Medical Insurance denies Mental Health coverage.?

I have an individual policy with Blue Cross and Blue Shield. When I first obtained the policy (after a switch in employment), I was given a book showing all of the doctors covered under my policy. I was happy to see that my thearapist was one of them and continued my thearpy with her. After the first session I receieved a letter from BCBS stating that my coverage did not include mental health issues (since I had only an individual policy and not a group policy) so they would not cover my bills. After extensive complaints and appeals they admitted that they sent me the wrong book for my policy which had stated that this doctor was covered by them and I was basically out of luck and ended up having to pay the bill myself. Can an insurance company really deny you mental health coverage? Isn't this a form of discrimination? I can't even see the doctor for depression without them denying my claim. What is wrong with this picture?

The policy would have outlined the services covered. The book was a reference for you - not the policy - and yes, they can deny you coverage if it was not part and parcel of policy itself.

An insurance can deny you coverage for anything - and unless you specifically requested and paid for mental health coverage, it isn't discrimination.

It's a pre-existing condition. (Not all BCBS policies are the same, there are different options and different policies.)

mental health and physical health are two different things. a fair amount of insurances do not carry health anymore. they can cover the doctor for prescriptions but no for the sessions. it sucks, but they have the right.

Yes unfortuntaly they can deny you health coverage for mental health, they can even deny you if you're overweight. there are plenty of stories on the movie sicko

I'm sorry, but I don't agree that mental health should be included, nor do I think that pregnancy (a planned event) should be included, nor do I think that STD's including AIDS from willful activity should be included.

Oh this sucks....but yes this can happen!

Individual insurance policies generally suck.....
And in fact, many employee insurance policies really have 2 policies, one for "health issues" and one for "mental health." So even though I have Humana, I have 2 Humana policies, of which the mental health section is managed by another group.

They screwed you by sending the wrong book. But they have the right to deny mental health coverage.
Even my policy which has mental health coverage can deny benefits for treatment.

This unfortunately is a result of managed care. They have some idiots making decisions about our health.

Can you work with your therapist to pay it off slowly? Or will she reduce her fee, so your bill is less?

BCBS does cover mental health (in my state anyway), but you have to see a doc. on their list. If you really need the services just switch dr.s.

My thinking is that the insurance company can decline to cover mental health treatment given that they draw up the policy in the first place. There's no law that I know of (in the US) that requires an insurance company to cover anything specific. There are some health treatments that the Federal government will allow for tax deductions, and mental health is most often covered. (Similarly, alternative treatments may also be not covered, depending on the treatment type.)

In my opinion, that you were given false information regarding your policy sounds like it is grounds for legal action. Since you in good faith placed a claim based on what they told you, I feel that they should cover your bills up to when you were told otherwise. However, I'm not a lawyer, so that's a lay opinion.

Much of the reason why mental health is treated differently from other health issues is the stigma that mental health is somehow quite different. Even though a tonne of research has indicated that many mental disorders are actually physical in origin (such as neurotransmitter imbalances), there is still the viewpoint that "it's all in the head". (Well, it is, but not in the way that they mean.) Even if it is a behavioural issue, it's still a health issue, but many groups are slow to adopt that. Even if insurance does cover mental health, it's often in a different category from other health issues.

It is extreeeeeeeeeemely wrong and scandalous that Blue Cross did this to you!
Unfortunately this happens with the Insurance companies all the time and it isn't just Blue Cross that is doing it.
The real ugly and disgusting sad part is YES they can and are getting away with it.
I have found that even WITH Insurance and me having the mental health coverage they can STILLLLLLLL DENY YOU!!!
What is wrong with the picture is $$ darlinK! YOu need to dish out more Ca$h or you aren't going to get that Premium PPO coverage that will give you the mentaL health you need.

Not ethical, but they couldn't care less. They can basically do what they want. They save all the mental coverage for themselves.

Unfortunately, you can see whomever you want to see, but certain insurances won't cover them. You were correct in finding out first if this new insurance would cover your therapist/doctor as this is usually what everyone would do in the event of new insurance.

Most insurance have a section with stipulations concerning mental health, drug detoxification program, etc. Some insurance will cover a certain number of visits, but it must be referred by your primary physician (your family doctor) and a form submitted to the insurance and approved before you can begin treatment.

That's why I have a health spending account where I set aside a certain amount for the year, deducted from my paycheck for money I can use in the event that insurance does not cover certain items (dentistry: porcelain crowns) and when they don't cover enough.

Blue Cross and Blue Shield used to be a great major medical, but due to more HMO's out there (most companies do not want to pay for major medicals anymore), there a usually a string of stipulations that come with using these insurance. Yours make a simple but costly mistake for you - sending you the wrong book. Think of this, what do you suppose they are paying these people for salaries? The bare minimum from their type of service, I would say.

My doctor who I like very much has an office in which my waiting to see him takes any where from 30-75 minutes of waiting time and it's mainly due to his office front desk staff who are women in their 60's and can only do one thing at a time. What do you suppose they get paid?

Insurance & the type of people working them are not the same as it used to be.

if you have sever unuff depression you can bill bcbs under you're medical coverage you just will have to fight with them insurance company's want o save money so getting them to cover and thing beyond regular doctor visits is a pain in the ***

I have had many battles with BCBS over a similair matter. I have enlisted the aid of my congressmen, the Insurance Commissioner, Mental Health Association, and letters from my therapist and doctor. With a lot of time and effort, I have been successful in my attempts thus far. But it has been a demoralizing endeavor. But, this last time, I even got a letter of apology from one of the individuals in the company who had the power to overturn previous denials. I am facing another such encounter now in the following weeks, and I will see how successful I will be this time. It would seem that with their admittance of the mistake that they could possibly be persuaded (maybe with the help of some important individuals) that your situation could be reconsidered. You may want to contact a lawyer just to see if you have some legal grounds.

I wish you success and well being.