Private health insurance that covers therapy?

[kwynn]

I'm in sort of a pickle. If you all remember, my husband made 10x what I make and I moved across country for his job, and I was then unemployed for a few years.

We were living very cheaply, nothing special, nothing extra--a cheap apartment, a paid off 13 year old car, no cable TV, basic cell, nothing to really cut.

I'm living proof that, no matter how much you are saving, it isn't enough.

I was on my husband's insurance. I have my own business. I'm 28, so too old to be on my parents' insurance.

My husband's insurance offered me COBRA, which I had to take, since his insurance got cut off retroactively to the day he died. I used services that month before I knew.

I told myself I would keep the insurance through the end of the year to get my some therapy, anti-depressants, etc. and then find something else. I will have spent $4k on this insurance this year and that's not even counting the fact that I try to only go to therapy once a month to save money.

Unfortunately, it is *so* expensive---it's $512.00 a month for just me and the co-pays, etc, are still very high.

This expense is really killing me. I can't afford it. It's my highest expense beside rent. It does include a gym membership, but I can just get something at a cheap gym for like $30/month.

If you were me, what would you do? Is there any insurance out there that would cover therapy? Might it be better at this point to go with some very cheap plan and pay for therapy out of pocket?

I'm sorry to be so lazy about this---I just am overwhelmed and do not understand purchasing private health insurance that well.

I need someone to be like "Here's what you should get."

[rikki]

Some of my students see therapists based on a sliding scale. Would this be an option in your area?

[kwynn]

Oct 31, 2012 10:40:39 GMT -5 rikki said:

Some of my students see therapists based on a sliding scale. Would this be an option in your area?

Unfortunately, no...I live in a somewhat rural area and I have a decent amount of assets, but little actual income. It's sort of a weird situation. Also, there are grief groups, but they are on Saturday and I work every Saturday, and then the other specific young widow or suicide loss groups are too far away from me to be reasonable.

To tell you the truth, it's actually hard for me to go to another therapist. It's just so painful to have to tell the whole story of what happened again.

I've been on a waiting list since April to get 3 free counseling sessions from an organization here, but I'm not sure what's going on with that.

[Deleted]

I'm so sorry about your husband.

I'm self employed and have private health insurance. It only covers in patient mental health treatment, as is the case with most private insurance policies I have looked at. My therapist charges $150 an hour. I went weekly for a couple of months but spending over $600 a month on therapy was killing me.

If you have always been healthy, you can probably find an individual policy for less than $200 a month. However, I personally don't think it would be worth it if you then spend $150ish per month on therapy, because you will likely also have a higher deductible, copays and maximum out of pocket on an private insurance policy. I think your medical costs would very likely end up higher than what you are spending now on Cobra, but it can't hurt to shop around to see.

[kwynn]

What if I went with something *really* cheap like this:

www.uhone.com/Quote/PlanDetails.mvc?ProductType=LONG%20TERM

And then just went to therapy 1x per month for $150 or so?

So that would put my total costs at $68.14+$150=$218.14 plus any additional things I had to pay for out of pocket that month, like $60 in medications, etc. So let's factor in maybe $100 extra dollars a month. $318.14

Right now, the same things would run me:

$512 (COBRA) + $35 (copay for one therapy visit) + $17 (medication copay)=$564

I would still be ahead $200/month with the cheap plan, which is a decent amount, less if I don't need any medications or anything that month.

[HoneyBooBoo]

kwynn, I am so sorry that you have to deal with all of this. If you can wait just a little bit longer, will you be eligible for any of the insurance exchanges that are forming up with Obamacare?

[kwynn]

Oct 31, 2012 11:11:43 GMT -5 HoneyBooBoo said:

kwynn, I am so sorry that you have to deal with all of this. If you can wait just a little bit longer, will you be eligible for any of the insurance exchanges that are forming up with Obamacare?

I'm going to plead ignorance on this one---I don't know what's to come at all. I haven't been following it.

I have no medical conditions at all. I am not high-risk, never smoked, have always been continuously covered by insurance. I am not eligible for an employer plan.

Would any of that be covered under an insurance exchange?

I just can't find any health insurance that will cover therapy. Wondering if I should go with something dirt cheap just in case of emergencies?

