December 2008 Newsletter
December 1, 2008
CrazyBusy Tip of the Week
A study on connection done with those in middle age shows that well connected people can fight off infections better than those who are not well connected. In fact, it was also found that having a variety of connections is healthier than just having a few. Those who had six of the 12 types of connections below did four times better at fighting off colds and viruses than those with fewer connections.
My message is this – as you prioritize your life heading into this holidays season there is good reason to make time for, and cherish, your connections whatever or whomever they are.
The 12 Types of Connections
- Family of Origin
- Immediate Family
- Friends and Community
- Work, Mission, Activity
- Creating Beauty (art, music, literature etc.)
- The Past
- Nature and Special Places
- Pets and Other Animals
- Ideas and Information
- Institutions and Organizations
- Whatever is Beyond Knowledge (unknown truths)
- Yourself
taken from Hallowell Connections, www.crazybusylife.com
Blessed is the season which engages the whole world in a conspiracy of love.
~ Hamilton Wright Mabi
Have you ever bemoaned a rainy December day?
Celebrate instead.
Winter Rain
I saw a trifling raindrop
Clinging to a bough
A tiny prism raindrop
Flaunting rainbow light
My darkness fades to see its color
Splendor born from winter rain.
~ Susan Reuling Furness 2005
Economic Considerations When Choosing an In-Network vs. Out-Of-Network Provider
With the huge number of health plans out there, few psychologists and counselors decide to sign up “in-network” for every product available nationwide. I personally have signed up for some plans and not others– just like my own physician’s office. So, when families call me based on my expertise areas or because they’ve received a trusted referral to me, they often have additional questions if they find out I am out-of-network for their plan. Many potential clients are confused (or sometimes directly misinformed by their insurance company!) about what it would mean financially to seek services from an out-of-network provider or to use their traditional insurance vs. their EAP (Employee Assistance Program). Ultimately, I always want what’s best for the family or individual– including financially. These potential clients often consult with me to better understand their insurance options and to confirm my network status for their plan. Additionally, many want some advice about what factors to consider before deciding whether to meet with me (who seems like an especially good fit or to whom they were actually referred) vs. looking for an unknown, in-network provider that might save them some dollars in the short term. To guide them in this decision, I often outline three issues to consider.
First, many clients are confused, or are even actively misled by the insurance company, to think that if they choose a provider out-of-network there will not be any insurance benefit. Typically, this simply isn’t true. Although a few plans truly do not cover out-of network services at all, most provide a decent benefit but with different rules applying. For example, in researching a number of local employers who have Blue Cross of Idaho “PPO” plans, I found that roughly 80% still provided an out-of-network benefit for mental health services. The difference with seeing an out-of-network provider on these plans might be in having to meet a deductible before benefits begin, or in reimbursing 50% of costs out-of-network rather than 70% in-network. Finally, you should know that under Idaho law all plans are required to apply out-of-network services towards the deductible if that service is a covered benefit at all. As always, call your insurance plan directly to check on these finer details.
Second, except for prescriptions and family doctor visits, most insurance plans require that a deductible be met before any benefits begin, regardless of the provider’s network status. Thus, during the time the deductible is being met, clients often have the freedom to choose any provider they wish at no additional cost. Some clients with higher-deductible plans even realize that it will never make any difference whether they seek services in-network or out-of-network, because realistically their counseling needs would be met before the deductible is reached and insurance payments began. Then if future medical needs arise, they would have made significant progress towards this deductible. Alternatively, once a deductible is met and an actual insurance benefit would begin, the client can always choose to transfer counseling at this point– but in the meantime he or she enjoyed the freedom of working with their first-choice therapist at no additional cost, gaining valuable tools and ideas that can continue to be expanded with a new therapist.
Third, while most of us love living in a smaller community like the Treasure Valley, realistically this always limits the number of specialists for any given problem– whether medical or psychological. Be sure to ask the providers you’re interviewing whether they have any special training and supervised experience in the areas they claim expertise. Some may claim to practice in areas in which they really haven’t had any special background, like family or couples therapy. While interviewing potential therapists, some clients come to realize they actually have more than one specialty they are seeking, like wanting expertise in ADHD or divorce issues, but also needing a skilled family or couples therapist. Others seek an area of expertise like bipolar depression or severe anxiety, but also think a male therapist specifically would have a better chance getting through to their child. In these instances, the question may arise whether any provider with the correct expertise areas will happen to be in-network for their insurance. If not, the caller faces a difficult decision. Should he or she stick to someone in-network or within the EAP benefit who’s cheaper, even if the provider doesn’t have the particular skills or knowledge base they are looking for? I certainly have seen some cases where this “hope for the best” approach worked out OK. I’ve also met with many adults, children or families after lengthy previous therapy either failed to be helpful, or even backfired and made things worse. In the meantime, the client was still making a significant investment of their money, time and emotional energy, but without getting a good benefit back from this investment. For some, as the weeks and months rolled by, new consequences of not receiving the right help quickly enough often mounted up, including failing grades, damaged relationships, worsening symptoms– or in the worst cases something like a related job loss or divorce. In short, as with any medical care, seeing the right specialist, and doing so in a preventive, timely way may be more costly up-front, but save you money in the long term– precisely because the treatment received was more targeted, effective and efficient, including financially.
~ Stephen H. Hill
Christmas is a necessity. There has to be at least one day of the year to remind us that we’re here for something else besides yourselves.
- Eric Sevareid
Christmas is the season for kindling the fire of hospitality in the hall, the genial flame of charity in the heart.
- Washington Irving
Christmas, children, is not a date. IT is a state of mind.
– Mary Ellen Chase
What do you call someone who is afraid of Santa Claus? – answer: claustrophobic