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

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Reply to "Therapy and insurance... how much are you paying?"

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[quote=Anonymous]I did the math on our out of network -- between our copay and deductible I would have had to spend $8000 out of pocket before I saw a nickel of reimbursement on a $220 an hour psychologist.   That is for a "gold" plan in the Obamacare marketplace.  The good thing is that for some amazing reason they do cover the 2x weekly psychotherapy before deductible (for an in network provider).  This is actually helpful.

However, we just switched to new insurance with a much lower deductible which is supposed to be a "better" federal health insurance plan.  For the same provider, I will pay the deductible plus a $25 copay.  That means instead of paying nothing to his psychotherapist, I will end up paying $1550 a year.  For the psychiatrist, on 4 med check visits at $275 each out of network, I get 35% reimbursement of UCR which probably will amount to about $50 on a $275 visit.

I think out of network and in network OOPs are separate ($5K each), so I don't think I will hit either OOP and even if I did, I would still be responsible for the balance billing.

I tried to get an in network psychiatrist at Children's, but I couldn't even get them to return my call despite returning an intake packet multiple times and going down to the office in person. [/quote]

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