Because behavioral health is different – suddenly

And this is what they want me to make lemonade out of
And this is what they want me to make lemonade out of

Apparently, my employer has ditched Blue Cross – Blue Shield for Optum Health (United Behavioral Health), and now I have to jump through yet more hoops to hunt down an ASD diagnosis.

To use my meme-of-the-day from last week:


For years, I was dealing only with BCBS, and it was fine. It was a far cry better than Harvard Pilgrim / Optum / UBH, that’s for sure. They pulled some rotten things like delaying or denying payment to some providers for services rendered, and I got occasional inquisitive calls to justify my assistance and make sure the servics weren’t workman’s comp-related. But I didn’t have issues with finding out about plan details and limitations, as well as figuring out payments to providers.

I have no idea how this is going to work out. I cannot find plan information anywhere, and having dealt with Optum Health in the past (through Harvard Pilgrim), I can tell you it was a total nightmare. Their whole approach seems to be more about cutting costs, controlling expenses, and helping employers not pay so much for coverage. Keeping people in need out of the provider stream seems to be their primary goal. Mission accomplished.

The thing is, behavioral health is not an expenseit’s an investment. And by switching from BCBS to Optum, my employer is just screwing themselves by making it harder for employees to get the help they need. Employers do a pretty fantastic job of making their staff mentally ill. Why not just put the finishing touches on it, and keep them from getting the help they need to stay fully functional?

Oh, but wait – we’re disposable, after all. We can always be replaced. And probably for cheaper.

It’s an accessibility issue. It’s an ableism issue. It’s pseudo-Darwinism at its best, it seems to me. Only the strong will survive. Except that under the conditions most of us are living with, even the strong will go down. Especially the strong. Because we’re the ones putting ourselves out there, day in and day out.

And this is — yet again — where I come down in favor of ASD self-diagnosis, as much because of access issues as because of accuracy and expediency. Official diagnosis is all too often not available for people, due to money, time, access, and provider (in)competence. The ones who are the most vulnerable are the ones who need the diagnosis the most.

But they’re the ones least likely to get it.

So, we have to take matters into our own hands.

But that doesn’t help with the Official Story we need in place to deal with law enforcement, healthcare providers, insurance, and other sorts of providers who may need to know about our traits and tendencies to best serve us — or at least not kill us. And no, I’m not being flippant about it. Kayden Clarke is just one glaring example.

So, I guess I’ll collect all the information I can get up front, and then walk my way through the process of finding out what’s available to me… and if I can get to it, at all. In the past, Harvard Pilgrim forced me to get medical clearance for help with issues that could literally not be medically documented. Six months of diagnostic hell and repeated dismissal ensued.

I really don’t know what I’m going to do, if I have to do this. Because I need an official DX to talk effectively to doctors, in the first place.

It’s so much easier to not need any help at all.

If only…


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