Psychiatric Care in the United States

Photo by Ryan Hellyer

Photo by Ryan Hellyer

My friend Pauli weighs in on what psychiatric care ends up costing in the United States. God forbid if you need hospitalization.

Medical Insurance Coverage

Mental health insurance coverage is much more limited than standard medical, which generally involves an out of pocket co-pay for “in network providers” of $15 to $25 for an office visit. Most annual lab tests are covered in full, while certain procedures may require a 20% co-insurance payment or go towards an annual deductible which can run anywhere from $500 to $5,000. Unless you are with an HMO, you are free to go to a specialist without prior approval by the insurer.

Seeing a Psychiatrist

Your PPO insurance may allow you to self-refer to a psychiatrist, however, the earliest I could see a shrink calling 6 different offices to get much needed antidepressants, I found the minimum wait was 6-8 weeks for 5 of them and one with a 3-month-long waiting list. I wasn’t suicidal, but with that kind of wait, either I would have been, or I would be over it. I didn’t want to risk it, so I saw my family practice doctor, and we went through various antidepressants until I came out on the other side of the issues that were bothering me by talking with a competent counselor.

Counselors

Getting in to talk to a counselor to work through problems is considerably easier than seeing someone who can actually prescribe medication. However, it is more costly and generally requires pre-certification. You are generally approved for no more than 13 sessions per calendar year and you will pay 50% of the fee allowed by your insurance. You’ll want to look for an “in network” provider, and you better make rapid progress or you will be paying the full allowed fee in short order.  That or make sure you have your mental breakdown no earlier than October so you can start over in January.

Your Experience

What is your experience, if any, with psychiatric care in the United States? I’d especially like to hear from you if you’ve been hospitalized. Anonymous commenters are welcome. You can read about my own experience as well.

2 thoughts on “Psychiatric Care in the United States

  1. I was able to see a psychiatrist in the U.S. after waiting two weeks. This was when I was very suicidal.

    It was $200 a visit (my insurance wouldn’t cover a thing) plus medication. I was in dire need of help and I couldn’t afford to keep up my treatment. I eventually stopped seeing my psychiatrist and went off meds simply because I couldn’t afford them anymore.

    I also stopped seeing my counselor because it was too expensive as well, and, again, my insurance wouldn’t cover it.

  2. You’ve pointed out another failing of health insurance I didn’t include: The pre-existing condition clause. Since I have been covered by group health insurance since I was a child without a break in service, this hasn’t been an issue for me. However, this is a real problem for many who cannot work for extended periods and/or afford to pay for continuation of a plan under COBRA while unemployed. Waiting a year or 18 months for coverage means either foregoing treatment or going deeply into debt.

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