Depression makes it almost impossible for me to seek help for MDD.
And as I finally begin to address it and seek out professional treatment, the paperwork and insurance have me circling the drain. Fresh out of 5 East last year, I knew very quickly that my insurance did not cover all mental health issues.
I understood and accepted paying out of pocket for these expenses.
Then, in August of last year, I was back under an all-inclusive benefits package that includes many mental health benefits. Proudly presenting my newly acquired insurance cards at my next scheduled therapist appointment, I was told everything going forward was covered.
The tech made it clear they would contact my new insurance carrier and alert me if there were any issues.
Fast-forwarding to March of this year and bills began showing up for services rendered. These were the same services I had been told were covered under my insurance.
And being told that I would be alerted if these visits were not covered, I was devastated. Not only was I now on the hook for the past six months of invoices, but I must also change providers if I want my visits to be covered.
It gets even more convoluted when I speak with my insurance carrier.
Talk therapy is covered differently than psychiatric appointments for medication management. In fact, there are two separate companies my employer contracts with, each with its own specialty. I discovered that my psychiatric appointments are being paid through my regular health insurance. These are medical visits with a doctor.
But my therapist appointments fall under a different umbrella.
The only way to have these covered is to speak directly to this group. And then choose from their pre-qualified list of providers. Then you must give your new therapist a code they can reference for billing. And I must call my insurance mental health group with the name of the therapist I will be seeing. They also want the date and time of my first appointment.
I have depression for crying out loud, and all these steps are incredibly difficult for me.
And my depression is not as crippling as some. Yet my anxiety at jumping through the hoops is impeding my progress. So I pull out my unhelpful thinking style of time travel. Then I project a day and time where I would be mentally ready to take on the phone calls.
And of course, there will be follow-up phone calls needed. Then when I must leave a message, I must pick the best number for a callback. And I must be ready to answer the phone.
I have pages of notes related to my conversations with or messages left with providers.
My self-advocacy is the tool I am using to complete this mission of securing a talk therapist under my insurance. While coping with depression, I am responsible for lining up a new talk therapist.
And I must provide all the payment information to them. Plus, I must respond to the insurance company with all the details of my pending first visit.
If these challenges were not enough, March of this year is when the Global Pandemic became the focal point of everyone’s existence.
In-person visits to talk therapists soon became phone calls. Making a connection with a new therapist just became that much harder for me. Depression and I could see the therapist doing a crossword puzzle on the other end of the phone. All while I was spilling my guts out.
I am sure this wasn’t occurring, but unhelpful catastrophizing of a phone call, made me think this was more than possible.
With my depression, I am forced to make phone calls to my insurance company to understand where I stand. I am searching for answers as to why certain activities are not covered related to mental illness unless I do it their way. Without depression, their way would most likely be a snap.
But getting on the phone to face these issues is daunting for me with my depression.
Kicking the can down the road, I lull myself into a false sense of security. I say, “I will do this tomorrow.” And when tomorrow passes, it’s ok. I will make the calls the next day. While I am negotiating with myself, these bills need to be paid by someone. This provider is holding me responsible. I am looking at my insurance company for support.
This standoff has the potential to negatively impact my positive credit rating, which I have worked extremely hard to produce.
Part of me says just pay the darn things and move on. Yet, I feel that there is more to the story. These visits could and should be paid by my insurance. The fellow I spoke with two days ago, at my insurance company, was clear that he couldn’t be clear.
He sounded as if he knew something he wasn’t saying. We ended our conversation with me being transferred to a department that had nothing to do with my concerns.
But this is how I found out that Psychiatrist appointments are covered.
Yet talk therapist appointments require seeing someone on their approved list. If I didn’t have MDD, this would be easy. But if I didn’t have MDD, I wouldn’t need to negotiate through the bureaucracy of my health care provider.
Break your arm, and the course of action is clear. Have a mental health issue and the path forward is challenging at best.
Mental health issues still carry a stigma with them.
Add that to the underhanded way depression makes me think about things and seeking help is often exceedingly hard. For me, it leads to concealing my depression and minimizing the impact episodes of depression have on my life. It’s all about me, but I know others are impacted by my depression. I sometimes do not deliver on promises.
So, I will forge ahead, deciding how much energy I am willing to invest in getting these bills paid.
Here’s a thought. How about an Ombudsman to advocate for and assist those of us who want mental health services but are too depressed to act on those desires?
My concealed depression is written under the alias “Depression is not my boss.” I have certifications in SMART Recovery and am a Global Career Development Facilitator.
Diagnosed with Major Depressive Disorder last year, I am sharing what I learn. If you know someone who might benefit from reading this, please share.
I very much appreciate your comments.