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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by mair on January 1, 2006, at 16:02:19
I feel strange posting here since I've been so absent for so long.
As of today, I no longer have any medical insurance for therapy. My office decided to switch to a plan which has much greater management controls on mental health. My therapist is not in the "network" so my health insurer will no longer reimburse me for any portion of what I pay.
The new plan saves money for everyone who works where I do, except for me; It's hard not to feel that all of those savings are coming at my expense. When this was discussed with my colleagues, one of them just told me to switch therapists, particularly since mine had done such a poor job of "curing" me.
It's hard for me to argue with him since I get very defensive about the amount of therapy I've had. I've seen my present T for over 6 years. Because she was so worried about me last spring, I started seeing her 3x a week. So the timing of this is just so bad.
It appears that meds, while helpful, don't do great things for me (I've tried between 20 and 25 different drugs) and I seem to be impervious to short term therapies, of which I've tried many. And since I'm such a non-revelatory, private, mistrusting person, therapy is an unbelievably slow process for me. 1x a week was pretty worthless; I did better with 2 and better still with 3x. I'm pretty sure there are people here who've opened up more to their therapists over a 6 month period than I have in 6+ years. So my T is loathe to have me cut back right now.
I'm hopeful I can work something out with my office to pick up some of the cost, but that requires a level of advocacy and openness that is counterintuitive. Under the laws of my state, I can appeal to my insurer for an up-to 2 month transition period, during which they'd have to continue to cover me, but it requires a showing that my illness is debilitating and life threatening. My T is willing to say what needs to be said with no reservations, but I don't like seeing that kind of thing in writing, and frankly, 2 months seems like a drop in the bucket. Also the idea of the transition period is to allow me to get used to a new therapist (laughable, since it took me at least 5 years to get at all "used" to my T), but I have no intention of starting up with anyone else, and i don't know if that would make a difference to my insurer's legal obligation to cover me in that 2 month period.
I only found out about all of this in early December and feel that I've wasted every session in December talking about what the lack of coverage will mean. My T has pointed out to me that it would seem much more affordable if I actually fully billed people for my services; Billing is a big issue with me; I rarely feel that I'm worth what I'm supposed to be billing, so I either hugely discount my bills, or don't send them out for and age, if ever. She's also pointed out that the real challenge will be for me to decide that I'm worth the money that I'll now have to spend on therapy. She's surely right about that.
I already pay my T somewhat of a reduced fee because I see her so often, and she's offered to reduce her fee more for the 3rd session, if I stay with it. For my part, I've promised my T that I'm not going to quit precipitously, but mostly I've just pushed the whole issue to the side because I don't really want to think about it. I'm sort of sick of talking to her about it, and her dire predictions of how poorly I'm going to fare without therapy are pissing me off anyway. It's one thing to consider theoretically, but I think that once I start getting these humongous monthly bills, I just won't be able to stomach it, and I'll feel too guilty raiding money otherwise set aside to help cover my kids' college costs. Since I can't expect to progress in therapy at any greater rate than the glacial speed of the past, there just is never any light at the end of the tunnel.
I realize my predicament still puts me way ahead of most of the people here who are uninsured and can't afford therapy, so this all sounds pretty whiny to me. It's just that it is a big deal to me. My first uninsured session is tomorrow morning, and I find myself just not wanting to go.
Mair
Posted by crushedout on January 1, 2006, at 16:26:00
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
god, mair i can relate so much to this. my coverage just changed, too. it's terrifying stuff--i feel so much for you. i keep telling myself it's only money and i'll find a way (with my t) to make it work but it makes me feel so insecure. (which is why i've retreated into drugs-not a recommended course of action.)((((mair))))
Posted by Dinah on January 1, 2006, at 17:08:34
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
I sent you a babblemail, Mair.
Don't feel funny about posting. You're a long term babbler who has helped any number of us.
I think changing therapists at this point isn't such a good idea. You've worked so hard to build up a rapport with this one. Don't feel guilty to do what you need to do to see your therapist as often as you need to see her. You *are* worth it.
What's your husband's reaction?
Don't worry about the coworker. My bosses periodically make the same sort of comment. They just don't have a clue. I try not to let it get to me, or to be angry at them about it. It's ignorance of the process.
