I am in the process of switching health insurance, and I am trying to get a plan that will fit my needs, but it is all so confusing. The T I hope to start therapy with said that I need to make sure that there are no visit limits for biologically-based mental health conditions. I thought she must have meant non-biologically based, (as I wan't BORN with the trauma), but as I sit here reading the info. packets, here's what it says:

"Treatment for rape-related mental or emotional disorders and treatment for children under age 19 are covered to the same extent as biologically based conditions."

While there is a visit limit for NON-BIOLOGICALLY based conditions, there is NO limit for biologically based conditions.

Now I can understand the children bit, since a child should be covered 100%, but I wondered why rape-related disorders were included in this. Granted, it's not a bad thing since that means that I will have unlimited care, but it's not like it says "PTSD-related conditions" or anything. Why are "rape-related disorders" singled out?

Well I found this on the net:

5. What are covered biologically based mental illnesses?

The term “biologically based mental illness” under the law means a mental, nervous or emotional condition that is caused by a biological disorder of the brain which results in a clinically significant, psychological syndrome or pattern that substantially limits the function of the person with the illness. The law provides for large group coverage of these illnesses in both children and adults. The following disorders satisfy the definition of a biologically based mental illness:

schizophrenia/psychotic disorders
major depression
bipolar disorder
obsessive-compulsive disorder
delusional disorders
panic disorder
bulimia
anorexia


How that fits in with rape is beyond me. Why your government even classifies things like this, is again, beyond me. I say take it and run!

bec

That is interesting - does anyone know under which law and who is required to adhere to that law? My insurance companies have always put a limit on the amount of therapy visits per year I'm allowed to have. This is the first time I've ever heard of this.

Look up Timothy's Law. It lists what is what in each state and when it comes into effect. I guess this is a new law that was just passed, a parity bill... kinda interesting I'm reading the background on it now...

bec

Hi nic, This makes me wonder why rape is singled out. There is a sexual assault therapy clinic in my home town that is FREE.

I used to volunteer for the hot line there, so that part I understand but the therapists get paid so it must be government/state funded.

I don't see free therapy for anything else where I live so there must be some reasoning to what your insurance is offering that qualifies sexual violations to be singled out????

Interesting to find out why?

Tammy

Hi folks, Timothy's law has changed the limitation on visits in New York state. I think other states may have it now too though. Timothy is a boy who committed suicide but before he did this had been denied continued counseling because of the limitation stuff insurance companies did. They supposedly aren't allowed to limit the visits anymore. Most insurance companies have setup a new co-pay schedule as a result where your primary care co-pay is a lower fee than specialists - which therepists are considered - so they don't limit visits but it now costs more. Hope this helps with that part.

Valuable information Grae for those US folks.... thank you.