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Affording Counseling and Therapy

Insurance, EAP, Community Support, and Budgeting

We all know that accessing healthcare can be daunting, especially when it seems (or is) not affordable. Here are some options to check out that may make it easier for you to get going with a provider.

Insurance

If you’re paying for it-may as well see what you can get from it, right? The easiest way to find out what your plan offers is to just call the number on your insurance card (and it’s also a good opportunity to practice managing emotions and reactions as you breathe patiently through the fiftymillion prompts until you get to a person). So after you get through to a human, what do you ask?

Hi, I’m calling to find out about my mental health benefits through my plan.

At this point, the lovely representative will likely tell you if you have a deductible, which is the amount you would have to pay before the insurance will pay for services. Even if you have a high deductible, most insurance plans require that therapists only charge the rate that they would receive from the insurance company. For example, if the insurance company pays the therapist $80 for a traditional 55 minute session, the therapist can only ask this of you, rather than the self-pay rate they may have. After the deductible is met, there may be a co-pay or the insurance may cover the session in full. A co-pay is the portion of that example $80 fee that you would be responsible for. So if your co-pay is $20, your therapist would bill the remaining $60 to your insurance.  This is at least how it works in my practice. Some therapists prefer to have you handle the insurance by submitting bills/statements to the company so that you can be reimbursed directly by the insurance.

If you are calling to be referred to provider, the insurance company will provide a list of in-network providers, but if you are connected to a therapist already that is NOT in-network, you can ask if your insurance provides out-of-network benefits. My experience has been that not many do, but it’s worth asking anyway.

Also make sure to ask specifically about the type of counseling you are doing. Individual sessions are billed in various increments and standard for my practice is an individual 55 minute session (code 90837), but I’ve also billed for inclusion of family members, or for shorter sessions, so you will want to ask the insurance company specifically if they cover couples or family sessions, as not all may. Further, I am finding that most plans cover in office sessions at the same rate as online sessions, BUT that may be true. Luckily, there have been cases where the plan actually offers better benefits for online sessions, which was a nice surprise!

*Please be aware that to use your medical insurance, providers have to provide a diagnosis and prove that sessions are “medically necessary” to access your insurance benefits.

Employee Assistance Programs

I’ve been finding that many people do not know about their EAP benefits, which is a shame, because there are usually free sessions! EAP benefits usually include a variety of services, with the idea that a supported employee is a more effective employee. Companies usually outsource these benefits, so it’s important for you to ask and understand the name of the company that is providing the mental health/counseling sessions (i.e. ComPsych, Health Advocate, Cigna). This is separate from insurance and my experience thus far has been that I do not have to provide a diagnosis to the company. EAP is intended to be short-term stabilization/connection to resources and the 3-10 sessions can do just that. For those that want to continue with their counselor, they typically continue through self-pay or use of their insurance. Since we already know that EAP is short-term, if you have an idea you would like to continue with the counselor, it’s best to discuss this up-front.

Hi, I’m calling to find out about counseling sessions available through your program; can you tell me how it works?

The lovely EAP representative will likely ask you what issue you are working on (as they sometimes provide additional sessions for a different issue later on), who it is for (EAP sessions may sometimes be available to family members), and if you have specifications for a provider (location, demographics, takes whatever insurance). If you already have a counselor in mind, the EAP company can see if they are already contracted with them or may be willing to on-board the counselor, which your counselor may or may not choose to do.

EAP rep. will then notify the provider that they’ve been assigned to you, and/or will provide you with an authorization number (*remember* to ask and write down how many sessions/dates allowed to give to your therapist). The therapist usually submits a request for payment directly to the EAP company without needing you to do anything.

Community Support

There are various free or low-cost options for various needs and each agency will usually specify through their website or a phone call what those requirements are. For example on the Mental Health Association of Central Florida’s website, their criteria for the Outlook Program is: over 18 years of age or older, primary psychiatric diagnosis of depressive or anxiety disorder, comorbid medical conditions, permanent residence in Orange County, uninsured, and of preference, recent medical hospitalization or visit to the emergency room. A quick online search for “free counseling in *your city*” should return some leads to explore in your community.

There are also national resources such as Open Path Collective that gather counselors who are willing to provide low cost services to those that sign up/qualify.

Many counselors also provide spaces for “sliding scale” for those who cannot afford their full-fee. This would be negotiated according to the therapist’s practice. While I would not be able to pay my own bills if I offered sliding scale to everyone, it is important to me that people get the help they need, whether that is with me or another option.

Budgeting

This is the path I chose for myself as I don’t have an EAP program and I wanted to continue with the provider I was already working with, even though she does not take my insurance. I’ve had to do some mental cartwheels around this to reframe how I view where my money goes. This really only became clearer after I kept better track of where my money was going. When I found that I was spending more on going out to restaurants than on my health, I had to make some adjustments because while socialization and experiences do contribute to my own healthy state of mind, I needed to find a better balance. So, I add it to my “medical” budget each month and adjust other budget items as needed to be able to make this happen for myself. Interestingly…I have found that by doing “the work” with her, my money/budget habits have improved anyway!  

Regardless of what path you choose, it’s important to determine your “why” and the strength of your “why”, which will fuel your determination to finding any way to get the support you need.

* Photo by Fabian Blank on Unsplash



After getting the opportunity to work with some social workers, fire fighters, teachers and other helpers in our community, I’ve found that I really enjoy supporting those that support others. I remember the secondary trauma I experienced myself as a younger social worker, the many times of burnout, and seeing those around me leave their professions due to the usually thankless, high-stress work environments.

