When looking at purchasing insurance, look back at your previous year.
Items to consider
· Weekly mental health therapy
· Chronic illness
· Copays for visits
· Copays for medication
· Out of pocket maximums
· Deductibles.
If you are a high use individual, and if you see a therapist, you automatically fall into this category, then the weekly copay for your therapy must be accounted for in the selection of your plan.
If your plan has a 4000 deductible and a 8000 out of pocket maximum, then if you are seeing a therapist weekly, and your co pay for the plan is 55 dollars. That means that you will pay the full fee (123) out of pocket until 4000 is paid, before your co pays begin. At that point you will begin to pay your 55 dollar a session. So, you will have 32 sessions of therapy, or 8 months of therapy before your cost goes down to 55 a session. At that point therapy will reduce from 492 a month to 220 a month. With other medical bills you may reach your out-of-pocket maximum at which point the therapy would be free.
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Looking at two plans, one where you pay 120 a month with a 4000 deductible and a 55-dollar copay, vs a plan where you pay 200 a month and have a 1000-dollar deductible and a 15 dollar copay, which one is more economical, with weekly therapy. The first plan would cost you 6080 for the deductible, copays and the premiums. The second more expensive plan would cost 4000 for the deductible, the copays, and the premiums. 2000 saved by spending 80 a month more for a premium. Keep in mind that the reduced copay will be for therapy, insurance and for medications, so your overall costs can be reduced by increasing premium.
If you are in weekly therapy reviewing your insurance needs in this manner can be an effective way or reducing overall costs.