Therapy and insurance... how much are you paying?

[Anonymous]

For those of you with Flexible Spending Accounts who are using out of network therapists -- do you put the whole charge on the FSA card? Or pay with another card and only submit to the FSA after you know what the insurance company is going to cover? I can't figure out what makes sense.

thanks

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think there needs to be federal investigation into the “allowed amount” bullshit. $80/hour is not the going rate for therapy anywhere. They should be required to reimburse based on the actual real world price paid by the insured

$80 for 30/45 minutes is reasonable. If they up the allowable charge, then the providers will just increase their rates even more. If a provider is in-network, they are required to take that amount and you co-pay and that's it.

Therapists don't generally charge for a 30 minute session. And $80 for 30 minutes = $160 for 60 minutes. My child has had psychologists at several different practices, and the charge is for an hour, usually. The insurance company will tell you $80/hour for a psychologist is the "going rate". Nope. Try $160-$200/hour.

If the insurance companies' allowed rates were reality-based, more providers would take insurance!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think there needs to be federal investigation into the “allowed amount” bullshit. $80/hour is not the going rate for therapy anywhere. They should be required to reimburse based on the actual real world price paid by the insured

$80 for 30/45 minutes is reasonable. If they up the allowable charge, then the providers will just increase their rates even more. If a provider is in-network, they are required to take that amount and you co-pay and that's it.

Therapists don't generally charge for a 30 minute session. And $80 for 30 minutes = $160 for 60 minutes. My child has had psychologists at several different practices, and the charge is for an hour, usually. The insurance company will tell you $80/hour for a psychologist is the "going rate". Nope. Try $160-$200/hour.

If the insurance companies' allowed rates were reality-based, more providers would take insurance!

Yes, they do. And, they charge because people are willing to pay out of pocket. Ours pay for 30 minute speech and OT sessions. We can go multiple times a week but only 30 minutes a day. Ours pay nothing for out of network or no referral.

[Anonymous]

I have never heard of a psychologist with 30 minute appointments.

[Anonymous]

Anonymous wrote:I have never heard of a psychologist with 30 minute appointments.

30 min is often a med-check

[Anonymous]

Our “Cadillac” insurance plan won’t cover our kid’s therapies at all because DC was born with it and besides therapy is “provided by the public school system.”

If DC had gotten TBI from a bad accident it would be covered though.

A few years ago we were horribly broke and I came to realize it was a blessing in disguise because it was during age 3-5 and Medicaid paid for everything and I never had to make one phone call or fill out any forms.

Now, we are going without much but hopefully will have a waiver next year.

[Anonymous]

Anonymous wrote:Our “Cadillac” insurance plan won’t cover our kid’s therapies at all because DC was born with it and besides therapy is “provided by the public school system.”

If DC had gotten TBI from a bad accident it would be covered though.

A few years ago we were horribly broke and I came to realize it was a blessing in disguise because it was during age 3-5 and Medicaid paid for everything and I never had to make one phone call or fill out any forms.

Now, we are going without much but hopefully will have a waiver next year.

Medicaid is the most generous with services. You basically have to be very rich or very poor to get help for your kid.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have never heard of a psychologist with 30 minute appointments.

30 min is often a med-check

For psychiatrist. (Which at our practice is $150.) Psychologists do 45 or 55 minute appts.