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Your Finance: paying for children's counseling therapy

Mental health coverage has a lot in common

Mental health coverage has a lot in common with airline pricing, where seats on the same plane may sell at many different price points. Credit: iStock

When I signed up my kids for therapy after my divorce, I made some financial mistakes. The biggest was choosing an out-of-network provider over one who takes my insurance.

Instead of a simple $20 co-pay, I spend $150 out of pocket and get 70 percent of it reimbursed, which works out to about $1,000 more over a school year.

In contrast, I have a friend whose child's therapy sessions require no copays at all.

In this way, mental health coverage has a lot in common with airline pricing, where seats on the same plane may sell at many different price points.

Nearly half of all psychiatrists no longer take insurance, according to JAMA Psychiatry.

Add to that an overall shortage of providers -- there are 8,700 child and adolescent psychiatrists, compared to about 50,000 for adults, according to Dr. Paramjit Joshi, division chief of psychiatry and psychology at Children's National Health System -- and you have a supply and demand problem that makes cost a real issue for parents.

Stay in network: Finding a provider in your area may be easy enough, but finding one whose availability suits your child's schedule could be downright impossible. To avoid the appointment runaround, lean on your plan's customer service department to make calls for you.

Reduce copays: My friend with the zero co-pay has insurance through the state's child health plan, but enrollment in the plan is possible only if you don't have access to other coverage.

Most people who are on health plans through their workplace don't have payment wiggle room, but you can ask individual providers what they can do to help, especially if you have a high deductible.

Many private-pay therapists have sliding scales based on income; others have lower fees if you work with a trainee.

Also check state resources to help pay for therapy, especially if treatment is needed for some kind of trauma following a crime. Many states have victim funds.

Mark progress: Therapy can seem endless, so parents need to make sure it's staying on track. After the initial evaluation, make sure you have a clear treatment plan and markers to help you figure out if your child is making progress. If there's little improvement, get a second opinion. And don't feel bad about moving on if the therapist is not the right fit.

Paperwork fights: For ongoing treatment it's important to make sure the insurance company is not crimping your coverage. After a while, insurers may say the sessions are no longer medically necessary, especially if your child has a serious ongoing problem.

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