionate treatment in psychology, at least in addictions (where compassion is unusual, so depression should probably be good as well). They often have studies going on in which you can get excellent care, even if you are not in the "new treatment" group. And yeah, they seem to have that sliding scale thing as well.

GP for quick refill of meds that worked before is also a good place for interim care. Good luck!!!
posted by Maias at 5:45 PM on March 29, 2011

If you just want meds, go to your GP. If you need someone to talk to, find a therapist with a sliding scale.
posted by desjardins at 5:45 PM on March 29, 2011

As an IT contractor, you should be able to afford 1 visit a week to a doc who charges $60-$120/session out of pocket. It's not fun, but it's better than the alternative.

And look for a job with a less greedy temp agency.
posted by orthogonality at 5:59 PM on March 29, 2011

I am uninsured, and when I told that to my prospective psychiatrist, he offered me a sliding scale. For him, the fact that I just write him a check instead of making him go through insurance hoops makes up for the lower price. So make some calls, ask if they'll do a sliding scale or prorate your appointments so a med check is cheaper than a talk session.
posted by freshwater at 8:24 PM on March 29, 2011 [2 favorites]

Washington State has insurance parity laws requiring health insurance companies to cover mental health care the same way they cover medical care. It used to apply only to employers with over 50 employees, but it now covers any employer-offered health plan. Details here.

If for some reason your plan isn't required to comply with the law, then I'll second what others have said: Make an appointment with a general practitioner and request the meds you need.
posted by amyms at 10:23 PM on March 29, 2011

For therapy, try your county mental health department. They have sliding scales.
posted by cass at 10:34 AM on March 30, 2011

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