How to use mental health benefits under commercial insurance, Medicare, Medicaid, and employer plans — including parity rules, appeals, and reducing out-of-pocket costs.
Renee, a 38-year-old hospital nurse in Tampa, married Marcus last summer and merged households with him and his two kids from a previous marriage. Both Renee and Marcus had family insurance through their employers, two solid PPO plans on paper. When Renee took her stepson Jace to start weekly therapy for adjustment disorder in October, … Read more
Brianna, a 34-year-old freelance graphic designer in Austin, Texas, sat at her kitchen table last November with four browser tabs open and a half-cold cup of coffee. She had been seeing a trauma therapist twice a month for almost a year and knew she needed to keep that going. Her old employer plan ended December … Read more
Yvette, a fifty-eight-year-old retired postal worker in Houston, Texas, lived with type 2 diabetes, mild heart failure, and a thirty-year history of bipolar II disorder. For most of her life, her medical care happened in one universe and her psychiatric care in another. Her cardiologist sent her labs to an electronic record her psychiatrist could … Read more
Marcus, a forty-one-year-old account manager from Charlotte, North Carolina, had finally agreed to enter a residential treatment program for his alcohol use disorder. His therapist found a bed at a respected facility for Monday morning. On Friday afternoon, the admissions coordinator called with words Marcus did not expect to hear: the insurance company needed to … Read more
When Eleanor died at seventy-nine in her Sarasota, Florida, condominium, she left behind a thirty-eight-year-old son named Daniel who had lived with schizoaffective disorder since college. Eleanor had been careful her whole life. She had saved methodically. She had worked with her bank to draft a will that left Daniel half her estate, about $190,000 … Read more
Priya, a twenty-nine-year-old graphic designer in Austin, Texas, had spent three weeks calling therapists in her insurance network. The eight names that had openings were either booked into the following spring, no longer accepting her plan, or specialized in something that did not match her needs. When she finally found a therapist whose Instagram post … Read more
Bernard, a fifty-two-year-old line cook in Cleveland, walked into the ER on a Tuesday with chest pain that turned out to be a panic attack stacked on top of an ulcer. Three weeks later, an envelope arrived with a $14,800 bill for the visit, the imaging, and the overnight observation. Bernard had no insurance, two … Read more
Jordan turned 26 on a Tuesday in March, and on Wednesday morning the pharmacy in Minneapolis told him his Lexapro prescription wasn’t covered anymore. He’d been on his mother’s plan since college, hadn’t paid much attention to insurance, and assumed coverage would just continue until he found a real job. Instead, his coverage had ended … Read more
Marcus had been driving for Uber and DoorDash in Phoenix for almost three years when the panic attacks started. He was making decent money, around $52,000 a year, but he had no health insurance because he assumed contractors couldn’t afford it. After his third trip to the emergency room in two months, an ER social … Read more
Tasha noticed the changes slowly at first. Her mother Evelyn, 78, living alone in Charlotte, had always managed her own affairs, but in the span of about eighteen months she’d missed three Medicare Advantage open enrollment windows, let her supplemental coverage lapse, accumulated $4,200 in unpaid prescription copays, and started telling Tasha that “the people … Read more