Nov-03-2010

When Your Benefits End – How to Continue Therapy Without the Help of Insurance

All good things must come to an end – at least that is what some health insurance plans would have us believe.  While health insurance benefits for mental health treatment has improved over the years, thanks in large part to the 2008 mental parity act, your insurance company may still limit the number of sessions allotted each year.  Some health plans are stingy, allowing only 10-15 visits, whereas others are more generous – allowing up to 40-50 visits per year (and that’s a lot even for the most devoted therapy client).  But one thing most insurers have in common is that at some point they say enough is enough and try to end reimbursement for psychotherapy sessions.

So what is a person to do when therapy is working, but there is a need to continue?

  • Call your insurer. Before you get too upset, call your insurance company and ask for more sessions.  To find the correct number to call, look on the back of your insurance card for the number for “Mental Health” or “Behavioral Health.”  If all else fails, call “Customer Service.”  If you are lucky enough to reach a live person, (my trick: keep pushing “0”) tell them your situation and ask for more sessions—sometimes they say yes!
  • Ask your psychologist to call too. If you don’t have luck with your insurer, ask your psychologist if he or she would be willing to give it a shot. I haven’t had too much luck with this approach myself, but it has been known to help, especially if the insurer requires additional information from your provider to authorize more sessions.
  • Ask for a deal. If you have tried the above and are still empty handed, try talking to your psychologist about a payment plan that will work for you.  Maybe they are willing to work out a schedule so that session fees can be paid over time, rather than at the time of the appointment? Maybe they offer a sliding scale for clients who don’t use insurance?  Don’t be afraid to ask. You never know what you might be able to work out.
  • Call your human resources rep. Many employers offer mental health benefits through Employee Assistance Programs.  It may not be well-promoted, but it’s always worth the phone call to see if you qualify.  If you get your insurance through a spouse or partner, you may be eligible for benefits too.  And the best part about the sessions is that they are often FREE, so don’t miss the boat.

Just starting out in therapy?  Read my previous post about how to use insurance for mental health treatment.

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