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US Medicare choices and SRS

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RandiL:
Also related, for therapy Medicare will only cover lower-level LCSW therapists or PhD psychologists. Not the mid-level but common Licensed Professional Counselor LPC. So we are private pay on our therapy

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Confused1:

--- Quote from: RandyL on July 05, 2020, 01:41:11 pm ---Also related, for therapy Medicare will only cover lower-level LCSW therapists or PhD psychologists. Not the mid-level but common Licensed Professional Counselor LPC. So we are private pay on our therapy

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--- End quote ---

Thanks Randy,

I have to pay out of pocket for my Masters level therapist. She gives me a very good discount since I am on basic Medicare. She told me pretty much the same thing.

Confused1

Asche:
When I look at the descriptions of the Medicare Advantage PPOs, they look an awful lot like the plans my company was offering.  Are there any "gotchas", where the Medicare Advantage plan is missing stuff that would normally be in a company-provided group plan?

Also: I don't know about "Masters" counselors (is that the same as MSW?)  All the therapists I've dealt with are either PhDs or CSW's.   One that I had for a long time was a psychoanalyst, and she said that having an "R number" was key to getting insurance to cover it.  I think the issue is having a well-recognized certification, so that the insurer (who doesn't know squat about how good your particular therapist is) can trust that the "therapist" isn't just some random person who wants to collect insurance money.

RandiL:
I've noticed no difference in going from my employer PPO to Medicare Advantage. Just tweaks in copays, deductibles etc.

A therapist will know if Medicare will pay them. State certifications vary. We have Licensed Clinical Social Worker LCSW, and Licensed Professional Counselor LPC which requires more training and hours of supervision to get licensed. Medicare pays our LCSW's but not LPC's for whatever reason. And they pay PhD's. I think MSW is a degree but not a certification here in Colorado.

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Confused1:

--- Quote from: Asche on July 06, 2020, 12:42:38 pm ---
Also: I don't know about "Masters" counselors (is that the same as MSW?)  All the therapists I've dealt with are either PhDs or CSW's.   One that I had for a long time was a psychoanalyst, and she said that having an "R number" was key to getting insurance to cover it.  I think the issue is having a well-recognized certification, so that the insurer (who doesn't know squat about how good your particular therapist is) can trust that the "therapist" isn't just some random person who wants to collect insurance money.

--- End quote ---

I think Randy is right. Seems certifications might vary by state. I just wrote here what she told me she is. With what she is charging me I can't go wrong.  She has written letters that were accepted for both HRT and surgery. That serves my purpose. My second letter will probably cost much more.

Confused1

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