Best Insurance Plan for Access to Therapists/Mental Health?

We're choosing between Blue Shield of California and Kaiser (Oakland), and are entering into a therapy-heavy period for our daughter, ourselves, couples counseling and possibly family therapy. This question may be moot because every therapist I talk to doesn't take insurance anyway, but I'd like to hear your experiences with either insurer on this question (or any). 

Thanks in advance!

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Definitely not Kaiser. We've paid a lot out of pocket for therapy because Kaiser is so bad.  We like a lot of what Kaiser provides, but I can't believe how awful their mental health services are. They really aren't interested in that type of long term care. They will throw antidepressants at you, check in with you once a month, and decide that's all you need. They even misdiagnosed me, but when I went to a psychologist I paid for out of pocket, I was finally diagnosed properly - in my 30s -  in the first session. And the treatment was finally appropriate and effective for what I was dealing with. Kaiser has a great Peds dept, I had my kids there, I like their women's health. Their pediatric orthopedists are great. Mental health? Absolutely horrible. 

I suggest going to the websites of Blue Shield and Kaiser, do a provider search on each by web or by calling customer service, then call a few of the therapists that come up in the search to see if they are taking new patients and if so, schedule a phone or zoom consultation. We have Health Net and had absolutely no trouble at all via this process in finding several therapists to choose from.

You are wise to think about this before entering a therapy-heavy period. My family has been in a therapy-heavy period for an extended time. We have a Blue Shield of CA High Deductible PPO plan. I have not been able to find therapists that accept insurance throughout all of our years in various combinations of individual, couples, and family therapy. That said, I have been able to get a small portion of our costs (~30%) reimbursed after paying out-of-pocket. It's not much, but every little bit helps.

The claims for reimbursement take some time to set up and manage. Blue Shield has gotten better with the over the years and now has a straightforward online portal. Ask the therapists you are thinking of working with if they will provide a superbill for submittal to the insurance company (specific information is needed to file the claim). I keep a spreadsheet to track appointments, claims, and reimbursements, as occasionally Blue Shield will deny a claim for some reason (usually I've made an error inputting information) and not notify me. The good news is claims can be submitted within a year of the date of service, and I have not hit a max. coverage level despite years of therapy for various combination of family members. (Given the track record, perhaps the effectiveness of the therapy should be considered—ugh.)

Good luck in finding good-fit therapists. They are worth the time, money, and effort. 

I've been a member of Kaiser for 15 years and have found their mental health division to be almost non-existent. I've gotten referral to them and learned the wait time was ridiculous. For couples counseling, we were sent to a weekly workshop; it bore no resemblance to couples' therapy. I've continued to see my own therapist and have paid out-of-pocket for all of it. I hope someone has better news about therapy at Kaiser. Best of luck to you and your family. 

I have not used Kaiser but everything I have heard from other parents in this situation is Kaiser really lacks resources for this. With BCBS you can choose from among many therapists around the area. That said many are booked and we have sometimes had to go outside of the network to find appropriate care. Many many therapists do not take insurance because they pay so little. Still I think BCBS is a better bet. 

Kaiser does certain things very well-psychiatry/psychology is not one of them. I recommend Kaiser overall and you could certainly try a therapist there.  You might get lucky.  But my advice is to plan for private therapy.  Best of luck.

Hi - I've been a Kaiser member for years, and I think there are many problems with their mental health services.  Mental health practitioners went on strike a couple of years back objecting to the understaffing.  There was also a recent article about their underhanded workarounds to poor response times to calls  - they hired an outside agency to answer first time calls, but then didn't essentially change access to first time appointments.  It's almost impossible to get regularly timed individual sessions with a counselor due to understaffing, and Kaiser's whole emphasis on mental health services is time-limited group referrals.  So you can go to a group for your depression, but even that is limited to a certain number of session (6 I think).  Definitely try other options - I've seen a private practice therapist for a long time due to their poor performance.

Thank you so much for asking this question!  Blue Shield paid my therapist fairly easily.  Just google Kaiser Mental Health Care and you can find info about that.  But I am wondering too about this general question.

We have Kaiser and it's not been good for therapy. They mainly offer groups, and can't really see anyone including kids for individual therapy more than once a month (and even then, appointments are frequently cancelled.) We were offered for our teen to see a private therapist but it turned out that no one actually takes the plan that Kaiser offers for that. We ended up paying out of pocket. I would check the exact coverage on Blue Shield but it may be better.

Thanks everyone! Here and everywhere I'm hearing a universal thumbs down on Kaiser mental health services. I was leaning toward Kaiser because it was fantastic in SF when my daughter was little, but I now almost don't want to go with them on principle. Blue Shield PPO or HMO?

If Blue Shield PPO is an option for you, I would suggest it. We have a Blue Shield HMO and have found the mental health provider options very limited—we pay out of pocket for private therapists. I'm not sure what the PPO offers, but usually you can get some kind of reimbursement for out-of-network providers.

I see all the negative comments about Kaiser, and I was very surprised by my own experience. In the wake of a rather difficult illness, my Kaiser primary not only suggested that I consider treatment with Kaiser Behavioral Medicine, he made certain that I got an individual therapist. I have probably been lucky that things worked out for me, but it doesn’t seem to me that Kaiser Beh Medicine is always a hot mess.

Hi, sorry for the late reply. We have been quite successful getting mental health care for our son at Kaiser Oakland. He was diagnosed at Kaiser with ADHD and OCD. The clinicians we've interacted with have been excellent overall and available. They have groups classes and individual sessions. I will say that we did go outside of Kaiser for weekly therapy that my son needed for less than a year. We were fortunate to be able to pay out of pocket for that. I have had Kaiser for years and have been quite happy with the care I and my family members have received there. 

Hello-

Responding to the person who recommended Blue Shield PPO. I am a member, and I am not happy. Most providers are not in the Blue Shield PPO network. You get "reimbursed" for "out of network providers", but since this is 30% of the "allowed" amount, it is rarely higher than $40-50 per session - at a time when therapists charge $150+ per session. You have to provide a superbill via mail and now online as well, that in 3 out of 4 cases somehow "gets lost" and never is processed. Their online portal lost 2 out of 3 claims I submitted- after I got a confirmation that they were received! Long story short - they do everything they can to not pay. The providers on their list are either so bad that you should not go there, or are completely booked. Sorry for being the bearer of bad news.