Non-Kaiser Health Insurance for Mental Health Care for 17-yo

Hello Berkeley Parents.

We have a 17-year-old daughter who has been struggling with depression and anxiety, exacerbated by the school closure during the Covid shutdown. We have Kaiser as our health insurance carrier and we like them for routine and preventive care and I'd like to keep it for that reason.  However, their mental health care has been extremely disappointing (that is not even strong enough to express my feelings about that, but that's for another time and place).  We have found a non-Kaiser therapist who finally seems to be making a bit of a difference, but it is expensive to pay out of pocket.

I have read on some of the thread about mental health about having to buy separate health insurance to pay for these service and I'm wondering if anyone has any recommendations  any particular health insurance carrier that I can get for my daughter specifically for this purpose? I would appreciate if if your recommendation is accompanied by your own experience with these insurance carriers.

Thank you in advance for your help.

Parent Replies

Parents, want to reply to this question? Sign in to post.

I have not heard of an additional mental health insurance.  We have the same struggles with Kaiser for the same exact reason, and after a life time of being a member there I'm finally biting the bullet and switching to Cigna this open enrollment.  What I have done in the past is burn through our FSA account to pay out of pocket for non-Kaiser therapists.  Do you have and FSA or HSA option attached to your Kaiser insurance?

My experience has been that I don't want to see any therapists that take insurance. We now build the cost of self-pay therapy into our monthly budget. We've had really bad experiences with in-network therapists and finally gave up. 

I’m a longtime Kaiser patient and parent. KP is obligation to provide medically necessary mental health coverage. One should not have to get additional insurance. That said, mental health services from KP are abominable for the most part. I suggest you tell file a grievance with KP outlining the treatment your child needs. Ask you current outside therapist for help. State that you are not getting medical necessary treatment. Write that you want KP to pay for the out of network therapist. . Once you submit KP has 25 of so days to respond. They will say they are providing adequate care and will probably deny paying out of network. But ask! You can then appeal to the DMHC, a state agency that has doctors review claims. KP may be ordered to pay. Do this while you continue to get therapy that’s helping. 

   I cannot speak to your insurance plight. I'm sorry.  Our experience was & has been mostly without any insurance.  It's been tough.

   My adult son is diagnosed with bipolar --as well as epilepsy, learning challenges and PTSD.   Unfortunately, until he was in his 20's we were living in Texas at the time, with zero insurance, and very little support from the schools, from public services, etc.  We're here now, in California.  The services, mostly free, are so much better. 

  About your daughter, please check with the local branch of National Alliance on Mental Illness (NAMI). The East Bay meetings are held in a church in Albany. While your daughter isn't yet 18 (which seems to be the entry point) the staff know a lot about the resources in this area  --- for various degrees of mental challenges  https://namieastbay.org/   

You will learn a lot by attending one of  NAMI's support groups.  There you'll find parents who know the ropes quite well regarding what insurance has worked for them.

   Also, please give a call to the local Regional Center.  It's possible they can help or can refer you to someone who can.

   All the best to a dear mom who loves her daughter. 

I don’t have a positive recommendation but avoid MHN. Hardly any providers are included. Most of the people on their list of supposed don’t accept the insurance when you call them. And hardly any of those who do have openings. So the idea of finding a good fit is out the window unless you are really lucky. 

Have you asked Kaiser to pay for the therapist you found? Kaiser used to lay for outside therapists through Beacon insurance . You tell the Kaiser mental health felt you found a good therapist not in their department and they approve them, set you up with Beacon and you get a number of paid sessions that you have a copay for. I had 9 months of outside therapist treatment through Kaiser. If I had wanted more i think I could have had them. (Car accident trauma) Not sure now but I think the lawsuit their behavioral health department was subjected to resulted in this deal.  Pretty good. Only restriction is finding a therapist that takes Beacon. Never had the slightest push back from Kaiser. (About 2 or 3 years ago.) it went quickly and smoothly.

Thank you for all your replies. I appreciated all of them.

We are preparing to negotiate with Kaiser to at least foot some of the costs that we are having to incur with non-Kaiser therapist.  We are fortunate enough to have found one who was available and who seems to be helping my daughter, but $200 a pop, it adds up quickly. I am looking into switching to a UHC plan in the open enrollment if it doesn't work out with Kaiser. Her therapist would still be out-of-network, but they still reimburse. It' stressful enough trying to figure out the care she needs, I really don't need to have a stress of figuring out how to pay for it.