Frustration Multiplied

When dealing with a health insurance company, it's in your best interest to have a pillow handy to scream into. When trying to be the go-between for three health insurance companies, you may need a few more pillows. First there's Medicare, my primary insurance. Why it's my primary, I don't know. Then there's Medicaid, or AHCCCS, my secondary insurance. They provide supplementary services that Medicare doesn't cover but I'm too poor to afford. Then there's ValueOptions, my state-funded behavioral health insurance. They're in charge of everything pertaining to my mental health. They provide many more services that my primary and secondary insurances don't cover. They offer long waiting lists for services that should be easier to access, like counseling. And after being on one of those waiting lists for over two years, my name came up for a specialized type of counseling called Dialectical Behavioral Therapy, or DBT. But apparently there's a new policy. See, waiting on that waiting list for over two years isn't enough anymore. Now I have to provide written proof that my primary and secondary insurance companies don't offer DBT. And you may be thinking that this means ValueOptions will be contacting my insurance company. But oh, no...this isn't the case. No, I have to call the insurance company. I have to find out if they provide DBT. So I called my Medicare plan. The answer I got was that ValueOptions had to submit a prior authorization form for me to get DBT through ValueOptions. That didn't make any sense. So I called them again--same answer. So I called my case manager from ValueOptions. Couldn't get anything more than her voicemail. So I talked to someone on my clinical team. She explained to me the why's of going through my primary insurance. So I called Medicare again. This time they gave me a few names for psychiatrists. I don't need psychiatrists. I have a psychiatrist. So I called my case manager again. Voicemail. Left another message. Called Medicare again. This time they told me that they don't cover behavioral health services; that's for ValueOptions to provide. Well, I asked them, could I get a letter to state that. "Um, I don't think we do that." At this point I start wondering why I'm the one stuck in the middle of an insurance battle. So, she tells me, I can get a letter stating that behavioral health services aren't covered under my health plan, but in order to do that I have to get a referral from my primary care physician and he has to get the denial and then I can get a copy of it. You know what? Forget this mess! I started crying from frustration. And I'm still not any closer to getting what I need.