Description
The purpose of this assignment is to have some personal experience with trying to understand and access insurance coverage for mental health issues. Using your own health insurance policy** (if you do not have insurance, pick a managed care company and explore their mental health benefits package) and determine if the policy covers mental health and/or substance abuse coverage. Call the 800 number on the card and obtain the following information:
-Type of coverage available for (a) inpatient, (b) outpatient, and (c) partial hospitalization for (i) mental health (MH) and (ii) substance abuse (SA).
-Determine the fees, deductibles, and co-pays for the above three modalities, for both coverage areas (MH and SA).
-Ask if they will pay for out-of-network providers (i.e. professionals or programs of your choice that are not on their plan), and at what rates or percentages.
-Determine eligibility for services (mental illness or substance abuse) and whether pre-existing conditions are covered. Ask about reimbursement rates if treatment is not deemed ‘medically necessary’.
-Find out if you would need a referral by a primary physician for counseling.
Throughout your information gathering, keep notes on two areas:
- Information provided (or not) in response to your questions.
- Thoughts and feelings that come up for you throughout the process.
Once you have completed your investigation of benefits, you are to write an integrative summary of this information and process. Your summary should contain the following:
- A summary of information obtained in response to your questions. (1page)
- A summary of your thoughts and feelings in going through the inquiry process (1page)
- A discussion of the implications this process might have for a potential service provider, for clients, and for you as a counselor (i.e., personal thoughts and feelings) (2 pages)