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Mom says health plan would not cover daughter’s mental health care

CHARLOTTE — Some people looking for less expensive coverage than health insurance sign up for healthcare sharing ministries. These plans can help in certain situations, but since it’s not real insurance, it may not cover services that you’d expect, such as mental health.

Earlier this year, a Charlotte mother received a phone call no parent wants to get. She prefers not to use her real name, so we’ll call her Lauryl.

“This past spring, I was away on a business trip. (I) got a call from her therapist that (my daughter) was cutting herself,” Lauryl said. “They were extremely deep cuts, lacerations, in her legs that she’d been hiding for the past couple years.”

>> See our county-by-county mental health resource guide

She told Action 9′s Jason Stoogenke she took her 13-year-old daughter to Atrium Health where she was treated for several days.

Lauryl says she used to have health insurance but wanted something less expensive, so she switched to a healthcare sharing ministry. She assumed her plan would cover the bill for her daughter, but it did not.

“I was just flabbergasted,” Lauryl said. “I did not have a choice. She was contemplating suicide, and she was very open about that.”

The group Lauryl has coverage through is called Christian Care Ministry and its health program is called Medi-Share. It states in its handbook that it doesn’t cover mental health.

The company told Stoogenke: “Medi-Share believes it is critical to be 100% upfront and transparent with members and prospective members about what health care expenses the Medi-Share program shares, and what health care expenses it does not share.”

“While (Lauryl’s) situation is heartbreaking, Medi-Share’s obligation is to our membership as a whole and their sharable expenses, which requires enforcing the member-voted guidelines in order to be good stewards of the members’ dollars.”

“Medi-Share has successfully shared 100% of eligible medical expenses for the last 28 years and that is only possible by managing a program budget that honors our commitments. We are trusted to steward our members’ contributions and using their funds at our personal discretion violates our commitment to them and violates their trust.”

“Again, we are truly saddened by (Lauryl’s) daughter’s situation, but Medi-Share has never shared mental health expenses and states that clearly in Medi-Share Guidelines.”

Lauryl said she still owes the ministry money, but she’s not sure how much. She says her bill was originally $40,000 but Atrium Health reduced it to $32,000. She thinks she may have a cap of $10,500 under her plan, so she’s trying to sort it out.

The ministry says Lauryl can appeal her case and that it also has a charitable program for medical bills it doesn’t cover. It’s unclear if either will help in this case.

Lauryl said her daughter is doing better and that they now have insurance coverage through an Affordable Care Act plan, which covers mental health.

If you are worried about paying for mental healthcare, the group MoneyGeek says if you have real health insurance, it should cover mental health. The complicated part is knowing exactly what the plan covers and which providers are in-network.

“There’s actually a good deal of providers who do not except any insurance. They’re going to let you figure it out on your own,” said Doug Milnes of MoneyGeek.

If you have insurance and it will not pay for mental health, according to federal law, you have a right to appeal. You can also file a complaint with your state’s department of insurance. If you’re on a self-insured plan, the U.S. Department of Labor may be able to help.

If you don’t have insurance, you may want to try Medicaid, Social Security Disability Insurance Benefits, Supplemental Security Income, the U.S. Department of Veterans Affairs, the National Association of Free and Charitable Clinics (it has a search tool for finding help), programs through your work or religious group, and local colleges. You can also contact any local office that does counseling and see if it offers free services.

For more information, click here to see MoneyGeek’s guide to obtain mental health care you can afford.

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