Thursday, December 19, 2013

The Important Doctor Who May Not Take Your Insurance

The Important Doctor Who May Not Take Your Insurance

Feeling down? You may have to shell out more for treatment: Psychiatrists are significantly less likely to accept insurance than other types of doctors, reports a study from Cornell University.

Researchers found only about half of these mental health docs accepted private insurance, compared to almost 90 percent of doctors in other fields. 

While psychologists have a master's degree or Ph.D, psychiatrists have completed medical school, internships, and at least four years of training specific to psychiatric illnesses. So if psychiatrists are certified physicians, why don't they get the same coverage as your family doc? Because insurance companies often have guidelines for what in-network physicians can practice--and psychotherapists usually don't fall on that list, says Saul Levin, M.D., M.P.A., and medical director of the American Psychiatric Association. 

Sure, you can go to your primary care doctor for mental health issues. But a psychiatrist has had more in-depth training to deal with mood disorders than other docs. So know this: While insurance companies may not cover as many psychiatrists as other M.D.s, they do cover some. Most companies have a website to find in-network physicians, and if you can't find a specialist near you, call your provider and let them know: "Insurers have a legal obligation to ensure that the network of doctors they have meets the demand for services needed," says Dr. Levin. Alerting them of their thin list may encourage them to beef up the options.

And don't discount out-of-network options. "Patients routinely see psychiatrists on an out-of-network basis and then bill the insurer," explains Dr. Levin. "The insurer reimburses the patient a certain amount and the patient pays the difference between their doctor's fee and the reimbursement." Your out-of-pocket cost could only be $20, but check with the physicians and your provider to confirm your coverage before your first session.

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