underinsured and overwhelmed

I walked to the post box to retrieve my mail. Among the junk mail and some magazines, there was an envelope from my insurance company. Nothing unusual about getting mail from them, and perhaps I should have expected what would be written on those pages. I opened the envelope to find several Explanation of Benefit (EOB) statements for different aspects of the ECT treatment (e.g. psychiatrist and anesthesiologist bill separately), and they read that neither of those parts will be covered because “the maximum amount for this condition has already been paid.”

My ECT treatments are no longer covered by my insurance.

My heart sank, or more accurately, plummeted to some dark place in my stomach, or maybe even to the ground. I cried. Having one treatment is like paying for a monthly mortgage payment, or months of therapy. Thankfully, I have my parents’ financial support for these treatments (among other things), but how can I ask them to pay this much amount of money per treatment? Here I am, in my late 20s, having to contemplate whether this lifesaving procedure is worth having to pay completely out-of-pocket (it’s kind of like a ‘death panel’ of sorts). This is when I realized that not only is there no mental health parity at all, but that I don’t have a way to mitigate these circumstances. What am I going to do? But more importantly and broadly, what do people do when they’re placed in more dire situations?

I watch on the television with those people ravenously shouting against health care reform, and I wonder if they know why they’re carrying signs about socialism and Hitlerism. What’s frightening is that the health-care bill debate has ceased discussing how it will affect living human beings. Beyond those -isms are the faces of the 40+ million uninsured, the underinsured, and countless others who don’t even know they’re underinsured because they haven’t had to put their insurance to test. Though I would not wish this experience upon anyone (and I know it could be much, much worse), I wish some people knew what it’s like when insurance companies deny your application because of your pre-existing condition and even when insured, you’re left to pay for the costs when an illness strikes you. Then, they can ask themselves if our health care system is really working.

It’s a day before another ECT. My twentieth. I ask myself, is this treatment really necessary?

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3 Responses to “underinsured and overwhelmed”

  1. Good luck on all fronts.
    It seems that many of the limits that are placed on mental health insurance benefits are based on a presumption that, somehow, if there are not limits, patients will become lazy and drag out their recovery. So, don’t enjoy those ECTs too much because your insurer will say, “Game over.” soon.

  2. I am far below the poverty level and still cannot get ECT despite 10 years of indigent care which consists only of medication management and counseling. The state told me it is reserved only for the incarcerated who are transferred to the state hospital. At one clinic, went through all the meds they use for MDD and the Dr said “sorry, can’t help you, you’re just going to have to go to counseling.”

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