In a case where a behavioral health facility is denying access to appropriate care because of a bleeding disorder, your insurance company can be an ally in advocating for admission or helping you to find another, more appropriate facility.

Conversations with insurance providers will vary based on your type of coverage, your state, and your individual circumstances.

Whenever possible, these conversations should be conducted as a joint call with your treatment team and the insurance provider to request assistance in advocating for access. There is no one-size-fits-all approach; strategies should be tailored to each situation.

To begin, first identify your insurance provider (commercial, medicaid, managed care provider)

• There may be a separate number for behavioral health facilities. 

• If the you have a case manager through your insurance plan, consider reaching out to that contact. 

If you have an employee assistance program, you should reach out to them if you are comfortable. They may have recommendations for facilities that are covered by the your insurance.

(Once you get to a live representative.)

“Hello, my name is [insert name], and I am seeking assistance in securing access to behavioral health treatment. I have been denied admission to [list facilities] due to my stable, well-managed bleeding disorder, despite having a clearly documented and effective treatment plan.

With this plan in place, my condition should not prevent me from receiving the behavioral health care I need. It’s important that patients like me with chronic, manageable conditions are not excluded from essential behavioral health services.

Can you help me with this?

• Would you be willing to join me in a call with the facility to advocate for access?

• Do you have a list of other in-network treatment centers that may be appropriate for my needs?”

Send the following to the insurance provider:

• Insurance provider email template: Personalize this template to request the insurance company’s help in securing access to behavioral health treatment.