CPTSD/DID mental healthcare in Los Angeles?
December 14, 2021 3:06 PM Subscribe
I'm looking for suggestions for the most cost-effective way to access mental healthcare (ongoing therapy sessions) for my spouse who has CTPSD and DID. We have Kaiser insurance which I gather now isn't the best for mental healthcare, but I can also change my insurance if I do it before the end of the month. Suggestions for insurance plans or specific therapists that take insurance very welcome!
We have been highly recommended The Pasadena Trauma Centre but they do not appear to take insurance, and we can't afford health insurance plus additional weekly therapy costs. My spouse currently has the Kaiser Gold 80 HMO plan (https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/summary-of-benefits/ca/individual-family/2020/off-gold-80-hmo-coinsurance-ca-en.pdf). This has a zero deductible but only for in-network therapists which seem impossible to find. Does anyone know of any gold-dust trauma therapists that are in-network for Kaiser (remote would be possible)? Or any insurance plans that would allow us to access good CPTSD/DID healthcare options?
(I tried searching on Psychology Today for therapists that take Kaiser, but most of the ones that said they accepted Kaiser on their listing told me they actually didn't when I phoned them, I'm not sure why.)
We have been highly recommended The Pasadena Trauma Centre but they do not appear to take insurance, and we can't afford health insurance plus additional weekly therapy costs. My spouse currently has the Kaiser Gold 80 HMO plan (https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/summary-of-benefits/ca/individual-family/2020/off-gold-80-hmo-coinsurance-ca-en.pdf). This has a zero deductible but only for in-network therapists which seem impossible to find. Does anyone know of any gold-dust trauma therapists that are in-network for Kaiser (remote would be possible)? Or any insurance plans that would allow us to access good CPTSD/DID healthcare options?
(I tried searching on Psychology Today for therapists that take Kaiser, but most of the ones that said they accepted Kaiser on their listing told me they actually didn't when I phoned them, I'm not sure why.)
Response by poster: Thank you for the responses so far. Yes, we can change insurance if we do this before the end of the month (although I've been advised to do it as early as possible to avoid any hiccups or losing any days of coverage.)
posted by rose selavy at 5:38 PM on December 14, 2021
posted by rose selavy at 5:38 PM on December 14, 2021
My experience in the Bay Area with a really good Blue Cross Blue Shield PPO plan is that most therapists don't take insurance at all. I've never had an HMO plan but at least with a PPO the therapist can bill you "out of network" and there's some cost coverage, but not 100%.
Also the best way I've been able to find in-network providers for anything is via the insurance portal itself.
posted by sm1tten at 6:40 PM on December 14, 2021 [1 favorite]
Also the best way I've been able to find in-network providers for anything is via the insurance portal itself.
posted by sm1tten at 6:40 PM on December 14, 2021 [1 favorite]
Best answer: Having had both Kaiser insurance, and a CPTSD diagnosis, I can almost guarantee that any other insurance option will be better. You have listed two "big" mental health diagnoses, and regular insurance just doesn't provide adequate resources for those, typically. Certain treatments and certain providers that specialize in trauma don't take insurance, ever. The likihood you will end up paying out of pocket, no matter what health insurance you are on, is really high. Planning for that eventuality might be something you want to look into (flexible spending accounts, etc). If your partner needs to be hospitalized at any point through kaiser, their inpatient mental health services are not designed for individuals with PTSD (doubly so for CPTSD) and hospitalization, even if necessary can exacerbate the problems dramatically.
I tried searching on Psychology Today for therapists that take Kaiser, but most of the ones that said they accepted Kaiser on their listing told me they actually didn't when I phoned them, I'm not sure why.
Lots of therapists overstate their qualifications, and the insurances they take on Psychology today; the website does not work well and should not be relied upon. That website, especially as you get beyond basic therapy, is hot garbage and not a good resource. It's not vetted, it's entirely provider generated information. I have gone to therapists who say they do EMDR on psychology today, and they're like "oh what? uh, hold on" and then admitted I was their first patient for that (it went as well as you would expect). Finding the equivalent of a 'primary care therapist' to refer you out to a psychiatrist or other specialists is valuable
If you have a teaching/research or university hospital nearby, find out what insurances they take. My insurance randomly covers my family for mental health services through a local research school and it has been a boon for accessing high quality, harder to find resources for treatment. You might get a provider who is pretty green, but they'll have a whole department backing them up. It is a valuable resource.
Getting mental health set up on new insurance is difficult and time consuming. This is not...uh, ideal, and may be considered unethical by many individuals, but depending on how acute your spouse's symptoms are, if they are hospitalized, even for a very short time after you set up new insurance, they will be moved up on providers wait lists drastically, which can help you get settled into a new care team more quickly.
posted by furnace.heart at 6:43 PM on December 14, 2021 [1 favorite]
I tried searching on Psychology Today for therapists that take Kaiser, but most of the ones that said they accepted Kaiser on their listing told me they actually didn't when I phoned them, I'm not sure why.
