Tell Us How Your Health Insurance is (or isn’t!) Working for You

By Dania Douglas | Nov. 22, 2016

 

Imagine parents who make call after call, only to discover the soonest a nearby therapist can see their child is in three months. Imagine a young professional who can barely afford the out-of-network psychiatrist she is seeing, so she cuts back on appointments, putting her stability at risk. Imagine a family who cannot find a residential eating disorders treatment program within their insurance network, so they incur mountains of debt to send their daughter to an out-of-network facility. 

These scenarios may sound far-fetched, yet for many Americans living with mental health conditions, they are reality.

“[My relative] has had terrible trouble finding a psychiatrist in our community. He has been traveling 50 miles each way to see a psychiatrist. The wait lists for all psychiatrists locally are between 6 months and two years.” [Survey Respondent]

Last week, NAMI released a new report, Out-of-Network, Out-of-Pocket, Out-of-Options, The Unfulfilled Promise of Mental Health Parity, that describes the barriers millions of Americans face in finding and paying for quality mental health care. Based on an survey of more than 3,000 people living with mental illness and their family members, the report found that people had far more difficulty finding mental health providers in their health insurance network compared to other types of medical providers. This means that people often faced longer wait times and relied on more expensive, out-of-network care for their mental health needs. 

People with mental health conditions have faced persistent discrimination in insurance coverage; for many years, people with mental health conditions were often denied coverage entirely and those who did have insurance faced unfair limitations on the amount and type of care they could receive.  Despite recent progress—including new legal requirements for fairness under the  Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act—significant challenges remain.

“The majority of the mental health professionals in my area do not participate in any insurance plan . . . We have depleted our savings and incurred much debt to get the quality mental health care we need.” [Survey Respondent]

NAMI’s report recommends that health plans:

  • Maintain accurate, up-to date provider directories
  • Provide easy-to-understand information about mental health benefits
  • Promote integration of mental health and primary care
  • Expand mental health provider networks
  • Cover out-of-network care to fill provider gaps

What You Can Do

Considering filling out this year’s survey about your experiences with health coverage. The survey makes it possible for NAMI to identify where there has been progress and where we need to advocate more strongly. And your stories help us, as well.

Filling out the survey will take about 20 minutes. And make sure you share it with your family and friends. The survey closes on Wednesday, December 31st, 2016 at Midnight EST.

NAMI envisions a future in which the promises of parity are truly fulfilled. People with mental health conditions and their families deserve access to timely, affordable and quality mental health care. Until effective treatment, services and supports are available to people living with mental health conditions, NAMI will remain a leading voice in the fight for parity.

Comments
Sara Smith
In Portland, Oregon, and we rank 2nd to dead last for childhood mental health illness and treatment of and care. We care far more about our dogs and pets then we do our children in Oregon and it reflects in our statistics. My family has "good" private insurance, with bad mental health care options, and NO options left to assist my child with severe and escalating mental illnesss. We have had 4, 10 day acute inpatient stays in psych ward for child in last 3 years. No follow up or after care. Therapy 1x week plus psychiatric for meds is not enough. As we don't have Medicaid as child is insured via spouse, there are no wraparound services for our child. The only "care facility/center " covered by insurance is always full and will not help.

I no longer can work, as I now run 247 inpatient alone in home for sick 13 year old. Had to install cameras and extra locks. I don't get breaks and this should not be my job. I spend 50hrs plus a week searching, calling, emailing, begging for help for child. That's when I am not in crisis with her, or trying to find her, or at scheduled appointments with her over a 30 mile radius, etc.

At this point, I have begun a large paper trail and journals that will be published if the worst case scenario ever happens. The so called health agencies have made it clear that they can't help my child until she's gone. As such, should the worst happen, I will ensure they receive her body and the media will receive my documentation of our struggle. If she does not get help, we will lose her soon.

If I hear one more commercial from these so called do-good non profit facilities about how they help families, I will need admitted as well.

