Thanks for the recommendation, BG. Both my GP and my insurance have said that my medical coverage and my "behavioral health" coverage don't really interact. So, my GP can't really formally refer me. She can prescribe basic ADs or give me the phone number for the psychiatrists who work out of her medical group, but that's it. I am not a fan of insurance companies either and this one has screwed me twice in the past...but, it was an Aetna representative who first suggested I try this if I was having trouble finding someone in network to meet my needs, so maybe there's hope. The worst that can happen is they say no and I'm paying the same amount I am now (and some rejection triggering as a result, but I have a T to help me deal with that).

I asked for an exemption for my oldT because he was the only one around here would treated very young kids for ADHD. Then they extended this to me when I needed my own therapy sessions. I pleaded that it was better for my son and I to see the same T as it was a family matter. So they granted that too for me. Luckily my current T is IN the plan (one of few around here) but now my son has no T because they will not do another exemption and want me to drive an hour away for a child T. That is impossible as I work till 5:30 at night and we cannot spend late hours in the city with a young child.

I hate insurance companies.

I would play up the religious aspect and tell the rep that this is a deal breaker. You MUST have a Christian counselor. I'll bet they will allow him in the plan.

Good luck.
TN

Thanks, TN. I thought of just saying indoctrination in a cult-like religion as a child (as I spent nearly every weekend at my grandma's and she would always take me to Kingdom Hall), but that sounds like an exaggeration. My H says he does consider JWs a cult, but knowing so many (very nice) JWs and having a ton of them in my family, I just feel guilty for calling them that. They are quite controlling, though, as compared to my experiences at church. No room for independent thought and very closed off to the outside world. Anyway, I just don't want to feel like I'm "lying." It seems like no matter what I do or say, I always get internal accusations of "lying" or "exaggerating" and that's where I'm at with the insurance thing. Well, T still hasn't given me his taxID, and it's a holiday, so I still have a while to research and think about it.

Today, I called two of the three remaining in-network Ts for dissociative disorders and asked if they have experience with my diagnosis. Waiting for a call back.

Then, I called insurance to verify process for applying for a single case agreement. Turns out my T has to be the one to apply. Now, I feel trapped, because it means asking him to do something that will consume his time with no guarantee of success, which will mostly benefit me and not him. I let him know the information, but I cannot ask him to do it. I told him that I felt so conflicted internally and paralyzed (but not why I am paralyzed). If I ask and he says yes, I will feel like the biggest burden, especially if it ends up losing him money or doesn't succeed and wastes his time. If I ask and he says no, there will be internal rejection freak-outs and projections that it is actually him hoping my finances will push me out of treatment with him, because he's sick of me. That would require him to basically be outright lying to me on a regular basis. I know him saying no would be for the same reason as it was when my H asked him to apply to be in network for Aetna and that is just because he doesn't think they'll accept him. But, it feels like it is all about me...so I can't ask. Internally, it is like "Oh well. The usual. No one can help!" It's not true but it's easier to think that no one can help than to find out that the people who you need and want to help aren't willing. I...suck...

So, my T responded and at first I thought he was responding to the unasked question which I didn't want him to answer, because I'd rather talk about what the two answers would mean before actually getting an answer. Thankfully, he just told me that in his experience, that's not the way insurance companies worked. He said they're usually only interested in locking the provider in for all clients and that SCAs take a lot of work by the client to prove why they need it. So, he basically doesn't believe that he has to call in for the SCA. He wanted me to enlist H to argue the case for me, not because he doesn't think I could do it (he thinks I'm more than capable and have a very good case), but he is worried about me getting distressed. Part of me was like, "Hey, f--- you! I am working hard to take care of this on my own as much as possible," and another part was saying, "He's being protective of me!" and all filled with mushy feelings there.

I don't want to involve H anyway, because H said if I can find any other in-network provider that does my diagnosis, he expects me to switch if they won't take T, because the amount of money it will save us would allow us to keep our condo (or be just shy of that). He said he is willing to switch too, but he doesn't have attachment BS he is working through. So, that has me feeling very trapped, because I am (once again) in the place of having to choose what feels safest/healthiest for me as an individual and what is in the best interests of my family. It's a very familiar place to be in, like when I chose not to go back to my mom's after she kicked me out, knowing it meant that my younger siblings would not have me around to protect them directly, but would have the benefit of a healthier big sister, showing them how to set boundaries and take care of herself. And, I honestly don't know what the right choice is.

There is one T, an MA, who is a Christian counselor (according to Aetna's webpage) with experience in my diagnosis (according to my voicemail)...but it is a woman. I have such nasty female transference issues with women in positions of authority that I cannot even fathom working with a woman. Also, as I told my H, I just "can't" leave my T right now. I am so attached. I am making progress. I feel safer in therapy than I have in my first nine months. I don't want to go.