[ijack]

Do you have employees? I'm not exactly sure how it works, but if you own your own business can you get a group plan that may cover more? If you want to PM me your state I can do some looking for you on mental health coverage too.

[Deleted]

Oct 31, 2012 11:31:16 GMT -5 ijack said:

Do you have employees? I'm not exactly sure how it works, but if you own your own business can you get a group plan that may cover more? If you want to PM me your state I can do some looking for you on mental health coverage too.

Group health insurance won't be any less expensive than what she's paying for COBRA. Group health insurance is very expensive, and the only reason it's typically not expensive for an employee is because the company picks up all or part of the premium payment. What she is paying right now is the actual cost of the group policy for her own coverage, but her H's company likely paid for part of the premium before. As the business owner, she'd be paying this herself PLUS all or part of the premium for her employee.

[ijack]

Oct 31, 2012 11:34:05 GMT -5 @godawgs said:

Oct 31, 2012 11:31:16 GMT -5 ijack said:

Do you have employees? I'm not exactly sure how it works, but if you own your own business can you get a group plan that may cover more? If you want to PM me your state I can do some looking for you on mental health coverage too.

Group health insurance won't be any less expensive than what she's paying for COBRA. Group health insurance is very expensive, and the only reason it's typically not expensive for an employee is because the company picks up all or part of the premium payment. What she is paying right now is the actual cost of the group policy for her own coverage, but her H's company likely paid for part of the premium before. As the business owner, she'd be paying this herself PLUS all or part of the premium for her employee.

I agree with this, but it typically has better coverage than individual policies and COBRA will run out. If she does have an employee that is paying for an individual plan, maybe they'd be okay with chipping in some too.

[jennistarr1]

I would ask your therapist which insurance she's in network for and call them for individual quotes

[atouchofklasse]

Can you get some sort of group insurance through a professional photography association?

[mrs.spunky]

There are some companies that offer plans to sole proprietors but it depends on the state. For instance, NY has them but NJ does not. Check out ehealthinsurance.com.
It would likely be better for you to get a low cost, high deductible plan for regular doctors/hospitals and pay OOP for therapy.

[mrs.spunky]

Oct 31, 2012 12:20:45 GMT -5 atouchofklasse said:

Can you get some sort of group insurance through a professional photography association?

This is another idea. You may be able to find a PEO (professional employer organization) in your area and go on their group plan.

[hereonceagain]

Have you talked with your current therapist about this? I'm wondering if he/she would have some way to assist you.

I was in a bind once with insurance. I was healthy thank god, and decided to just pay cash for everything (not buy insurance). It worked out well for me for those few years. I know it's highly not recommended, but sometimes you are really not left with options. When I wasn't covered, I found many places willing to cut my bills. It was cheaper to pay the bills than buy the insurance.

Wish you the best!

[cjeanette]

I would consider a high deductible plan and use an HSA to pay for the visits.

[hocus]

Have you considered getting a traditional job with health insurance? It might be better in the short term than keeping your business afloat.

I'd get some quote for basic insurance, which you can do on the internet, but if you plan to do any counseling then chances are you're going to close to the $500 you're paying now so I'd stay on your cobra plan and cut else where in your budget.

Also have you considered selling your assets? If cash is tight that might also be your best option.

[jewel]

I'm so sorry you're going through this.

I would also probably go with a low-cost insurance plan and pay for therapy out of pocket. If you are willing to switch providers, you could probably call around for a better price. In my area (MCOL), I can get some excellent therapists to offer $60/hr for low income, and half that if they are still working on their license.

Many HMOs (Kaiser, if they are in your area) offer therapy and psychiatry, but their premiums can be just as high.

If you are collecting SSI in your husband's name (or are very low income), you may be eligible for county mental health services, if you county offers them. If eligible, you could qualify for free psych treatment and ongoing therapy. If your county has mental health services, even if you don't qualify, they could likely give you some great resources.

[bluefish]

kwynn-

So sorry you're going thru all of this right now. I'm an old nestie with a new name. I've recently had to research many insurance options, and will PM you my resources.

[kwynn]

I wanted to update and answer some of the questions. I don't know how to multi-quote, I'm sorry.

Q: Group plan/employees?
A: I don't have any full-time employees. My husband did my books and worked for me a bit, so I actually took on his job role as well. I have a part-time assistant who has insurance through her other full-time job.

