Obtaining outpatient treatment with medicare
Monday, July 19, 2010 at 10:35AM
Q. Is there a way you can work with your insurance to pay for outpatient treatment including a therapist, dietician, and groups .. I know this would help my recovery.. I have already been fortunate to have had inpatient treatment but what would be most helpful would be outpatient treatment.. I am on social security disability on medicare.. and if I could afford the right outpatient treatment.. this would expedite and maximize my recovery .. Its funny how they will pay for higher levels of care.. but it is the outpatient treatment now that would be most affective at this time in my recovery... In general.. insurance tends to not support this form of a treatment team...
A. Great - tough - question. Here are some thoughts from the MentorCONNECT leadership team that may be helpful in figuring out the best way to address this issue with your individual insurance provider.
She would likely need to find a medicare provider who works with eating disorders.This is where it gets tricky because there are likely not too many providers of medicare who specialize in eating disorders, but there may be a few. She would need to contact her insurance and to ask for what she needs. They could then make the referral.
Medicare is a whole different issue then traditional insurance for the most part. It will depend on whether she has part A and or Part B. Her best bet is to get a supplemental plan to go along with the medicare. Medicare alone will not usually pay for a lot of mental health stuff. The bigger problem is that not a lot of therapist take medicare - mostly because medicare reimbursement is nothing compared to private insurance and private insurance. Her best bet is to look into something like MHMR or state and local mental health resources in her area. In Texas it is MHMR but I am not sure what it would be called in her state. You can get therapy that way as well as work with a psychiatrist. Hope that helps.
Some outpatient day programs can actually get all of those things covered by insurance. Also, I was able to get partial reimbursement from my insurance company for my therapist. Finally, if her general physician or referring physician gives her a medical reason to see a dietician, she may be able to get that covered.
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