View Full Version : How often do you see a psychiatrist/therapist?


MochiGirl
10-20-10, 07:24 PM
I ask because I was reading the fine print in our health insurance summary of benefits, and while mental health visits are covered (30 per year) it apparently excludes ADD! It also says cognitive behavioral therapy is excluded, and DH's psychiatrist suggested he do that. I will of course call our insurance co. and get this clarified, but if it's true, we will be paying for all his treatment out of pocket.

How often does an ADD patient typically see a psychiatrist at the beginning (when treatment is still being worked out), and after that, for maintenance? Also, do you know how many sessions one typically sees a cognitive therapist? Is it an ongoing thing?

Thanks for any information you can provide.

StoicNate
10-20-10, 07:35 PM
I usually see my GP/Family doctor every month.
My GP is the one I see for my ADHD and everything else.

I used to have a Psychologist, but I quit going.
It wasn't worth the stress trying to get in contact and making an appointment.
(The Psychologist took almost 2 weeks to call me back.)

hmmmm
10-20-10, 07:39 PM
As often as you need.

wolfshades
10-21-10, 11:17 AM
I used to see a therapist once every two weeks for quite a while. (Not about ADD but about depression). Eventually though we both realized there was no further need of appointments.

It *is* ongoing at first, only because it takes a while to get to the root of things, and you have to come to a few important realizations about what's important to you, and how you're going to cope with your life as it is. (Actually come to think of it - there's a lot more than that, but those are the core things). Hopefully, you'll develop some healthy habits that allow you to manage impulsivity, focus and the like.

When I finished my series of appointments, my therapist left the door open, saying I should come back once in a blue moon "just to check in" - to make sure I was on track. Which I did.

Now that I have my diagnosis for ADHD (which I'm kind of surprised that she didn't pick up on), I plan to go back for more appointments.

Truly truly sucks that your medical benefit plan specifically excludes ADD. If it were the case with me, I would be talking to the company AND to the media about it. And whoever else wanted to listen. It sounds medically discriminatory, quite frankly.

namazu
10-21-10, 01:01 PM
MochiGirl,

How recent is the statement of benefits?

I ask because there have been some recent changes to U.S. law that address coverage of mental health issues. Basically, insurers are required to cover mental health treatment the same way they cover somatic health treatment. There are some limitations on this (and they may be within their rights to exclude certain forms of treatment or certain diagnoses -- ???), but I'm not entirely clear on the details myself.

Here's a summary of the Mental Health Parity Act:
http://www.dol.gov/ebsa/newsroom/fsmhparity.html

This page has more recent info:
http://www.hhs.gov/news/press/2010pres/01/20100129a.html

It's this part (from the first link) that makes me think they might be allowed to limit coverage for number or types of visits: "Provides that employers retain discretion regarding the extent and scope of mental health benefits offered to workers and their families (including cost sharing, limits on numbers of visits or days of coverage, and requirements relating to medical necessity)"

But I'm not sure they can exclude ADHD altogether, as it's a legitimate medical diagnosis, and I'm not sure they can exclude CBT if it's considered "medically necessary". I should look into this...

In any case, you might want to double-check on the mental health coverage provisions just to be sure they haven't changed on you.

Oh, and for what it's worth, I'm currently on the weekly shrink-visit plan because of various work-, family-, and comorbidity-management-related issues. Since I don't have much of a support network here, it's good to have someone to talk to. Thanks to the new parity rules, my reimbursement for a $150 (45-minute) therapy visit has risen from $61.88 to $83.13 or so. It's still a huge expense, but I don't have too many other expensive vices, and it's really important for my health at the moment. Hopefully I'll get back to a point where once a month is sufficient.

- Namazu

buddy
10-21-10, 01:16 PM
I see a psychiatrist every 3mos. but can go in more often if necessary.I call his office & get my prescriptions every month.The psyc. I was seeing for 10 yrs. before this one insisted on seeing me every month.

namazu
10-21-10, 01:40 PM
Update (past the edit window for above post)...

This site...
http://www.insure.com/articles/healthinsurance/mental-laws-by-state.html
...suggests that in some states, by state law, insurers have special coverage requirements for "Serious mental illness: Major mental illnesses, typically defined in state statutes as schizophrenia, schizoaffective disorder, psychotic disorders, bipolar disorder, major depression, panic disorders and obsessive-compulsive disorder."

Some states, like Delaware, Virginia, and West Virginia explicitly include ADHD in their definition of serious mental illness. Most states don't.

However, I think the national law (requiring coverage for all mental health conditions in the DSM-IV) overrides the state laws unless the state laws provide *extra* coverage.

ADDitude magazine has an article on this:
http://www.additudemag.com/addnews/71/7132.html
and this linked site claims (all medical?) mental health issues and substance abuse issues must be covered:
http://www.cadca.org/resources/detail/historic-healthcare-reform-legislation-signed-law

It's enough to make one's head spin, but all of this makes it sound to me like your insurer should *not* be able to deny coverage for ADHD treatment, though they may be able to restrict the types of treatment they allow.

In any case, I hope you're able to get coverage for whatever treatment you and your family may need!

MochiGirl
10-22-10, 08:09 AM
Thank you all--really helpful. Clearly, I have to investigate the insurance situation further.