Anyway, I called Aetna back and they said the SCA is not a matter of proving anything, but of the provider requesting authorization and discussing/agreeing to their terms. I think T is scared about getting locked into Aetna for everyone. It sounds like he has had bad experience with insurance companies in the past. So, I texted him know the information that they said it's a matter of him doing a phone call with them and agreeing or not and we can discuss later. I don't want to waste session time on this stupid $#!+, but it's not fair to expect him to take more out of session time trying to deal with it either. Ugh.

I feel like I'm chasing my own tail on this issue. If my H finds out that I could have this other woman for $30 a session and she has plenty of availability for me (she offered me four different early evening sessions as possibilities within the next week or so), he will expect me to take that opportunity if Aetna won't cover T. I don't want to hide it from him, because that is lying...but he didn't listen when I said, "I just can't do that right now."

The result of all this? I just want to quit therapy altogether. LOL.

Yaku... I have never wanted to see a woman T either and the thought of it just turns my stomach. I tried to overcome this with "D" who I saw last summer and she was the one who did the useless "transition" session with oldT and then betrayed me and threw me under the bus. She just confirmed what I knew all along which was that I needed to keep away from female T's. I know there are a few good ones on here that members see but for me it just does not work.

Aside from that.... Your T is probably worried about something that is not going to happen. My oldT was an exemption for me and all he did was to fax the insurance company a copy of his license and then he had to fill out treatment plans every 3 months to chart my progress and what we were working on. These can be VERY general and not hard to fill out. So then they would grant me 12 sessions and when they were done (3 months) he would do another treatment plan for me.

I paid my T his usual fee and then submitted his receipt to claim money back for me. I did not get all the fee back. I got about half back. But that was a huge help for me as it was both me and my son going to therapy at that time. The worse part is that YOU have to keep up with the paperwork and to follow up with T when he needs to submit another treatment plan (when you are out of sessions). My oldT certainly did NOT have to include all his other patients in this insurance plan. It was a private arrangement for only me and my son. The insurance company provided a special number that I needed to note on all the claim forms I submitted. It was a number only for me.

I was very matter of fact about it. I just told insurance that I chose to use Dr. X and they asked me for his name address and phone number and then they called him and asked for his license. Done deal. I think your T is worried about something that he really does not need to worry about. I know that T's hate paperwork but if you tell him you will be doing most of it then maybe he'll feel more comfortable.

I'm sorry this has become so complicated for you.

Good luck
TN

Glad I'm not the only one with woman issues. Both of our Ts have labeled our moms as narcissists if I remember correctly...maybe it has something to do with that. She seemed very nice on the phone, but she called me back AGAIN to offer me a free session to learn about her methods, how she incorporates Christianity, maybe her being able to see me in conjunction with my therapy (which, I don't need that sort of drama and my T isn't too positive on). The only benefits I can see are:
-No worry about extreme attachment urges with a woman. I have never had a positive transference experience with a woman in my life.
-Saving about $700 a month if I can't get T on a SCA.
-She's in my area all week long, it sounds, so possibly having more appointments.

On the other hand, I will probably want to kill her. J/K, but I will seriously have no ability to get close to her at all at this point.


I think T must have had some really bad experiences with insurance companies or something, because he keeps saying these sort of things about how horrible they are, how they make treatment so difficult, how they keep religious therapists out, how it is a battle to get them to work with you, have to fight for care, etc. The thing that pisses me off is that Aetna doesn't have a form he can fill out or a SCA procedure sheet so I can show him how it works. So, I basically just have to verbally convince him to make the call. Maybe some week I will have him schedule a daytime session and use it just for us to do that or something, so he gets paid for the effort and any questions can be resolved then and there. I don't know what else to do...

I'm sure he had problems with insurance companies. My T does not hold them in high regard. He says it's just a game they all have to play to get the patient treatment. I can imagine it's harder for religious counselors. I did not have Aetna, I have Blue Cross.

Hope things go well for you tonight.

TN

Thanks. He said he'd rather deal with the administrative stuff via text, because he didn't want any of my session time wasted on it. So, we talked about it a bit, but only the difficult feelings it brought up around needing help and how I was trapped with both yes and no being scary and painful. It sounds like he will call, although I'm not sure, and we'll see what happens. He tried to act positive about me having another option (for our financial situation or eventually if I feel I have done what I'm meant to with him) with this other therapist, but it freaked the kid parts out so badly! That wasn't his intention, but I felt like he should have known better. He reiterated that he would never ever push me out though, which helped a bit.