A guest post from consumer advocate Jessica S.:
As a consumer of behavioral health services for many years, it was not until I pursued specialty treatment for PTSD that I learned the depth of the injustice to behavioral health consumers done by insurance companies. It was an accepted norm that the therapy I needed would not be covered by my insurance because the network of providers available to me through my insurance company was laughably inadequate.
Upon starting treatment with my new provider I was encouraged to file for reimbursement with my insurance company and informed of my rights as a consumer to have mental health covered the same way physical health is. I began filing my claims and was denied any reimbursement by my insurance company due to a rule they were enforcing only for consumers – a requirement that all claims had to be filed within 90 days of service. The claims filing system is burdensome, so I had been saving my claims to file at one time rather than take on this tedious process. Devastated by this outright refusal to acknowledge my treatment costs, I contacted the Maryland Parity Project who helped me figure out who I needed to contact and what I needed to do to get my money. It took a long time, and it was not easy. I had to involve the Attorney General’s office and the Maryland Insurance Administration. The Health Education and Advocacy Unit of the Attorney General’s office took my complaint seriously and agreed that the insurance company was violating my rights. They were able to get the insurance to waive the 90-day requirement and after 5 months I received 1/5 of what I had paid out. It was so low due to insurance low reimbursement rates. What happened next changed my life in more ways than I have fully processed. I was asked to testify (share my story) in front of the Maryland State Legislature about my experience and the need for legislative action to prevent insurance companies from imposing such an unfair standard onto consumers.
I am a very private person, and it scared me to think about so publicly sharing that I have suffered from PTSD. I knew it was the right thing to do and that the cause was greater than my desire to stay private. Standing up for myself and sharing what I had been through just to get my insurance provider to do what they were supposed to do was so empowering. One of the most important lessons that I’ve taken with me is just that: stand up for yourself. No matter how tedious and frustrating or how the odds aren’t in your favor. I kept going with this issue and realized I was involved in something much bigger than just me. I learned that battles like this take time, and all I really had to do was not give up. They depend on people giving up and sadly many do because the barriers put in place to keep consumers from accessing care are traumatizing. After my testimony, my insurance provider decided they should reimburse me fully due to the fact that they do not have any providers within their network who could provide me with the treatment I needed (and because I called them out publicly for their despicable treatment of consumers). After 10 months, I finally received FULL reimbursement with interest.
At times I feel saddened and angry that I had to sacrifice my privacy in order to get coverage for my treatment. Not only did I have to stand before a group of legislators, but I also was later informed that many other people had access to my claims information. I feel that my privacy was severely compromised by my insurance provider. I feel so passionate about what I went through and continue to feel outraged for myself and for all suffering from mental health issues that I am continuing to speak out and work with the Mental Health Association of Maryland on addressing these issues. I am still in treatment and will have to file claims again if I want to be reimbursed for my treatment costs.
For everyone in treatment for a mental health condition please know that your voice matters. Please speak up and utilize the resources that are available to help you. Find your voice and hold insurance companies accountable for their continued discriminatory behavior towards consumers with mental health disorders.
If you are interested in getting involved in advocacy or education, sign up for MHAMD’s Citizen Action Team. To commit to five minutes of change-making advocacy per week, join the Citizen Action Team’s Commit2Five campaign.