Q: What state?
A: I'm in Florida, but moving to Pittsburgh in April. I don't know if that makes a difference at all. Do they have group policies for sole proprietors in FL or PA?

Q: Do you get any benefits through social security or something that helps you as a widow? Is there anything out there healthcare related that is out there you can take advantage of besides the COBRA?
A: If you are a widow with no children and under 60 or so, you don't get anything. If you never remarry, you will get your husband's social security when you turn, i think, 65. That's 40 years from now, so when they sent me that letter, I was like "Uhhm, not helpful."

I don't believe there's any kind of healthcare you can take advantage of since healthcare is closely tied to employment in this country. (Begin political rant?)

Q: Low income/SSI?
A: I'm not that low-income I'm just a LOT lower income that I was before. I make about 25k---but it's straight commission, so it's variable and never guaranteed. My expenses are 25k. So I have to figure something out. In April (end of my lease), I am moving and getting a roommate, so that should give me a little more cash, reducing my rent/utilities from $1000 approximately to $600 (new place is more expensive but I'll be splitting it). I feel like if I could just get rid of this health insurance problem I would be in a much better place.

Q: Also have you considered selling your assets? If cash is tight that might also be your best option.
A: Well, by assets, I mean retirement and investment accounts...my financial adviser really is advising me to not touch them as much as possible and to really try to make it on my own. I don't have anything legit to sell like an extra car (we only have one).

Q: Have you considered getting a traditional job with health insurance? It might be better in the short term than keeping your business afloat.
A: Yes, I have considered and am looking for sure. It's a shame because my business is really doing well, very busy, and I do enjoy it. I feel like I would rather do a job I love and be a little bit poorer than give up my dream, especially because my business really is growing and doing well.

CJeannette: "I would consider a high deductible plan and use an HSA to pay for the visits."
Okay, this is what I'm thinking, but can you talk to me about this like I'm five years old? What is an HSA? What would you consider high-deductible, 10k? I think this is the best idea for me but I don't really know a lot about this.

You ladies are awesome...no one in my real life wants to talk about this stuff. They aren't knowledgeable and just feel uncomfortable talking about concrete things. People just say "Give it time" or "You don't have to make any decisions now" or "It will work itself out" and, while those things are comforting, it doesn't really solve real problems I'm having.

You ladies here are so sweet--I really appreciate all your kind words. Don't feel you have to say sorry all the time--I am going to have a lot of money questions in the next few weeks (I have not dealt with *anything* at all for 7 months, so my life is a mess needless to say) and I know it's a terrible situation and just something no one wants to ever experience.

[heyney]

(hugs)

Try ehealthinsurance.com and hopefully you can find something to make it work with your budget

[Deleted]

I think that with something called (I believe) mental health parity, things like therapy should be treated as any other illness under an insurance plan. I'm sure this somewhat varies (like some plans can completely exclude types of coverage, mental health related or not) but I'm certain some must exist that do cover it.

I also think that it might be cheaper for you to just pay out of pocket and get on a cheap plan otherwise.

I hope this isn't an insensitive question - since you used to have much more income and live frugally, is there a lot of savings that you were left with? What about life insurance (although I guess maybe that's not covered given the circumstances?). Do you truly not have the money available, or is it just a matter of not wanting to spend it? I can completely understand if it is the latter - I wouldn't want to pay that kind of money either - but given what you've been through my vote would be to just spend whatever it takes to get yourself what you need and not to worry too much about being frugal right now.

GL.

[jewel]

Oct 31, 2012 14:47:54 GMT -5 kwynn said:

Q: Have you considered getting a traditional job with health insurance? It might be better in the short term than keeping your business afloat.
A: Yes, I have considered and am looking for sure. It's a shame because my business is really doing well, very busy, and I do enjoy it. I feel like I would rather do a job I love and be a little bit poorer than give up my dream, especially because my business really is growing and doing well.

I might consider a part time job that can work around your photography schedule. I believe Starbucks usually provides excellent benefits for part time employees, and if you just worked mornings, it may not affect your business much. Many of our local grocery stores have similar benefits. I think it's definitely possible to get some kind of position that allows you to continue with your dream, but also makes your life a little more comfortable, at least for the short-term.