Lots of therapists overstate their qualifications, and the insurances they take on Psychology today; the website does not work well and should not be relied upon. That website, especially as you get beyond basic therapy, is hot garbage and not a good resource. It's not vetted, it's entirely provider generated information. I have gone to therapists who say they do EMDR on psychology today, and they're like "oh what? uh, hold on" and then admitted I was their first patient for that (it went as well as you would expect). Finding the equivalent of a 'primary care therapist' to refer you out to a psychiatrist or other specialists is valuable
If you have a teaching/research or university hospital nearby, find out what insurances they take. My insurance randomly covers my family for mental health services through a local research school and it has been a boon for accessing high quality, harder to find resources for treatment. You might get a provider who is pretty green, but they'll have a whole department backing them up. It is a valuable resource.
Getting mental health set up on new insurance is difficult and time consuming. This is not...uh, ideal, and may be considered unethical by many individuals, but depending on how acute your spouse's symptoms are, if they are hospitalized, even for a very short time after you set up new insurance, they will be moved up on providers wait lists drastically, which can help you get settled into a new care team more quickly.
posted by furnace.heart at 6:43 PM on December 14, 2021 [1 favorite]
Best answer: Finding resources for DID is incredibly difficult and honestly it is expensive.
First I'd reach out to the Pasadena Trauma center directly if you haven't yet. There are many situations in which a private provider may use a sliding scale (to be clear, sliding scale may be 50 dollars out of pocket a session instead of the full price. It would be harder to find someone who will go lower than that) but won't advertise it directly but may mention it to a referring institution. They may be able to provide some recommendations for you. Unfortunately as these specialized therapists are rarer and in high demand, you really have to advocate for yourself to get what you need.
SIDRAN is a national training institute that has a helpdesk to help people with PTSD and dissociative disorders find treatment, you may want to reach out to them directly for recommendations. The link above is to their help desk.
SOCAL Empowered is a inpatient treatment center in orange county that claims to treat DID (I have no idea if they are considered to be good at it or not). Inpatient centers have to do referrals to outpatient therapists at discharge if one is not established, and they likely have connections in LA. I'd reach out and ask if someone could help provide you some names if the other two resources fail.
Anybody you call, if they say no (they are full, that they aren't taking new cases, that they don't take insurance or sliding scale) ask if they know someone who may be able to help. This group of therapists is fairly small, does lots of training together and case consultations. They know of each other so keep asking around.
Insurance wise I'd suggest a BCBS PPO if you can, and stay away from any HMO plans. The broader the better. Also, if one needs inpatient hospitalization, you may be able to go out of the local area to find a treatment center that is actually a good fit. Low deductible, because therapy every week(sometimes multiple times a week depending on his current needs) you will go through the deductible every single year without fail. A year of therapy once a week can bill somewhere between 6,500 to 13,000 depending on rates(125-250 per session is what I used in that calculation). A PPO will have out of network coverage and you can bill yourself even if the provider doesn't bill. In general it will cover somewhere between 30-50% of the cost. *All plans vary, check carefully with any plan you chose
Good luck!
posted by AlexiaSky at 1:18 AM on December 15, 2021 [4 favorites]
First I'd reach out to the Pasadena Trauma center directly if you haven't yet. There are many situations in which a private provider may use a sliding scale (to be clear, sliding scale may be 50 dollars out of pocket a session instead of the full price. It would be harder to find someone who will go lower than that) but won't advertise it directly but may mention it to a referring institution. They may be able to provide some recommendations for you. Unfortunately as these specialized therapists are rarer and in high demand, you really have to advocate for yourself to get what you need.
SIDRAN is a national training institute that has a helpdesk to help people with PTSD and dissociative disorders find treatment, you may want to reach out to them directly for recommendations. The link above is to their help desk.
SOCAL Empowered is a inpatient treatment center in orange county that claims to treat DID (I have no idea if they are considered to be good at it or not). Inpatient centers have to do referrals to outpatient therapists at discharge if one is not established, and they likely have connections in LA. I'd reach out and ask if someone could help provide you some names if the other two resources fail.
Anybody you call, if they say no (they are full, that they aren't taking new cases, that they don't take insurance or sliding scale) ask if they know someone who may be able to help. This group of therapists is fairly small, does lots of training together and case consultations. They know of each other so keep asking around.
Insurance wise I'd suggest a BCBS PPO if you can, and stay away from any HMO plans. The broader the better. Also, if one needs inpatient hospitalization, you may be able to go out of the local area to find a treatment center that is actually a good fit. Low deductible, because therapy every week(sometimes multiple times a week depending on his current needs) you will go through the deductible every single year without fail. A year of therapy once a week can bill somewhere between 6,500 to 13,000 depending on rates(125-250 per session is what I used in that calculation). A PPO will have out of network coverage and you can bill yourself even if the provider doesn't bill. In general it will cover somewhere between 30-50% of the cost. *All plans vary, check carefully with any plan you chose
Good luck!
posted by AlexiaSky at 1:18 AM on December 15, 2021 [4 favorites]
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My suggestion if you try the Kaiser route is to have your SO be AS BADLY OFF AS POSSIBLE on the questionnaire and in the screening. I kind of got the impression that I needed to be drinking, drugging, cutting, suicidal before I'd get permission, I'll put it that way. (I'm going to get in trouble here for saying that, but that's also the conversation I had with my therapist and another therapist I know later.)
posted by jenfullmoon at 5:15 PM on December 14, 2021 [3 favorites]