Charlotte, North Carolina – Some people looking for less expensive health insurance coverage sign up for Health Care Participation Ministries. These plans can help in certain situations, but because they’re not real insurance, they may not cover the services you’d expect, such as mental health.
Earlier this year, Charlotte’s mother received a phone call that no parent wanted to get. She prefers not to use her real name, so we’ll call her Laurel.
“Last spring, I was away on a business trip. I got a call from her therapist that (my daughter) was injuring herself,” said Laurel. “They were very deep cuts, lacerations, in her legs that she had been hiding for the past two years.”
>> See county-by-county mental health resource guide
Jason Stojnici of Action 9 told that she took her 13-year-old daughter, whom we’ll name Sam, to Atrium Health where she was treated for several days.
Laurel says she had health insurance but wanted something less expensive, so she switched to a co-Department of Health Care. I assumed her plan would cover Sam’s bill, but it didn’t.
“I was blown away,” Laurel said. “I had no choice. She was contemplating suicide, and she was very open about it.”
The Lauryl group covered by the Christian Care Ministry and its health program is called Medi-Share. It states in her pamphlet that it does not cover mental health.
The company told Stoogenke: “Medi-Share believes it is critical to be 100% upfront and transparent with members and prospective members about which healthcare expenses Medi-Share shares, and which healthcare expenses Medi-Share does not.”
“While (Lauryl’s) situation is heartbreaking, Medi-Share’s commitment is to our membership as a whole and its shareable expenses, which requires that the guidelines that members vote on be enforced in order to be good stewards of member dollars.”
“Medi-Share has successfully shared 100% of eligible medical expenses over the past 28 years and this is only possible by managing a program budget that meets our commitments. We are trusted to oversee our members’ contributions and using their funds at our personal discretion violates our commitment to them and violates their trust.”
“Again, we are really saddened by the (Laurel) daughter’s situation, but Medi-Share has never shared mental health expenditures and makes that very clear in the Medi-Share guidelines.”
Laurel says she still owes the department money, but isn’t sure how much. She says her bill was originally $40,000 but Atrium Health lowered it to $32,000. She thinks she might have a maximum of $10,500 under her plan, so she’s trying to work it out.
The department says Laurel can appeal her case and that it also has a charitable medical billing program that does not cover it. It’s unclear if either would help in this case.
Laurel says Sam is doing better and that they now have insurance coverage through the Affordable Care Act plan, which covers mental health.
If you’re concerned about paying for mental health care, MoneyGeek Group says if you have real health insurance, it should cover mental health. The complicated part is knowing exactly what the plan covers and which service providers are within the network.
There are actually quite a number of providers that do not do this except for any insurance. They’ll let you figure it out for yourself,” said Doug Milnes of MoneyGeek.
If you have insurance and it won’t pay for mental health, according to federal law, you have the right to appeal. You can also file a complaint with your state’s Department of Insurance. If you are on a self-insurance plan, the US Department of Labor may be able to help you.
If you don’t have insurance, you may want to try Medicaid, disability insurance benefits, Social Security, Supplemental Security Income, the US Department of Veterans Affairs, the National Association of Free and Charitable Clinics (it has a search tool to find help), and programs through your business or group Religious, local colleges. You can also contact any local office that offers counseling and see if they offer free services.
For more information, click here to see MoneyGeek’s guide to affordable mental health care.
(Watch: ‘This would change her life’: Woman says she needs weight-loss surgery, won’t be covered by insurance)
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