How much is your co-pay for mental health treatment?

[mdmc]

In NYS, HIP Prime ( :eyes: "Prime"= pay more?) charges $40.00 for mental health treatment. There are other limits too, but I just want to know what the lowest co-pay is..

[cbayer]

1. One of the most shameful copay for mental health issues is with Medicare.

While the copays for everything else are 20%, they are 50% for mental health services and have yearly and lifetime limits.

And because the federal government's plan to cover the elderly and disabled in this fashion is so biased against mentally ill people, all the other insurance companies think it's just fine to take the same position.

Lack of parity for the mentally ill keeps people marginalized and maltreated.

Shameful.

Sorry, I just had to get that out.

[mdmc]

2. now what is the difference between medicare and medicaid?

Cause in NYS, the is no co-pay and no limits to the MH coverage of people on medicaid.

[cbayer]

4. Medicaid is the program for the poor. Medicare is for the elderly and disabled.

If someone is on Medicare and also meets the poverty criteria for medicaid, medicaid will pick up the copays. In general, most state medicaid programs do not have copays or deductibles for any of their services, as the group they cover tend to be very, very poor.

I hope that helps.

[mdmc]

7. yes it does help very much

I work with SPMI population (severe and persistant mental illness) - all are on medicaid..

[cbayer]

10. Bless you.

These are the people in our country most neglected and I honor all who care for them. Not the easiest job in the world, but it can be incredibly rewarding, IMO.

I saw something on PBS (Frontline? Independent Lens?) last week on how so many in the SPMI population are being incarcerated because of lack of services. Excellent show and highly recommended.

:toast:

[mdmc]

11. You are correct - no matter how much money you have,

SPMI can take everything from you..

Peace and God Bless..

[proud2BlibKansan]

3. I have a sibling who has mental illness

and my mom's insurance covered her 100% when she was initially diagnosed and treated. But that was over 25 years ago.

[cbayer]

5. Insurance coverage was very different 25 years ago. I have not seen a policy with

100% mental health coverage in a very, very long time. In fact, the coverage is generally so poor, that many hospitals have closed their psychiatric services completely because it wasn't financially feasible to keep them open.

Disgraceful.

[proud2BlibKansan]

6. Yes that's true

We paid for my sister to have private insurance for many years. But it finally got very expensive and she was close to maxing out her benefits so we applied for SS Disability and Medicaid. So now you the taxpayers pay for her health care. BTW, thanks!

[cbayer]

8. You did the right thing. A medicare/medicaid combo is the best thing a person

with chronic mental illness can hope for. Sadly, getting SSD is really hard for many and the requirements for medicaid are very stringent in most states.

I hope she is getting the treatment she deserves and is living a decent life.

:hi:

[proud2BlibKansan]

13. We hired an attorney

and it was still a bitch. There is no way that mentally ill people with no advocates could wade through the process. No way.

[nolabear]

9. Each insurer has its own panel of "preferred providers"

and most of those panels are now closed. Those of us mental health care providers who are not on their panels are reimbursed at a lower rate, sometimes as litle as 60% of our fee. Then there are the number of therapy sessions covered, which typically has nothing to do with diagnosis. We practitioners have the choice of asking patients to co-pay up to our fee, of reducing our fee, or of not seeing people who can't afford it. I know few who don't try to come to some arrangement, but it's terrible getting into a therapy relationship with someone and essentially doing triage and hoping what happens when they can't get the real care they need isn't terrible.

It causes a lot of us to leave the profession, because we care, and things get taken out of our hands completely. Lots of us do a little pro bono or very reduced fee if we can, but the need is endless.

[Speck Tater]

12. With no plan I'd be crazy to seek mental health treatment. nt

[LovetheUSA]

14. ZERO COPAY

I pay nothing for any type of medical treatment or meds!!!!

[mdmc]

20. Welcome to DU!

Who is your health insurance provider?

[LovetheUSA]

21. :)

U.S. Government

[mdmc]

23. God bless

Peace and low stress and thanks for checkin in..

[EFerrari]

15. What copay? Zero because zero insurance. n/t

[robinlynne]

16. copay? We can't get it. Meds are available, but not therapy. too expensive....

[EvolveOrConvolve]

17. My medical insurance policy doesn't cover mental health treatment

It will cover the prescription meds, but doesn't pay for the psychiatrist or psychologist. To compensate, my employer has a free "mental health" center where you're allowed two free sessions with a therapist. After that, I guess they expect you to be all cured and stuff.

[Thickasabrick]

18. I have to pay almost 80% for mental health services so I don't use

them. I probably need to but they just charge too much.

[HarukaTheTrophyWife]

19. $30 in-network

$3k deductible out of network, then they cover 70%.

[quiller4]

22. First I have to meet my deductible before insurance kicks in

at all. After that I pay 25%, insurance pays 75% to see a psychiatrist. If I go to a community mental health clinic then my insurance pays the full fee after I've met my deductible.

[MountainLaurel]

24. Same here

Of course, since my provider isn't "in network," it doesn't matter anyway.

[mdmc]

25. .

.