Bipolar Disorder Support Group
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My HMO has a 20 visit limit for mental health. This sounds bad, but:
1) Medication visits are billed as regular doctor visits, and do not count toward the 20 visit limit.
2) When I go over the 20 visit maximum, I only get billed what the insurance company negotiated with the hospital. So, instead of $180 (full price), I am billed for $120.
Last year I was getting stabilized on medication, switched pdocs, and got therapy from a psychologist. I ended at ~32 visits, 20 were covered, 12 were not. I could afford it, so it's OK. This year, I'm getting therapy with my pdoc, I go every two weeks, it's not ideal, but it works for me.
This is in response to someone posting that with 20 visits a year, therapy is out of question. I just wanted to give an example of how it could be squeezed out of a HMO. Even a little bit is better than nothing.
1) Medication visits are billed as regular doctor visits, and do not count toward the 20 visit limit.
2) When I go over the 20 visit maximum, I only get billed what the insurance company negotiated with the hospital. So, instead of $180 (full price), I am billed for $120.
Last year I was getting stabilized on medication, switched pdocs, and got therapy from a psychologist. I ended at ~32 visits, 20 were covered, 12 were not. I could afford it, so it's OK. This year, I'm getting therapy with my pdoc, I go every two weeks, it's not ideal, but it works for me.
This is in response to someone posting that with 20 visits a year, therapy is out of question. I just wanted to give an example of how it could be squeezed out of a HMO. Even a little bit is better than nothing.
i'll say it again...AWESOME POST, cb72!!
xx, sL
It's worth mentioning that the med visits pay regular copay ($10 on my plan) and not the mental health copay ($20). I've been paying $20 all along, and when I discovered this, I stopped paying any copays, and am waiting to be billed after the visit.