The healthcare system in the United States is lousy, especially when it comes to mental health. As of 2014, nearly 4 million mentally ill citizens still do not have health insurance, and paying for treatment can easily bankrupt some patients. Without insurance, a patient with bipolar disorder can pay at least $500 a month for minimal treatment. that’s just for two bipolar disorder medications and a psychiatric medication management appointment. most patients need more than the minimum. It’s just not feasible, but if you have bipolar disorder, you need treatment. otherwise, the result keeps getting worse. So what can you do before you have to decide between paying for food or paying for drugs?
This is a scenario: You are 27 years old and have been dropped from your parents’ insurance. you were lucky enough to be one of the 30% of people your age who got a bachelor’s degree, but you have $35,000 in student loan debt, high credit card debt, car payments, and house payments. He has a full-time job with benefits, earns around $35,000/year, and his net worth is around $8,000. It’s not a fantastic situation, but you’re getting by. that’s an average scenario.
People with bipolar disorder are not average.
Here’s the revised scenario: You’re still 27 and your parents’ insurance has dropped you. she tried to get a college degree, but academic and social stress triggered her first manic episode. You did your best to keep going, but you’re not part of the 16% of people with bipolar disorder who complete an undergraduate program. you still get the debt, though maybe less depending on how long you were in school. he has managed to be in the 60% of people with bipolar disorder who have a regular job, but his symptoms are severe enough that he can only work part-time. you end up earning only $300 a week. you don’t have health insurance.
There are ways to combat the financial costs of bipolar disorder. here are some:
affordable care actrunning the above scenario through healthcare.gov using austin, tx as the location, the cheapest plan resulted in a $0 monthly premium, $0 deductible, and a $850 annual maximum out of service. pocket. specialist visits are $25 and generic prescriptions are $10. for the two prescriptions/one visit minimum, that’s $45/month instead of $500. Obviously, this will vary depending on where you live and what your income and family situation are. Enrollment usually begins in November, but you can request a special enrollment.
medicaidour example person would probably qualify for medicaid. Medicaid is a federally funded program for citizens or legal residents under the age of 65 that provides health care to low-income people. Nationwide, people with mental illness who live up to 133% of the poverty line generally qualify for Medicaid. that’s about $1300/month for an individual.
Thirty-one states and the district of columbia have enacted expanded medicaid, so in these states you can earn a little more and still qualify. To see if you qualify, visit your state’s healthcare website or healthcare.gov.
medicare For citizens or permanent residents who are age 65 or older or who have become chronically disabled through mental illness, you may qualify for Medicare and Social Security Disability. For insurance, you can expect to pay a premium, but there are supplemental insurance programs, as well as disability. disability benefits will help supplement lost income and provide health coverage. You can work while disabled, but only up to a certain income level.
Now, disability can be difficult to obtain. it is a long and highly scrutinized application process. requirements include two years of documented periods of unemployment due to symptoms, as well as a limited ability to maintain social and work activity. I recommend having an attorney or mental health social worker available to help with the application process.
Community Health Centers/Free Clinics Community health centers provide care to people who cannot otherwise pay for it. there are no qualifications or application processes. In general, you pay what you can. Depending on the clinic, they may offer everything from family medicine and pharmacy services to dental health care. some also offer advice. the services they provide depend on the staff and resources available. To find one near you, you can do a search for your location and community health center or “free clinic” or you can visit http://findahealthcenter.hrsa.gov/.
make some phone callsusually people want to help you. Call your local psychiatric hospital for information on free services or support groups. You can also talk to your current doctors and pharmacists about discounts or payment plans if you can’t afford the self-pay option. if you’re a student, your school/college likely has resources for mental health care.
You can find me on twitter @laraerlabouff or on facebook.
photo credit:richie diesterheft
See also: Who Can’t Pay for Health Care? – PMC