Insurance Denials for Treatment

[amychris]

Hey! Does anyone have experience with their insurance denying IOP or PHP treatment for mental health? We’ve done the peer review process and that was denied. Now I’m doing a member appeals process but that can take 30 days. I’m afraid my mental state is too poor to even survive without a hospital stabilizing me. However, if I go to the hospital, I can’t work (I work part-time from home) and I don’t get paid time off. I’ll keep calling insurance incessantly in the meantime, but they literally won’t take my feedback or allow me to advocate for myself. 😭 Thanks everyone❤️

[KimTCC]

Please check if your state has short term disability benefits. If you are in the state that doesn’t have that benefit, please check with your employer or your parents if you have your insurance through them to see if their employer has a short term disability benefit that is added on as an optional benefit that can be enrolled in. I hope that makes sense. If you do have this benefit, it will help you with partial income replacement so that you can go to the hospital and get help. ❤️

[KimTCC in reply to KimTCC]

as far as the IOP or PHP it’s gonna depend on if you have an HMO or PPO you and what your specific plan covers. They all vary. You can try and work your way up to the supervisor and a lot of times with mental health benefits insurance companies will have a mental health advocate that you can speak to as well.

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Prayers to you.