By Julius Rapier, as told to Hallie Levine
I've been open about my mental health experiences since 2018, when I was diagnosed with bipolar disorder at the age of 22. Many people don't realize bipolar disorder isn't just a mental illness — it's a serious disability. Before treatment, I found it incredibly challenging to do daily activities like going to work or class and seeing friends.
Today, my bipolar disorder is well-managed with a mix of medications and talk therapy. But those types of treatments aren't cheap, which is why I'm glad I have health insurance. Here is what I think everyone who has a mental health condition needs to know about to help them manage the costs of mental health care.
Make Sure You Have Health Insurance
I can't stress enough how important this is. I speak from personal experience. I've struggled with my mental health since middle school, but until a few years ago, I never thought about the cost of my treatment. Then, when I was 26, I needed to leave my job and go on disability so that I could better manage my bipolar disorder.
Originally, I thought I'd apply for Medicaid, a joint federal and state program that provides free or low-cost health coverage to low-income Americans, including some with disabilities. I was eligible, but after I submitted my application online, my local Medicaid office never got back to me. They made it hard for me to follow up with them, too, so eventually I gave up.
That led to a new wrinkle when it came to my federal disability benefits. The Social Security Administration requires you to get re-evaluated by a doctor periodically for proof that you still have a disability significant enough to prevent you from going back to work. But if you don't have health insurance, and you don't work, it's hard to pay for medical visits. I lost my disability for a few months because I couldn't afford to see a physician.
Use the Health Insurance Marketplace
Right now, I'm self-employed, so I don't get health insurance through my job. After what I've gone through, however, I never want to not have coverage again. I currently get my health insurance through the Health Insurance Marketplace, which is regulated by the federal government. It allows you to enroll in a health insurance plan and compare different ones for coverage and affordability. You also can see if you qualify for tax credits for private insurance, or even no-cost care through Medicaid.
I didn't know about the Marketplace when I first left my job to go on disability. I only learned about it when I saw advertisements for insurance companies and called them to find out how I could enroll. They directed me to Georgia Access, which is my state's version of the Marketplace.
When I applied, I learned I qualified for tax credits based on my income. I only have to pay $138 a month for a plan that covers most of the cost of my mental health care. I generally only pay $20 a week as a copay for my weekly talk therapy sessions, and I don't pay anything for my prescription mental health medications.
It is important to check your plan each year to make sure you are getting the best deal and all your mental health providers are still in your network. Last year, I forgot to renew during the open enrollment period, so my health insurance company automatically renewed me into my plan. But the monthly premium had gone up by about $600, which seemed ridiculous to me. I was able to go back into the system and switch to a less expensive plan, but it would have been a lot easier, and a lot less stressful, if I had done that up front.
Set Up a Payment Plan
I spent about $5,000 on mental health care during my year without health care insurance. It would have been even higher if I hadn't been able to negotiate some of those costs with my providers.
I found it very helpful to set up a monthly payment plan. Even before you do that, ask about the hospital or medical center's financial assistance policy. You may be able to get services on a sliding scale, based on your income. When I asked about it while I got mental health treatment at Emory Healthcare in Atlanta, I was sometimes able to get as much as 40% off the cost.
If you are able to get a payment plan, make sure it's at a zero-interest rate, or at least a very low one. I have to admit, it's still painful to have to pay off medical bills every month. You'll have to figure out other areas of your life where you can cut costs, so you have enough to put toward your payment plan. You can write down all your bills and expenses to see where you may be able to scale back, or you can use a budgeting app to help you see where you spend most of your money each month.
Make Sure You Stay in Your Health Insurance Network
Marketplace plans are great, but if you go out of network, it can definitely cost much more. Unfortunately, many therapists these days don't even take insurance. Finding a good one is a tedious process.
I would go to a website that helps you book providers, type in my insurance, and see which local therapists came up. I'd read the reviews, and then choose several who looked promising. But every third office I'd call, I'd learn the therapist no longer took my insurance. I finally found someone I like and feel comfortable with, but it definitely took some time and effort.
Be Prepared for Extras
When I first went on disability, I found an intensive outpatient program that I thought would be perfect to help me with treatment. It didn't seem as restrictive and intense as a residential program, and I liked that it still encouraged me to stay in my daily routine. Unfortunately, at a cost of about $1,900 a day, there was no way I could afford it. But as soon as I got my current health insurance, I reached out to them to enroll.
While the program itself was considered in-network at my health plan, my insurance didn't cover everything. I was still responsible for a copay of about $112 a day for each day I participated in the outpatient program. My total bill came out to about $1,200, which I'm still paying off on yet another payment plan.
But in my mind, it's worth it. I've seen dramatic improvements in my mood and overall functioning since I did the intensive program. You can't put a price on anything that helps you better manage your mental health so you can live your best life. But having health insurance sure makes it easier to swing financially.
Where to Go for Low-Cost Mental Health Care
Even if you don't have health insurance, you still have options. It's worth a little research to see if one of the following is right for you:
If you need help to pay for prescription psychiatric medication, talk to your doctor. Some drug companies offer prescription assistance programs, and your doctor can provide the documentation you need to access them. They may also be able to refer you to county or state prescription programs that can help share some of the costs. Another option is the Partnership for Prescription Assistance, at 888-477-2669.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Julius Rapier, 29, mental health advocate, Atlanta.
Social Security Administration: "Disability Benefits | Your Continuing Disability."
Healthcare.gov: "The Marketplace in your State."
Patient Advocate Foundation: "How to Save Money on Medical Bills."
Mental Health America: "Paying for care."