Trying to get survey completed tonight. Thank you for your work and advocacy.
12/16/2016 4:04:05 AM

Kevin McDuffie
Loo looking for a mental health doctor or phycologists or phycaritist who except nc medicaid i am diagnosis with ptsd\major depression \majoranxiety
12/13/2016 10:10:07 PM

Sue C.
Our son suffers from a mental illness and we worked hard to get him on both Medi-Cal and Medicare. We also filled out the detailed paperwork to qualify him to continue to be covered by my employer's Kaiser insurance (due to his disability). He primarily is using Kaiser but it took 4 hospitalizations to get him stabilized with a diagnosis and medication. He finally digressed to the point of requiring over 6 months of psychiatric care at an inpatient, locked facility. Kaiser is paying for his care there but now, with Kaiser, he does NOT qualify for any of the county run transitional residential facilities. We will have to cancel his Kaiser and time it so he can leave the locked facility and hopefully transition directly to a transitional residential facility. Health insurance shouldn't slow down the process.
12/6/2016 11:45:39 PM

Desta
We were able to put our son in sessions with his pysciatrist and his counselor until my husbands job changed. Before they mental health professionals were just like our primary care doctors and we had a co-pay. Now they put the mental health under the dedectible so we have to meet a $1000 deductible before the insurance pays a dime. Mental heal is just as important as physical health and should not be looked upon as if it is a secondary priority.
12/5/2016 11:16:32 PM

Mason
In Massachusetts.
I have been dealing with MH, depression and mood disorder all my life; it just seems the older I get the worse it gets; Especially this time of year; I not only suffer from depression, I also suffer from Fybromyalgia., a chronic pain that I cannot get pain relief for, I have taken all types of depression MEDS, most I can't remember, but none have taken the pain w/agony, neither the emptiness that sworms me every day.

I can't imagine anyone in this type of situation who doesn't know GOD, my beliefs and the fact that I have two children are my RAY OF HOPE, not to GIVE UP. It just saddens me that their is not enough outlets for this type of illness, Dr's today, are not like they were years ago; no one really seems to care anymore. I have had no luck ever since I switched Tier's at my job, that has been 3 yrs now.

What is ONE to do in this situation :(

Thank you for listening.

MASON
12/5/2016 11:11:25 AM

Sandra Ronning
January 2017 will ring in the 4 year mark since my family was thrust into our mental health journey. And it will also mark the 4 years we have been waiting for treatment recommended by not one, or two or even 3 doctor's - 6 in total have recommended treatment that simply doesn't exist in the state of Utah. Until you are in this world looking out, you cannot begin to imagine the crisis we are facing. I've heard that addiction is a family disease; when combined with mental illness, it becomes society's disease.
12/1/2016 5:59:34 PM

Gail Jenson
My son has the minimum health insurance and he can't find any therapist that will accept it, so he switched his insurance and has the same problem. In the past he had gone for help to various therapists which we helped him pay for and the majority of them weren't very good and just made things worse for him.. He's given up trying to find help.
12/1/2016 10:20:15 AM

Kathy
I struggled when I was first diagnosed with Bipolar with the insurance. I had my bills were insane. After the Community Health Center in my area helped me get on Disability for my mental disorder I was put on Medicare, my insurance is very good. I receive all the medicine and psychological care I need. Although I do need to travel 70 miles to see a doctor I am very grateful to have an excellent doctor.
11/30/2016 11:35:10 PM

Carolyn Bowen
By the way, I am on medicare and a supplement. I received a letter today that my medicare is increasing from $158 a month to $485 a month!!! That doesn't leave much of my SS check! My son is the one with no insurance and mental health issues, but I may be joining him at St. Vincents hope clinic for othe rmedical needs with this increase in "affordable" insurance. Medicare?????
11/30/2016 7:47:22 PM

Carolyn Bowen
My son has the mental illness and currently has NO insurance. In Texas medicaid is not available if you have no income and his ability to keep a job is limited. God led us to St. Vincent Hope clinic in 2013 and it has saved his life. It is not ideal with different doctors and especially changes in meds, but without them he would have no health care at all. I have put them in my Will!
11/30/2016 7:44:37 PM

Ruth
In Arkansas it is taking people three months to connect with therapist or psychiatrist. We donot have enough professionals to go around.
11/22/2016 8:00:56 PM

Subscribe
 Security code