[birdmom]

Lots of places around here offer health insurance to part time workers (Starbucks, Wegmans, etc.) That might be an excellent option that would work around your business schedule. Maybe you can find someplace like that?

[Deleted]

Kohl's also offers health insurance to part time employees if you decide to go that route. I've gotten the best insurance quotes from a broker so maybe calling one is worth it. My state has a reduced health insurance plan for lower income people so maybe PA or FLA does as well. I bet this is a common problem amongst professional photogs so hopefully there is a something offered through a professional organization. Hope you find something soon.

[mrs.spunky]

An HSA is a health savings account. You may be able to deduct what you contribute come tax time. You can usually invest in mutual funds and ETFs once you reach a minimum balance and the $ grows tax-free for your medical expenses. You could get a high deductible health plan, one with maybe a $5k deductible, and then use the HSA balance to pay bills as you go.

[kwynn]

Oct 31, 2012 15:02:07 GMT -5 birdmom said:

Lots of places around here offer health insurance to part time workers (Starbucks, Wegmans, etc.) That might be an excellent option that would work around your business schedule. Maybe you can find someplace like that?

I've had a job like that in the past and am considering applying. The only downside is, I do not have open weekend availability which most want--I essentially have no weekend availability from now through next November. Also, maybe someone here can verify this, but my employee used to work at a place like that (Pier 1) and she said the health insurance wasn't very good and that it didn't cover much and you have to work 20 hours a week--if you dip below, you lose the insurance, so it was unpredictable. I travel out of town most weekends for work. Her advice to me is that it might be worth it for me to just purchase a cheap plan on my own and try to take on extra photography work instead to cover it.

I work for other photographers too as well when I have spare time and pull in extra money that way which is a good wage. I still have some contacts at the Quizno's and grocery stores where I used to work when I first moved to Florida, so I can look into that too. I'm not opposed to working hard--I'm just already working 80 hour weeks at my business and feeling a bit tense with that already.

I just don't have the energy I used to have.

Someone above asked about a professional photographer's association and insurance---I believe that's in the works but there's nothing available just yet. I'm going to double check though.

Buckybells asked: "since you used to have much more income and live frugally, is there a lot of savings that you were left with? What about life insurance (although I guess maybe that's not covered given the circumstances?). Do you truly not have the money available, or is it just a matter of not wanting to spend it?"

A: I don't mind answering at all. We're young, so my husband was working less than 5 years when he died. I was working less than that (I went to graduate school and then was unemployed for a few years). We had student loans and had used a lot of our savings to pay those off.

Almost all our money was in retirement and the savings we do have is what I have been living on these past few months since his final paycheck. I've been living on our "emergency" fund. I still have money (I can still pay my rent and everything--I won't be in the poor house at all, don't worry) but I do need to start being more careful with it and making some changes to make it last longer.

I've been in a fog for 7 months and I realize my money is dwindling now and I need to start making changes.

Life insurance--there was some, I believe. I actually haven't claimed it yet and don't really know how to be honest. I don't know if I would even get it given the manner of death and I just feel so sad claiming it--I literally don't want it. It's psychological for me that one.

[kwynn]

Oct 31, 2012 15:13:10 GMT -5 @notquiteblushing said:

Kohl's also offers health insurance to part time employees if you decide to go that route. I've gotten the best insurance quotes from a broker so maybe calling one is worth it. My state has a reduced health insurance plan for lower income people so maybe PA or FLA does as well. I bet this is a common problem amongst professional photogs so hopefully there is a something offered through a professional organization. Hope you find something soon.

I need to see a broker. Do you know how I would find a trustworthy/good one? Do they charge for the consult?

I know most of my photographer friends have Kaiser, but it's not available in my stste, I don't believe. It's supposedly excellent.

[bluefish]

Be careful with the insurance offered through many retail establishments. These so called "mini-med" plans were supposed to have been a thing of the past with the passage of the ACA, but many companies have been granted waivers.
Most of the time you could purchase a policy with better benefits on your own.

[cjeanette]

An HSA is money you can deduct so it helps on that part. The premium on the insurance in lower which helps. When I did this privately from my family (through BCBS but am in KS so not sure what they offer elsewhere) my deductible was 7k. It's 6k now through work so not really that different.

I strongly prefer the high deductible plan regardless but the lower cost might help you out while still keeping you covered if something expensive happens.