No matter where you live, there are alternatives to expensive medical care. Those who don’t have insurance, or whose insurance is inadequate, will want to investigate these resources.
In some cases, creative private-pay arrangements may be possible with psychiatrists and other providers. Parents have traded services or products for care, and others have arranged payment plans or reduced fees based on financial need. The larger the provider, the more likely it is to have a system in place for providing income-based fees. The smaller the provider, the more receptive she is likely to be to informal arrangements, including barter.
My insurance coverage is very good: Blue Cross/Blue Shield. We’ve had no problems with having them cover the doctor and hospital and drugs. The only thing they don’t cover is Lisa’s therapist, because their definition of a clinical social worker is a social worker who has a master’s or doctorate degree, has at least two years of clinical social work practice, and a license if required by the state. Our therapist doesn’t have a master’s, but has a license and over 15 years experience. Lisa has formed a very tight attachment to our therapist and neither of us want to change. To make it affordable to us, her therapist is only charging us half price to keep Lisa from having to go somewhere else. –Donna, mother of 16-year-old Lisa (diagnosed bipolar II disorder, post-traumatic stress disorder, and anxiety disorder)
Hospitals and major clinics usually have social workers on staff who can help you make financial arrangements.
Sources of free or low-cost healthcare or therapeutic services may include:
- Public health clinics, including school-based health clinics
- Public hospitals
- Medical schools, and associated teaching hospitals and clinics
- College special education programs (for learning disabilities and cognitive testing, and sometimes for direct help with educational planning and techniques)
- Hospitals and clinics run by religious or charitable orders, such as Lutheran Family Services clinics
- Charitable institutions associated with religious denominations, such as Catholic Charities, the Jewish Aid Society, and the Salvation Army
- The Urban League, which provides counseling services for troubled teens in some cities and can sometimes refer clients for psychiatric care
- United Way, an umbrella fund-raising organization for many programs that can often provide referrals
- Children’s Home Society, the Boys and Girls Aid Society, and similar local children’s aid associations
- Grant programs, both public and private
In the UK, special resources outside of National Health include:
- The Mental Health Foundation
- Community Trust associations, particularly the Zito Trust (0171 240 8422)–see the Mental Health Foundation web site and CharitiesDirect at for lists of many UK trusts related to mental illness, substance abuse, and related issues, including many that focus on particular ethnic or religious communities
- The New Masonic Samaritan Fund (for members and families of Masons)
- The Samaritans (0345 909090)
Medical Savings Accounts
This is a new healthcare payment option in the US that may have benefits for some children and adults with bipolar disorders. A medical savings account (MSA) allows families to put away a certain amount of money specifically for healthcare costs. This income will then be exempted from federal (and in some cases state) income taxes. Unused funds continue to gain tax-free interest. These accounts can be used to pay for insurance deductibles, co-payments, prescriptions, and medical services not covered by insurance.
Families faced with paying out-of-pocket for an expensive residential program or experimental medication might be able to use an MSA to reduce their costs by an impressive percentage. You’ll need to check the regulations of the specific MSA plan to see what expenses will qualify.