A topic that I am increasingly concerned about for this upcoming election cycle is healthcare, particularly health insurance. We are sick here in the US, with people regularly dying because they lack access to quality, affordable healthcare. Can you imagine; in this “elite”, “first-world” country, people are dying because they lack healthcare and comprehensive insurance? This affects people with acute illnesses and chronic illnesses alike. People are skipping important doctor’s visits and trips to the emergency room because they simply cannot afford it.
In all honesty, I don’t know very much about health insurance, but I already know that I can’t afford it. I am currently on my parents’ Highmark plan, which I’ve been told by my healthcare providers numerous times that it is one of the best plans they have seen. This is absolutely true; especially for behavioral health, which is my number one health concern. Since my Bipolar diagnosis a few years ago, I have had countless trips to psychiatrists and therapists. However, my highest copay was $15 for a regular visit at a private practice and $30 for my initial intake visit there. Last year I saw a therapist every single week, and for about four months I had a $0 copay, and afterward, my copay was $10 per visit. I am beyond lucky for the amazing coverage that I have and for my parents who allow me to continue using it until I get lawfully kicked off at the age of 26.
I have already begun to look around for a new insurance provider, as I count down the days until I am on my own. I cannot stress enough how important it is to find an insurance provider that is good for your specific healthcare needs. That being said, I am looking specifically for health insurance that focuses on behavioral health. When you are living with a chronic mental illness, the amount of times you see your doctors is almost ridiculous. Because I depend on my medications, I have to see my psychiatrist every 1-3 months and cannot go more than 7 months without having to go through the psychiatric intake screening process all over again (lengthy, more expensive copay, and overall a pain). It is also recommended that I see a therapist at least once a month. That is my most basic treatment plan, but nothing seems to be basic with illnesses.
There have been many occasions where I’ve had to make emergency appointments because of a mood episode (hypomanic or depressive or some strange mix of the two). In the case of an episode, it is crucial for a patient to see a doctor immediately to handle the situation. Then there is always the chance of needing to be hospitalized for an episode. This hasn’t happened to me yet, but I’m prepared in case it does in the future. Sometimes an episode gets to a severity that requires stabilization and monitoring; it’s just part of the experience of the 4.4% of American adults living with Bipolar Disorder.
At this point, I have yet to even talk about the part that can be the biggest pain in the a** –medications. Basically, if you have been diagnosed with Bipolar Disorder, you are pretty much bound to medication for life. You can always opt-out of taking medication as part of your treatment plan, but it is not encouraged to do so. That being said, I am currently prescribed two different medications to treat my Bipolar symptoms specifically. One of my medications is a generic brand so it’s pretty inexpensive. However, the other is name brand, and ridiculous is an understatement for the market price that it goes for. When I was originally prescribed this medication, it was on the market for $400 for a monthly supply. My insurance brought it down to about $75, and the coupon voucher that the drug manufacturer distributed brought it down to $15/month. Fast forward two years, and now this drug goes for $1,500 for a month’s supply on the market. Even with my insurance and this coupon voucher, it only brought it down to $800. Basically, I can’t have that medication anymore because drug companies can charge as much as they want.
Navigating through health insurance as a person with a chronic mental illness is an absolute minefield, there is so much to figure out. Will the federal government put an end to the outrageous prices of life-saving medications? Perhaps by implementing price ceilings? What about the PA state gov? Something has to give.
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