insurance without assurance (what mental-health parity?)

It’s the night before another round of ECT, and I’m worried. I am not worried about the procedure itself, but I am worried whether this treatment is even covered. I do know one thing: any treatment by a psychiatrist is no longer covered  because I’ve reached my lifetime maximum benefit for mental health care. For those insured, the  general  lifetime maximum benefit is usually in the millions. However, many insurance companies have a separate lifetime maximum for mental health-related charges –somewhere in the low thousands (I believe mine is $3,000). So, when I opened up my EOB statement for my usual psychiatrist appointment, the form informed me that they no longer cover any part of those appointments because I’ve exceeded my lifetime limit.

Great. I think I’ve had this policy for a little over a year now, and I’ve already maxed out a portion that I relied on the most. Therapy takes time, which obviously equals more sessions. And the insurance company so conveniently places a cap that ensures that people can only benefit for a short period of time. There is suddenly a bit of reluctance on my part about seeing Dr. A so regularly, knowing that not a single bit of my session with Dr. A will be covered from now on.

I also noticed something else on another EOB statement. They are not covering the ECT psychiatrist’s charges from a recent treatment. So, I can’t tell if it’s just the psychiatrist’s part that’ll not be covered, or if they are considering the whole procedure to be under the mental-health limitation. Ugh. I get a little nervous before the ECT anyway, but this insurance uncertainty is making me even more disturbed. When they help me lie down on the gurney, instead of hoping that the anesthesia will work fine, I’ll be thinking about how I’m going to pay for what I’m about to be engaged in.


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