Oct 12, 2012

Medicare Blocks Access to My Therapist of 10+ Years

Not that I haven't had anything to say...just nothing I've been passionate enough about to write. That has changed. If any of my readers know a Congressman, please pass this along. I married in July to the man I've been with for 11 years. I had to coordinate the end of my coverage under my previous husband with the divorce and being moved onto my husband's policy. He has excellent coverage from working for the state government for several decades. We both thought his coverage would be my coverage.

When he went to add me, he was told, since I was on disability, although I had declined Part A Medicare at the time, I would have to apply for Part A and that would be my primary insurance. That would backed up by an Aetna HMO or PPO, whichever we choose. We thought that would mean if a doctor or provider did not accept Medicare, it would be picked up by Aetna. We were wrong.

A provider must accept Medicare. As for doctors, under our plan, all Hershey Medical doctors are covered and they are excellent. However, my therapist since 1999 is not covered by Medicare. Medicare requires that a therapist be a doctorate level psychologist or a social worker to be covered. My therapist is a Master's level psychologist with excellent and constantly updated skills in treating DID.

The realm of therapists who treat DID is a very small percentage of all therapists. The country is in shortage of such therapists. Now add the requirement that of that small number of therapists, Medicare recipients can only see those who have a Ph.D. That knocks out most of the DID-treating population.

I can continue to see my therapist if I pay out of pocket. Any therapist charges in the neighborhood of $100 a session or more. I had only been paying at most a $35 copayment for more than a decade. I guess I'm middle class but that is too expensive for once every few weeks. It's like another car payment.

So now I'm caught in the Medicare trap. My therapist is far more qualified to treat me than many who do treat DID because of all her experience and ongoing education. Without researching, I don't even know if the social worker must be licensed or not. My husband did call his benefits contact to make a plea for me to be covered for my existing therapist because of the circumstances. We have yet to receive an answer but are doubtful.

I will have DID the rest of my life even if issues are few and far between with my level of healing. It makes me angry for so many others who are on Medicare. Quite a few with DID are on Medicare because of lack of ability to function for years even if they had held a high functioning job until the day their amnesia broke.

When our president is in office and away from campaigning and uncertainty, I will write, since that's all I can do unless people like me have a voice. And I have to pray Medicare will not be upended in ways beyond my comprehension with certain election results.

Am done with that rant but wanted to note it's ironic that today I saw Argo, about the rescue of the six Americans who escaped from the Iranian Embassy to the Canadian Embassy in 1979 and my last post was about Iran. Excellent movie, by the way.

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