does health insurance ussally cover shrinks?

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Young Grasshopper

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Nov 9, 2007
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i was just glancing at my health insurance website and was looking for a psychologist. well under the mental health section i saw this:

80% of eligible expenses after satisfying $500 deductible.



Any combination of Network and Non-Network Benefits for Mental Health Services and/or Substance Abuse Services is limited to 30 days per calendar year.





Notification/Authorization Required

Please remember that you must call and get authorization to receive these Benefits in advance of any treatment through the Mental Health/Substance Abuse Designee. The Mental Health/Substance Abuse Designee phone number appears on your ID card.



If you don't notify Care Coordination, Benefits will be subject to a $500 penalty.



does this mean there is a $500 co-payment with every visit or soemthing? i cant understand this talk.
 

lxskllr

No Lifer
Nov 30, 2004
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The deductible is usually a per year charge, but you can only tell by reading the fine print. Look for some type of glossary that breaks down their standard terms.
 

Young Grasshopper

Senior member
Nov 9, 2007
936
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thanks, i believe i am going thru depression at the moment and decided to get help. should i go to a psychologist or Psychiatrist? i know one can prescribe things and the other cannot.
 

QED

Diamond Member
Dec 16, 2005
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Your deductible is how much, for each calendary year, you are expected to pay out-of-pocket for medical services before the insurance company starts picking up the tab.

It generally does not apply towards your PCP doctor (and in most cases, specialist doctors) office visits-- you generally only need to pay a co-pay fee (anywhere between $15 and $50-- should be written on your card).

Mental health/substance abuse coverage in some cases requires pre-authorization before you can actually use the services-- you simply have to call them, tell them that you plan on seeing a physcologist/physhcriatrist, and they will let you know how many visits you are authorized for.

 

lxskllr

No Lifer
Nov 30, 2004
57,670
7,896
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Originally posted by: Young Grasshopper
thanks, i believe i am going thru depression at the moment and decided to get help. should i go to a psychologist or Psychiatrist? i know one can prescribe things and the other cannot.

I don't know much about it. I would guess that a psychologist would be the first stop, and if he felt meds were necessary, would refer you to a psychiatrist.
 

guyver01

Lifer
Sep 25, 2000
22,151
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Originally posted by: Young Grasshopper
i was just glancing at my health insurance website and was looking for a psychologist. well under the mental health section i saw this:

80% of eligible expenses after satisfying $500 deductible.



Any combination of Network and Non-Network Benefits for Mental Health Services and/or Substance Abuse Services is limited to 30 days per calendar year.





Notification/Authorization Required

Please remember that you must call and get authorization to receive these Benefits in advance of any treatment through the Mental Health/Substance Abuse Designee. The Mental Health/Substance Abuse Designee phone number appears on your ID card.



If you don't notify Care Coordination, Benefits will be subject to a $500 penalty.



does this mean there is a $500 co-payment with every visit or soemthing? i cant understand this talk.

Ok.. lets put it into english



80% of eligible charges after paying $500 first


If you wanna see a shrink, and we say it's ok.. you can only go for 30 days per year.

Please remember that you must call and get Our Permission to receive these Benefits before you see a shrink, by calling our Mental Health/Substance Abuse Hotline. The Mental Health/Substance Abuse hotline phone number appears on your ID card.

If you don't tell us, we may cover you but we'll also charge you a $500 penalty.



Does that help???
 

QED

Diamond Member
Dec 16, 2005
3,428
3
0
Originally posted by: Young Grasshopper
thanks, i believe i am going thru depression at the moment and decided to get help. should i go to a psychologist or Psychiatrist? i know one can prescribe things and the other cannot.

Typically, one simply manages your medications while the other helps you through your issues.

For depression, I would probably see a phsychologist first-- he/she can evaluate you and see if this is something physiologically related or not. If so, he can refer you to a psychiatrist who should work hand-in-hand with your psychologist to develop a treatment plan that works well for you.
 

Gooberlx2

Lifer
May 4, 2001
15,381
6
91
It varies too much to say. Some plans will cover a certain number of visits, other a percentage of the bill, others not at all. And then however they tie in with the deductible varies as well. I'd say my plan is a fairly typical PPO, and it certainly wouldn't cost me $500 co-pay to visit a counselor (at most you'd just pay the counselor their fee out of your own pocket).

The impression I get from the OP's pasted text is talking about check-in-and-stay services, like substance abuse rehab or mental health rehab (like when people have serious nervous breakdowns and need monitored mental care). Not regular visits to an office.
 
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