(((Mair)))
Posted by mair on January 1, 2006, at 18:26:09
In reply to Re: A sense of foreboding (too long) » mair, posted by crushedout on January 1, 2006, at 16:26:00
I'm sorry this is happening to you too. After awhile, it becomes very difficult to accurately quantify the positive impact of a medication - how can you know how you'd do without it, when you've been on it for so long that you can't remember how you managed before? I feel a little of the same way about therapy. I don't know how I'd do without it. But everything about therapy carries with it such an emotional punch - right down to the detail of how you pay for it and how you justify the expense. So even if I resolve not to quit, the notion of continuing without insurance still looks dangerous and risky.
mair
Posted by Emily Elizabeth on January 1, 2006, at 18:30:03
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
For what it's worth, I would have rather had my mom spend some $ on her own therapy and made me pay some of my own college expenses. A well-functioning mom is priceless! In fact, it would have saved me big bucks on my own therapy! So although therapy is something you do for yourself, it is also something that you do for your kids.
I agree that you should do what you can to stay w/ your current T. T's aren't interchangable, in spite of what insurance companies think. What about going 2x/week? Is that a possibility?
Take care and keep us posted.
Best,
EE
Posted by mair on January 1, 2006, at 19:15:02
In reply to Re: A sense of foreboding (too long) » mair, posted by Dinah on January 1, 2006, at 17:08:34
Changing Ts is definitely not an option; I have too much invested in my relationship with this T; if something happened to her, I'd quit T rather than start again with someone else. Besides, even if I went to a T in the network, there would always be this issue about why I don't respond more quickly. I think most of the Ts in the network tend to be more CBT oriented.
My T has continually brought up how I might look at this differently if I had a physical illness like cancer. I tend to think I'd feel guilty about the financial drain from that too.
My husband is neither supportive nor non-supportive. He's never really involved himself in issues related to therapy unless I've fairly assertively forced him to be involved. I pay all the bills and file all of the insurance claims so he doesn't have a real handle on the cost. He certainly understands that I can't just change therapists, but I don't know how much he's really pondered the issue of why I'm still in T or why I go as frequently as I do. He seems pretty happy to stay out of that, and I'm not the kind of person who would naturally share things with him. I also probably can't simplify the issues enough to keep him paying attention and listening; it's all so muti-layered to me.
Posted by LadyBug on January 2, 2006, at 0:27:50
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
I know how you feel as I'm going through the same thing right now. I just got new benefits, not only with my new job, but my husbands new job too. We both have insurance and neither one has my therapist in network. She's given me a reduced fee too. I'm torn! If I switch in Sept. during the anual open enrolment period and chose the other plan, she will be on it. But then I lose my Dr.s. So it becomes a gamma of hard feelings. AND MONEY!! I usually go once a week unless I'm struggling. I've been seeing my T. for 9 years and can't even begin to think of seeing someone else. She is awesome. She feels like my best friend, best sister, best mom all in one.
I know what a delimna you are in. I agree that this isn't just an investment in yourself, but your kids as well. I hope I can be a better mom because of what I learn about myself in therapy. I've always found a way to pay her in the darkest of financial troubles I've been through and trust me, I've had more than my share of that! It is a sacrafice, but you are worth it!!!! Remeber that. Keep in mind that things will work out, they always do, maybe not the way we like them, but we learn to adapt to what happens in our lives.
Hang in there, it will be ok.
LadyBug
Posted by zenhussy on January 2, 2006, at 2:10:33
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
long day with too much drama here. very exhausted physically and emotionally.
what you've written and shared is important and we will respond with fresh eyes on the second.
SOOOOOOOOOOOOOOOoo glad to see you again sweetie. as usual wish things were easier and better...until then we are grateful you're still trying and working on this whole life thing.
with tremendous fondness,
__zh
Posted by LauraBeane on January 2, 2006, at 11:45:35
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
FWIW I think you've outlined the pros and cons of leaving your T quite clearly. Leaving now would cost too much. I mean emotional cost and cost in terms of time. Both are crucial issues and they deserve at least equal weight when you think about cost in terms of money.
