Is this not Bull-Crap??

So, one of the 3 counselors that I left a message with called me back. I set up an appt, and than I thought, "Do I need a PCP referral letter, even if she says she is covered by BCBS of ND?" Mark suggests that I call the actual member service dept. So I do, and after I talk with the representative, I scream at Mark for a short moment. And than he, looking stunned, gets on his company website to see if they offer any company-direct employee benefit assistance with mental health. Why? Let me share the BC with you.


Under Mark's company coverage plan we are entitled to 30 visits/year (per family) with the first 5 covered 100% for 'In' or 'Out' coverage providers. After that, under 'In' providers we pay $20 per office visit with 10% co-insurance. For 'Out' providers it is $20 per visit with 20% co-ins. I must have a letter of referral from a 'In' provider to be eligible for the 20% coverage plan with an 'Out'.


Under the current plan there are some exclusions, which mean, that if I am seeing a counselor for these things, I will not be covered by our insurance. It will be 100% out-of-pocket expense.
They are:

• Bereavement Counseling
• Martial Dysfunction
• Interpersonal Relationship Issues
• Sex Therapy
• Treatment of Gambling Addiction
• Treatment of Co-Dependency Substance Abuse (relates to anything drug or alochol)
• Psychotherapy
• Nicotine Related Issues
• Special Education or Therapy for learning disabilities or behavioral problems, whether or not, related to anything of mental dysfuntion, disturbance, or retardation.

Does anyone else see the BS factor?

For what reasons, other than what is stated above, would I attend counseling? So, if I am a "normal" person who needs assistance with "normal" issues, I need to pay for them myself. Nice.

Tomorrow I'll talk with the counselor (who is an 'Out') and discover how she gets around this BS.

PS I went to the store and got my Bloody Mary mix stuff. So, after the kids go to bed I'll enjoy either watching a movie, or reading my book, with a nice mild glass of Caesar with pickled baby corn. :)