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Re: Med-Checks/Insurance

Posted by friend on May 19, 1999, at 12:55:47

In reply to Med-Checks/Insurance , posted by SJ on May 18, 1999, at 22:43:01

> My insurance company requires that I get mental health referrals from a separate company, the name of which I guess I shouldn't mention (but it was called Greensprings just a few weeks ago). These people are not exactly pleasant to have to deal with, especially when one feels so bad. I'm pretty sure that one of the methods they use to limit claims is to make you so frustrated at dealing with them, that you just give up.
>
> I'm confused about how much I have a right to expect as far as treatment goes. The only language used to describe my mental health benefit from the primary insurance company is that it's covered at 50%, with up to 20 outpatient visits per year. However, this outfit will only authorize 5 or 6 visits, and only for "med-checks". This is demoralizing, considering they are aware that I'm suicidally depressed often times. I'm not interested in med-check only treatment, either. I can get THAT from my primary care doctor. Many of us here know more about the meds we take than our doctors do.
>
SJ---
Sorry - i can't answer your specific questions,
but here are some important facts to find out:
Each state has different legislation regarding
mandatory requirements for insurance companies regarding coverage. Hopefully, included in that
legislation, are specifics on Mental Health coverage. DO NOT ASSUME that all insurance companies know or comply with your state's legislation. Contact a state delegate in your state, and they can tell you what or where to find the legislation on STATE mental health.
One other point, it gets rather confusing on WHICH state covers you if you live in one state and work for a company in another state - so be sure to check out THAT part of the insurance law also.
Sorry I can't be of more help. I had to know these facts in order to fight for coverage.
good luck.


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URL: http://www.dr-bob.org/babble/19990501/msgs/6267.html