Could you tap into the college money for now (tough one, I know) as you continue to explore other ways to pay (ie, charging more for your services in your own profession)? It won't be forever. You could keep track on paper and make it a personal loan you make for yourself. If you stay with therapy, you will be able to proceed at your own pace exploring ways to pay back what you've "borrowed" from the college fund.
This seems like just too charged a situation for anybody to have to make such a major decision under such pressure at such an emotional time of year within such a short time period.
I agree with EE I think it was who said she'd rather have a healthy and happy mom than a financed college education -- and that it would have saved EE herself a ton of therapy bills! good point!
six years is a long time. I give you a lot of credit for staying with it. I'm sure that wasn't easy at times, especially given your tendency to hold it in so very tightly. I hope you can work something out.
Posted by crushedout on January 2, 2006, at 22:38:25
In reply to Re: A sense of foreboding (too long) » crushedout, posted by mair on January 1, 2006, at 18:26:09
I know exactly what you mean. I hate investing emotionally in someone who can only be there for me on the condition that I pay her. Especially because money is limited for me (I guess if money were no object, this wouldn't be such a huge issue, right?).
But I've decided that I'm going to invest the money for now. I realize that I can survive without her (my recent reduction in therapy sessions has made me more confident of this) so it makes sense to try to work with her and get as much out of it as I can.
As for whether it (therapy) helps, I've found myself doubting that frequently, but I've decided the only thing I can do is take the leap of faith that it will work and go for it. It's a constant struggle though.
Posted by zenhussy on January 7, 2006, at 16:24:09
In reply to Re: A sense of foreboding (too long) » crushedout, posted by mair on January 1, 2006, at 18:26:09
> I'm sorry this is happening to you too. After awhile, it becomes very difficult to accurately quantify the positive impact of a medication - how can you know how you'd do without it, when you've been on it for so long that you can't remember how you managed before? I feel a little of the same way about therapy. I don't know how I'd do without it. But everything about therapy carries with it such an emotional punch - right down to the detail of how you pay for it and how you justify the expense. So even if I resolve not to quit, the notion of continuing without insurance still looks dangerous and risky.
> mairMair,
we're still prodding the brain into response here but after reading this our first thought is it would be dangerous and risky to not continue based on what you've shared over the years.
going to print out your first post (reading on the monitor just ain't happenin' right now) and mull it over.
we'll warn you now that our next post will most likely be in support of your continuing therapy and possible ways of going about that or of reframing how you think about it.
we tell ya the truth because you are worth it and you do matter, you count, you're important and we'd be mighty lost w/o ya around.
fondly
__zh
Posted by zenhussy on January 13, 2006, at 21:05:46
In reply to Re: A sense of foreboding (too long) » crushedout, posted by mair on January 1, 2006, at 18:26:09
> I'm sorry this is happening to you too. After awhile, it becomes very difficult to accurately quantify the positive impact of a medication - how can you know how you'd do without it, when you've been on it for so long that you can't remember how you managed before? I feel a little of the same way about therapy. I don't know how I'd do without it. But everything about therapy carries with it such an emotional punch - right down to the detail of how you pay for it and how you justify the expense. So even if I resolve not to quit, the notion of continuing without insurance still looks dangerous and risky.
> mairwhat you write makes a lot of sense and is shared by many people with depression.....especially those who have met with mediocre response to both meds and therapy despite doing the work. not a fun place to live in or come from. questioning why bother with treatment when you can't tell treatment from non-treatment.....bleh!
the fear that comes to mind is what support outside of your therapist could take the place of your therapy? from what you've written about family and friend and coworkers it doesn't sound like there are a ton of places for you to take the pain, frustrations, disappointments, challenges and so on that are a package deal with some depressions.
it hurts to think of discontinuing therapy and shutting down because of the lack of that outlet.
no pressure but also did not want this to disappear with the roll-over.
fer old times sake,
__zh
Posted by zenhussy on January 19, 2006, at 16:12:59
In reply to A sense of foreboding (too long), posted by mair on January 1, 2006, at 16:02:19
hoping to hear more about this Mair. not meant with any pressure. don't want to see this slip silently away either as do many important threads...
This is the end of the thread.
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