The end of 2023 is upon us already. The end of the year involves a lot of planning for celebrations, travel for many folks and family time together. It’s a happy and busy time, but it’s also a time for other types of planning, including when it comes to health insurance. Not many people will have end-of-year mental health insurance information at the top of their needs list, but we’d like to offer some insight into how all of this works in case you’re thinking of getting some help.
We’ve discussed the complicated nature and confusion regarding health insurance and mental health insurance information several times in the past, including here, here and here. We also have breakdowns of which insurance companies are in-network with regards to our services and those which we accept and otherwise work with. We provide a wealth of mental health insurance information for those who need it.
One of the most common questions we face this time of year, however, involves how things tend to work with health insurance as the current year ends and the new one begins. This is a question that transcends any specific mental health insurance information. Below we’re going to offer you some insights that we hope are helpful. The bottom line, however, is that if you have concerns, you should contact the team of Orange County mental health professionals at SoCal Empowered so we can clarify any ambiguity you are facing.
Use It Or Lose It
Most health insurance policies come with specific sets of benefits and coverages for different types of problems. Health insurance policies can change from time to time, and most of those changes tend to arise on January 1 of the next year. Therefore, if you need the type of help that we provide, you should review your mental health insurance information regarding coverage in your policy and see if any of those benefits are changing in January.
Annual Deductibles and the Dreaded “Double Dip”
The more you dig into general mental health insurance information, the more confusing it can get. The world of insurance is riddled with jargon that is not intuitive to consumers. One term that arises from time to time is the “double dip,” which relates to a health insurance policy’s deductible.
A deductible is the amount a policyholder will pay for health coverage before that insurance company will start to cover a substantial percentage of subsequent costs. For example, it’s common for an individual to have a $5,000 annual deductible or a family to have a deductible of $10,000 annually.
That means that when someone faces health challenges, he, she or they will pay that deductible into health costs until that limit is reached. Beyond that point, the insurance company will pay a percentage of the overage. A common percentage is 80 percent. A “double dip” occurs when a provider takes payment in the form of cash towards a deductible twice within a short amount of time.
Example of a Double Dip
The best way to explain this within the context of necessary mental health insurance information is in the form of a hypothetical situation. Let’s say that Dave is suffering from Post-Traumatic Stress Disorder, or PTSD, and he decides to check into a residential mental health facility for treatment on December 15. He plans to stay there until January 15 of the following year.
Let’s further assume that Dave has a deductible on his health insurance policy of $5,000 annually, but as of December 15 he has only spent $2,000 towards that deductible. A “double dip” would occur if that mental health facility accepted payment of $3,000 in cash towards that deductible for the year and then, in January when deductibles reset, took another $5,000 towards the next year’s deductible even though Dave has only checked in for one stay.
That means Dave would have to pay $8,000 in cash for that stay at the mental health facility as well as whatever percentage of costs the insurance company does not cover after the annual deductible has been met. Those who have reviewed their mental health insurance policy may wonder about this, and this confusion may lead someone like Dave to avoid getting help either until January or until a later date.
SoCal Empowered: No Double Dips
We’d like to make it clear right now that should someone like Dave contact us in December and need a stay until the following year, SoCal Empowered will not double dip on that insurance policy deductible. We will accept payment for that first year’s deductible and work with the Daves of the world on the costs relating to January.
The reason? We don’t feel that monetary concerns, health insurance policy limits or confusion relating to mental health insurance information should prevent someone from getting needed help. We even speak directly with everyone’s insurance company to determine what will be covered before people come to stay with us. Confusion causes stress, and we work to eliminate that as much as possible.
Mental Health Insurance Information Differs By Policy
Overall, every health insurance policy is a bit different, so if you’re concerned about understanding your own mental health insurance information, you should work with us to help you understand what your rights and obligations are, whether it’s at the end of the year or not. You can also take a look at the Patient’s Bill of Rights if you’d like to learn more about what you’re able to assert.
Call Us and We Will Take a Look
If you or a loved one needs mental health help, the calendar should not determine whether or not you should get it. Your situation will likely get worse if it continues untreated. Contact us today so we can dig into the situation with you and help you understand the mental health insurance information in your policy. We’re here to listen and to help, so get started today.
