So, I reached a point in my downward spiral that I had to take action. I requested 6 weeks unpaid leave from my office to intensively work on my recovery. I know I won't "fix" my OCD, but I need to make substantial steps so I can reach the stability I need to go back to work. Because I've taken the risk to leave work for an extended period of time, I must make sure I get the help I need.

 

It was estimated that I would be in four weeks of full day treatement, then stepped down to half days for an appropriate amount of time. I know that my insurance covers up to 30 days of full days per year, so this should be no problem, right?

 

Wrong!

 

After just 9 days of full days, 4.5 of which were family days and therefore not the same level of treatment (very informative for family members, and my husband was able to be there, but our regular classes that I desperately need were cancelled), my insurance company decided that I must move to half days. Without getting into all of the logistics, I'll just say I can only do two weeks of half days without losing insurance coverage that I need for the rest of the year.

 

So I am fighting with every resource I have to get one more week of full days. Ultimately, I think one more week of full days followed by two weeks of half days would give me enough time to reach the level of recovery that I need to go back to work. Unfortunately, there's a very good chance that I'll have to pay out of pocket for that week, which is a significant amount of my savings.

 

It has been painfully clear since I started seeking treatment that my insurance company does not give a rat's ass about mental health, and the "benefits" of my policy are not meant to provide the assistance needed for crisis management.

 

Needless to say, I am really angry and frustrated. I have to wait until Monday to do anything about it, or even speak to a representative about it. Right now, I don't even know if my insurance will cover half days if I choose to pay out of pocket for full days before going to that.

 

When you are in need of serious help for mental illness, the last thing you need is the insurance company jerking you around and refusing to pay for the necessary care.

 

Grr!

5 Comments
  1. lldevoll 11 years ago

    insurance companies suck.

    |
    0 kudos
  2. Quest 11 years ago

    Seriously, I don't believe there's even one insurance company out there that was in favor of the passing of the Mental Health Parity legislation.  Does your insurance company still have limits on mental health care treatment?

    |
    0 kudos
  3. morella 11 years ago

    Yes, they have limits on every level of care for mental health treatment.  For the ones they cover fully (after you meet your deductible, of course), they do everything possible to get you out of that level of care before you reach the yearly limit.  I was flat out denied partial hospitalization (full days) back in October, even though the facility recommended it.

    They have a small limit on “regular” mental health appointments.  Included in this pool are therapy, psychiatry, and intensive outpatient (half days).  That’s why I can’t afford to do more than two weeks of half days, because I have to save the remaining covered appointments for my psychiatrist.  I have to pay therapy out of pocket because I don’t have enough covered appointments available.

    |
    0 kudos
  4. Quest 11 years ago

    I don't know the size of your company and number of employees but this could be why they have the limited coverage that they do.  It really is a rotten situation and wish for your sake it was different. 🙂 Quest

    |
    0 kudos
  5. morella 11 years ago

    [quote=ocd8mybrain] work half days? idk if i am right about this but so far what i am seeing with how my issues form is that things form patterns over time for me so i am figuring that “un-patterning” will be a time thing too.[/quote]

    That is a good suggestion and exactly what I was hoping to do.  I know that the physical environment (not my coworkers) of my office triggers my OCD, so I hope to get back into work slowly doing half days.  That will help me get back into being comfortable with being there.  The problem is that I know I’m not ready to start that next week.  But if I knew when to expect it, I could prepare myself.  Maybe it will work out…I appreciate the feedback.

    [quote=Quest]I don’t know the size of your company and number of employees but this could be why they have the limited coverage that they do.[/quote]

    It is a very small company, so that must be what it is. I fail to see how that makes any logical sense because we don’t need less health care than large companies, but I don’t expect insurance companies to make sense.

    :blink:

    |
    0 kudos

Leave a reply

© 2022 WebTribes Inc. | find your tribe

Log in with your credentials

or    

Forgot your details?

Create Account