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Dizzy_Cookie_8650 t1_jaan52n wrote

It’s a federal mandated benefit. Mental health has to be treated the same as any other illness. So the rest of those benefits on marketplace plans are subject to that same high deductible. That’s how they make it “affordable “. It drives most of the cost to the member. But if you see an in network provider the cost is discounted and you only pay what insurance allows so even though you’re paying upfront to meet the deductible it may not be as high as you’re thinking.

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Evening_Attention_45 OP t1_jaas7vn wrote

So this is even for in network providers. Even if it’s an in network therapist, you have to pay the full deductible before insurance will pay for any therapy sessions. There is a $50 copay for a specialist but mental health is not covered. It’s no wonder there’s a mental health crisis with insurance not covering therapy.

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Dizzy_Cookie_8650 t1_jaau1g6 wrote

Which plan are you looking at ? Omnia silver has a 30 copay for mental health, no deductible. I’m sure it’s pricey depending on your age bracket.

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Evening_Attention_45 OP t1_jab9a00 wrote

That's the one I'm looking at. Omnia silver is a $30 copay AFTER the deductible is met. That means I need to pay the $2,000 deductible before I get to pay $30 for each visit.

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Dizzy_Cookie_8650 t1_jaeezsr wrote

The silver actually only charges that copay if your IP. An outpatient office visit is straight copay. Im an insurance broker in nj. I don’t write individual plans but I’m familiar with them. Hope this helps. Good luck.

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