Oops, sombody pooped on my 'Parity': A mental health coverage rant
So I just got off the phone with our crapporific health insurance carrier, trying to get pre-authorization for my shrink visits so that they'll deign to reimburse some of the money I pay.
Even though there's supposed to be what they call "parity" for "biologically-based mental illnesses", which my particular illness (DSM IV 296.26, with a side order of 300.4) is, the insurance companies have devised all sorts of insane ways to avoid paying the bills. It's true that they try desperately not to pay ANY of our medical bills, but they're particularly awful about mental health.
First of all, if I don't get "pre-authorization," they penalize me by only paying half, rather than 80% (after my out-of-network deductible, of course, because any decent shrink is out-of-network..), of my 'eligible expenses'. Second, they farm me off to some 'behavioral health' division (Why is it 'behavioral' if it's biologically-based?), with a totally different claims address. Third, they needed crap from me like my shrink's Tax ID number and some number I'd never even heard of that proves she can prescribe for me. "She's prescribed for me before," I said, "I'm pretty sure she's allowed to." Fourth, they tried to only authorize 20-minute medication management appointments. No, I told them, I have 50-minute psychotherapy with medication management. Fifth, they gave me authorization for 8 sessions, after which my shrink will have to fill out a 'treatment plan' to get them to authorize another 8 sessions, and so on.
If I had diabetes, would my endocrinologist have to fill out a treatment plan every 8 times I saw her, justifying my continued need for treatment for my diabetes? Would I have to get preauthorization before initiating treatment with my endocrinologist for my diabetes? No, and no. Is someone who is in the throes of mental illness more, or less, capable of managing a pre-auth process than someone with diabetes?
You can take your parity, kids, and shove it up your ass.
posted by AmyN @ 2/03/2005 03:06:00 PM
2 comments
2 Comments:
Wait a minute. You're not insinuating that we have anything other than the finest health care system in the world, are you? Because such talk would obviously be treasonous.
Perhaps we can form a cartel of guerilla not-for-profit reimursement expediters. Get every last dime - because dimes are all they're giving.
Could depression be what abortion was? The issue that nobody wants to look at, because humane feelings are at odd with "grown-up" disciplines? I know that I'm asking for trouble here, because women are going to want to keep these two issues separate. But too many men don't; for them, abortion and depression are similar expressions of "female resistance."
Depression and abortion, in any case, are manifestations that take men not into account.
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