NOBODY TAKES MY INSURANCE

Discussion in 'General Parenting' started by miche, Mar 19, 2007.

  1. miche

    miche New Member

    This is so frustrating. I just talked to Johns Hopkins Medical Center and they don't take it either.

    I looked online and my provider does not have ANY psychiatrists in our network. ONly psychologists and social workers. What the heck do I do now?

    oh, and does anyone know where I can find a good nanny?
     
  2. miche

    miche New Member

    I have been pressing buttons on my phone for 20 minutes trying to find out if my insurance has ANY psychiatrists in network. It doesn't seem like they do. How can that be?
     
  3. smallworld

    smallworld Moderator

    Michelle, the three private psychiatrists my children go to are not in our network (and neither are most of the good ones in our city). But we get reimbursed for a portion of the costs when I file the claims. You should ask for in-network and out-of-network costs when you get through to the insurance company. Ask to talk to someone who can explain the full benefits of your insurance coverage.

    by the way, the psychiatrist easy child sees for feeding issues at Children's Hospital in Difficult Child is considered in-network. We pay a co-pay ever time easy child goes for an appointment.
     
  4. jannie

    jannie trying to survive....

    Why insurance company do you have?
     
  5. SRL

    SRL Active Member

    Many insurance companies do require preapproval for out of network providers but they do cover them in medically necessary situations when they don't have an equivalent specialist.

    Virtually all of the child developmental/neurological/mental health specialists are in high demand right now so this is common.
     
  6. JJJ

    JJJ Active Member

    Search for your county's youth mental health clinic. They generally take all insurance and have a sliding scale as well.
     
  7. miche

    miche New Member

    I have CareFirst Blue Choice HMO. They do not allow any out of network providers unless NONE at all are available within 25 miles of your zip code. I finally got a person on the phone, and they emailed me a list. Looks pretty slim, though. We'll see.

    I talked to the rep. Unless it is in network, they don't pay any portion of it.
     
  8. totoro

    totoro Mom? What's a GFG?

    We are in the same boat here!!! We have had to call and beg etc... Sometimes if you bug the doctor enough they will start taking your insurance, they did it with ours in Indiana.
    We have almost noone here under our insurance... but luckily we get out of network and they cover a little bit. But we have to meet the deductible... which for our "family therapist" is 3000.00!!! So she says it is jusy difficult child going to see her... so deductible is only 500.00!!! We figured it wouldn't hurt to ask, otherwise she would lose us as clients!!!

    Insurance makes me mad... we had to put difficult child's birth on our credit card because we couldn't afford it and know that we have insurance they make you jump through hoops... and god forbid if you have a mental illness.... :nonono:

     
  9. miche

    miche New Member

    I have great medical insurance for myself. Paid $20 to give birth each time, and that was the fee to use the TV/Phone in the hospital room. All care was free. My mental health insurance is very good.

    Too bad both of our children are on my husband's policy, and unfortunately mental health was not something that we even looked at when we chose the policy. They have very good medical insurance, as far as checkups, well visits, etc go. I can't switch her to my insurance now, but open enrollment isn't until November.

    I looked at the list of doctors they sent me, none of them are from a hospital, they are all private practice. There's only one that's from a hospital and they don't see children under the age of 5.
     
  10. shutterbunny

    shutterbunny New Member

    Miche,

    we've been in your boat, though we're not on an HMO plan so we can go out of network. It is very common not to find a GOOD in network psychiatric or neuropsychologist (I'd suggest a neuropsychologist) as a lot of them don't take insurance at all or they take a very select few. I read your thread from a few days ago (I actually joined this forum because I wanted to respond to that and logged on this am to do so and saw your post here) and I feel for the emotional position you are in right now. I REALLY do. I'll expand on my family's background in your other thread if you don't mind. Anyway, may I suggest asking your pediatrician. for a referral to a neurologist...let him know that your daycare provider as well as others believe this behavior is a component that has a neurological base and you'd like to get a neuro's opinion on it. Be firm, as great as pediatrician's are, they can be dismissive of us telling them what we want them to do...you can also ask him about a neuro psychiatric. My plan (Oxford) has no pediatric psychiatric's in network, but does have adolescent/child psychs. They have NO neuropsychologist's in network. If you can get your pediatrician or a neurologist to say you need a neuropsychologist (our pediatrician and neurologist and the preschool system did) and if you specify pediatric, specializing in YOUNG children, preadolescent, I'll bet your plan will be willing to let you go out of network.

    Just a thought. Good luck. To let you know, our neuropsychologist is not in network, the initial visit was a BIG bill ($400) but it was SO WORTH IT. The subsequent visits are short and much more affordable and at intervals that help with saving...I live in a northern suburb of NYC, and believe me a pediatric neuropsychologist is hard to find, but wow was it really worth it for us. This being said, we were referred to him by my son's neurologist who has also helped us immensly with my son's behavior...asking for a referral *if you need one* to a neurologist may be a great place to start rather than a psychiatric...from there a neuropsyh is also a great plan.

    Best of luck to you and later I'll reply to your other thread and maybe it will give you some hope in all of this...reading through the replies, you've gotten a lot of GREAT advice and I wish I'd found this forum before yesterday!

    Michelle
     
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