Even when patients have coverage, there are fundamental disagreements between insurance companies and doctors about what mental health treatment is medically necessary. The Investigative Fund spoke with doctors, psychologists, and licensed clinical social workers around the country who work regularly with victims of sexual assault. They said that their patients have been experiencing an increase in delays and denials, particularly for talk therapy.So, which is better? Having government coverage, or allowing insurance companies to decide what is "medically necessary?"
So, let's review a few things I've mentioned here over the past few weeks.
~If you've ever reported incidents of domestic violence to the police, seven states and DC can deny you medical insurance. Pre-existing condition.
~If your new baby is over the 95th percentile in size and weight, he or she can be denied coverage. Risk of obesity.
~If you have ever been raped and required treatment for PTSD or AIDS, you can be denied coverage. Pre-existing condition.
One of our local radio stations runs an ad for Lipitor, a blood pressure medication. The ad says, in part, that there is no generic form of Lipitor available, so if you switch to a generic, it's a different medication. The plummy voice of the announcer goes on to say that, if you're doctor has prescribed Lipitor, why switch? Yeah, well...I got news. Here's why people switch: because their insurance won't pay for it! That's right, folks...if your insurance company finds a generic of something else that THEY decide works just as well, you can kiss your Lipitor goodbye! That happened to a friend of mine.
I never heard of Medicare denying coverage for these reasons. I guess it must be because, by the time you get to Medicare age, life is a pre-existing condition!
Many thanks to Surfy for the link!