R there better insurance co's when considering a difficult child?

Discussion in 'General Parenting' started by lovemychocolate, Feb 26, 2009.

  1. lovemychocolate

    lovemychocolate New Member

    We have to choose now and looks like these are my choices: BCBS; GEHA; and AETNA. I've had BCBS in the past and I know they can be a pain to get referral's and some medication's are pricey. Just wondering if anyone has something to comment about re: insurance and difficult child's and testing, authorization, etc.--anything you want to add????

    Thanks!
     
  2. smallworld

    smallworld Moderator

    I don't think you can even make generalizations about the insurance companies because it really depends on the individual plan your place of employment negotiates with each company. Your best bet is to do a side-by-side analysis for mental health care costs.
     
    Last edited: Feb 27, 2009
  3. susiestar

    susiestar Roll With It

    We happen to have an excellent plan through Aetna, but when we had them several years ago the plan STUNK. So it really depends on the specific plan your employer offers. Sorry I can't be more help, but each company gets a different policy.
     
  4. gcvmom

    gcvmom Here we go again!

    I think SW is absolutely right -- you have to compare what's being offered to you in order to see how they differ and then decide what's going to serve you best.

    in my opinion, if you can afford a PPO, they almost always offer greater flexibility for treatment options. But again, it depends on what package your company has bought for you.

    Good luck! It's an important decision to make.
     
  5. compassion

    compassion Member

    I think also depends on particular treatment preferences. For an example, it would have beeen helpful to have a plan that covered some Residential Treatment Center (RTC). Also, certian psychiatrists and tdocs cover certian insurancea nd not others. We have BCBS. Her todoc is out of network, psychiatrist is now in network. I have applied for SSI so Medicaid will cover Residential Treatment Center (RTC). I was thinking that recently, perhaps another private insurance would have covered Residential Treatment Center (RTC) but get the impression it is mostly Meidicaid with the program she is in. Comapssion
     
  6. slsh

    slsh member since 1999

    I agree with- smallworld - you have to do a side by side comparison. I thought parity became law (no day limits on psychiatric admissions) somewhere recently (was it the first bailout?) but... I'm not sure.

    I avoid HMOs like the plague. We always pick the PPO option - it costs more but is worth it just to avoid all those referrals for medical care. Since we've moved to IL, regardless of what the medical ins. co is, the mental health portion has always been administered by a different company and there are always pre-authorizations involved, even for outpatient stuff (psychiatrist appts, etc.).
     
  7. robinm1922

    robinm1922 One day at a time

    I don't know how much option you have with shopping around, I have MDIPA / UBH and it has been wonderful. My husband works for the government so that may make a difference but so far they have covered everything I have needed. They are covering 10 hours of testing for her neuropsychologist testing, all visits to psychiatrist or therapist for a year (I have to get a referral each year from primary) at this point I wouldn't change my carrier.
    I wish you the best of luck and compare the benefits according to your needs.
     
  8. WSM

    WSM New Member

    All our programs here are medicaid programs too, but we are two employed professionals with insurance and make a decent living. But not decent enough to afford residential placement.

    I did not realize you could get Medicaid if you had insurance. (We have BCBS, too).
     
  9. lovemychocolate

    lovemychocolate New Member

    I knew I'd have to do a sbs comparison, but I had this sinking feeling that there would be some ins. co. with a bad reputation. Just needed to hear how others have faired with their insurance carriers. Appreciate the feedback.
     
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