Beliefnet
Beyond Blue

If a person weren’t mentally ill before dealing with health insurance companies about her mental health benefits, she surely would be after a phone call or two. Marbles start rolling out of the noggin a second after the back-stabbing representative asks you, “How may I help you today?” (as if she means it).
I’m now convinced that when Jesus instructed his disciples to pray for their enemies, he wasn’t referring to the loud neighbors with the yappy dog who craps on our lawn, or to Bush’s axis of evil. He had health insurance companies in mind.
I have been praying for CareFirst (a.k.a PayFirst CareLast) every day this week–almost hourly since I received a bill from Laurel Regional Hospital for $2,600, half of the cost of my outpatient treatment program almost two years ago. (That’s right, Sept. of 2005)
This disturbs me on several levels.
First, of course, is the whole philosophy about mental illness held by most health insurance companies; they are a larger, more bureaucratic, corporate, and criminal version of my friend Eileen, who swears that I am fabricating this whole “brain disease” stuff, and that anyone who suffers emotionally or mentally is a weak pansy who has certainly attracted it to herself by poor stress management. (“We are all dealt a share of life’s blows … get over it!”). I can forgive Eileen because I know that she doesn’t get out much and she’s been taught all she knows by some very ignorant but extremely persuasive teachers (which are plentiful today).


Health insurance companies, however, have read the same studies about depression as I have: that by using high tech brain-imaging methods, researches have been able to identify a number of regions in the brain, like Area 25, that malfunction in major depression; the refinements in brain-imaging technology today make it possible to show how the regional patterns of brain activity in a depressed brain differs from the activity in a non-depressed brain. Not to mention all the research into the genetics of mood disorders that can identify certain genes that predispose persons to mental illness.
Eric and I shelled out over $25,000 in healthcare costs/insurance premiums last year. We cashed out part of our retirement savings to pay for the Johns Hopkins bill ($8,500), even though we were told that it would be fully covered by insurance since I was admitted as emergency status. I paid (and continue to pay) for all of my psychiatrist visits out of pocket. And our insurance premiums run us about $1,000 per month.
Two years ago, I received a bill from Laurel Hospital for $5,500 to cover my four-day inpatient stay. This was after a nurse put her arm around me (she knew I was nervous that my stay wouldn’t be covered) and said, “We wouldn’t have admitted you if it wasn’t going to be covered. We’ve talked to your insurance company, and you’re good for up to five days, and for several weeks of outpatient care after that.”
A letter from Magellan, the mental health part of CareFirst, assured me that everything would be covered by CareFirst, and could I please fill out a survey on customer satisfaction.
All told, I spent more than 60 hours (plus sweat, energy, tears, and frustration) while in a very frail mental state arguing my case–copying explanations of benefits, procuring letters from evaluating physicians, requesting records from all practitioners involved–providing all the evidence I needed to hold CareFirst to their word. They finally gave in and paid the bill.
Now, two years later, I have to go to war again. I’m seriously considering litigation because I’d rather pay my lawyer friends $2,600 than the hospital, for a bill that CareFirst assured me that they’d pay.
Sometimes I wonder if they take advantage of persons suffering from mood and personality disorders because they know that these people are often too depressed or anxious while undergoing psychiatric treatment to assert themselves and bring out the mental and legal ammunition that is needed to fight for the benefits that were promised but ultimately denied.
The last time I was this angry, I ratted out a priest in college for making young women feel uncomfortable in counseling sessions and in confession. I submitted a 40-page report, a compilation of my evidence, to get his butt kicked off the campus for good. Fete accompli.
It felt good. Because I turned my anger into action. I think I may have to do the same with these healthcare crooks.

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