Insurance and Drug-Based Treatments for Depression

It’s good to see that the FDA is finally looking more outside the box for new drug-based treatments for depression [NPR.org article. There are plenty of people who the typical SSRIs that have been the “standard of care” for 20+years (Prozac etc.) don’t work on.

The problem is, 1: that it took them this long, when doctors have recognized ketamine’s effectiveness for years and have been doing it off-label for a long time, and 2: the last sentence in this article – basically saying generic ketamine is just as, if not more effective than this “new” drug, and the only real advantage of it is that insurance covers it.

Insurance covering something is a mixed bag. On one hand you may pay a bit less today, but now they have your data – the fact that you took ketamine for depression is now on your permanent medical record, and they also require a diagnosis, something that providers not billing insurance do not need to use.

Try getting a life insurance policy after your insurance company has a diagnosis of “treatment-resistant depression” for you as well as the fact that you used this ketamine drug, and see what happens. It could cost literally **more than 5 times** as much as a “normal” person. As opposed to someone who paid out of pocket for generic ketamine to a private doctor – this info would not be in the insurance company’s database for them to do whatever they want with.

And that’s just one example. Others can include getting a job, what the premium is on your medical insurance at different points in your life, etc. (officially some of these are not supposed to be affected by pre-existing conditions, but the fact is that they are. That’s a fact that has been demonstrated countless times in many ways).

In short, having any history of mental illness, especially one that can potentially be dangerous like depression on your “record”, most definitely will affect your life if it is in the insurance company’s database.

This is why Personally, I would be much more comfortable taking the generic and paying out of pocket than taking this “new” version, even if insurance offered to cover it.

Insurance and Psychotherapy

And yes, everything that I’m saying holds true for Psychotherapy as well. This is why people often choose to pay for Psychotherapy out of pocket instead of using their insurance, even if their insurance is willing to pay for some of it. Because while insurance may cover it, that comes at a price – the price is that you now will have a diagnosis and details of your condition attached to your name forever. And the effects of having those items on your medical record will almost certainly be much more expensive and harmful to you than the short-term savings of paying for therapy yourself.

(Of course no one tells you this. Because no one wants you to know. Insurance companies *want* you to use their services – they are required by law to pay certain amount of their money for treatment anyway, and they also get paid untold amounts of money for their data – some of it legitimately, and I have no doubt some if it in ways that you would be shocked at.)

Dr. Winder provides Individual and Couples Counseling & Psychotherapy as well as Divorce Mediation. Dr. Winder has developed a proven propriety program: STEP, that takes a holistic approach to helping people get their lives back. He provides counseling at both his Cedarhearst office as well as conveniently through online video conferencing. Use the small chat box to instantly connect with Dr. Winder or click the button to schedule a Free 15 Minute Consultation and start today towards the new healthier you!