If there is anything to be done to support you and keep you doing the important work you do, let’s make it easier for you to do this thing called “self-care”. Helpers tend to have interesting work hours; I offer flexibility during the day so that we can work around your schedule. And because it’s via video/online, you’re saved a commute to another office. All you need is an internet connection and device with video capabilities. Any questions? Feel free to call or message me at 407-437-5076. See you soon.



Spring Update – April 2019

I have so enjoyed working in my Orlando office and being in the Orlando area for many, many years. While there is never a perfect time for transitions such as this, I have decided that as of June 2019 I will be 100% providing video counseling, which allows me to see people located in Florida and Colorado, as I am licensed in both states. It may be something that people are not used to and I plan to offer free “try it out” sessions in the next few months. I prefer video counseling, but will also be available by telephone.

The platform I use is Doxy.me https://doxy.me/jenniferlombardolcsw  No need to download anything; you just need to click on the link a few minutes before so that you can test your video/audio quality! Many more insurances and Employee Assistance Programs (EAP) now cover tele-therapy. Some allow live video-to-video therapy sessions, others allow telephone only.  If you are interested, please reach out to them or me to discuss further.  

The “client portal” will continue to be utilized to schedule appointments and I will do my best to keep the calendar up to date. The schedule can be accessed here: Client Portal  (https://lombardocounseling.clientsecure.me/client_portal)

If you have any questions, feel free to call 407-437-5076 or message me through the Client Portal.

EMDR-What’s it about?

It’s magic y’all. Brain magic! Well…maybe it’s just neuroscience, but still…it can feel like magic when other therapies are not working for you.

EMDR or Eye Movement Desensitization and Reprocessing (Francine Shapiro has noted that she would have shortened the name, but it kind of took off…and now it’s too late) is a therapeutic method aimed at desensitizing sensitive subjects and reprocessing events/memories. While it has been found to be effective for addressing traumatic events, it has also been found to work well with other troubles such as anxiety and phobias.

Ok, ok. So the mechanics of EMDR look a little different than your typical talk therapy. The old school, traditional method of EMDR involves me waving my arm in front of your eyes so that your eyes are going *right*left*right*left*right*. I can also use other “bi-lateral stimulation” devices such as “tappers” and/or a head set. Stay with me, I know it can sound odd and truthfully, it seemed odd to me too at first, but one reason I was trained in this method is because I was able to experience how well it worked myself! I also sought the training because it is evidence-based and worked well with so many.

So the idea behind EMDR is that it may replicate what is occurring during REM sleep. Have you ever seen someone sleeping and marveled (or freaked out) at the motions the eyes made? The idea is that your brain has a way of healing itself and wants to heal itself and this is occurring during sleep and also during EMDR sessions. I can tell you that there is absolutely a commonality in how people process during an EMDR session. I do not share these experiences before an EMDR session as I would not want to lead or influence someone’s process, but there are definitely themes I notice that indicate that something awesome is happening in your brain and body. In general, the goal is to reduce how distressing you find an event and to have a healthier way of thinking about the event and yourself in relation to that event. So while it may not be magic, it is absolutely amazing and I’m happy to answer any questions you may have about if it is right for you!

Call to Artists! Display your Art.

Inspired by a very talented local artist whose work will likely be featured in my office in the near future, I’m reaching out to find other artists who would like to feature their art for a time span during this year. I find myself inspired by artists who can evoke emotions and thought with their art or who so ingeniously capture the experience of mood/emotion such as Toby Allen’s Real Monsters. Since I have the privilege of working with the young folks and families, along with adults, I would want to display something that all could benefit from.

While I thoroughly enjoyed the experience of creating this, below, I’m looking for something a tad bit more advanced! 😉

If interested, contact me at 407-455-2926 or JenLombardoMSW@gmail.com Emoji Art

The Body Keeps The Score

when-we-are-no-longer-able-to-change-a-situation-we-are-challenged-to-change-ourselves-1

I absolutely love that I continue to be inspired in my career; there is a never-ending supply of information and learning to be the best therapist I can be…I only wish I could just download it all to my brain in one day!

Currently, I’m wrapping up with “The Body Keeps the Score” by Bessel A. van der Kolk. He discusses the impact of trauma and adverse childhood experiences and treatments that work well to help people heal. One of those, EMDR (Eye Movement Desensitization and Reprocessing) is a practice I am trained in and it was enjoyable to read the successes the author had with this treatment and others, including yoga and neurofeedback.

Some of these styles can be confusing…”sorry…you want me to watch you wave your hand in front of my eyes?”, so feel free to do your own research and ask your therapist more about it.  As an EMDR practitioner, I want those I work with to be informed about how it works and what to expect, so if this is something you want to try-just ask me about it!

Next up on the reading list: Francine Shapiro’s “Getting Past Your Past”. Have you read it or have other recommendations?

 

New Year, Same You

It’s 2017! Time to change everything about yourself, right? Not quite…

As someone who gets incredibly excited about fresh starts, especially when a new year rolls around, it may be surprising to read that I don’t want you to “throw the baby out with the bathwater” (what terrible phrases we have in the English language). What I mean to encourage, is that you acknowledge the incredible amount of strengths and good that are already inside of you. Sure 2016 was pretty terrible for many people, but you did grow in some way.

Take some time to reflect on what you learned about yourself in the past year, especially the good bits. Write it down. Did you form new positive relationships? How about trying something new? Were you successful in any way? Did you have any days of inner calm and peace? What were you most proud of? How did you brighten someone’s day? You can likely find some positive qualities or achievements by taking time to remember and appreciate them. Notice how you feel when you think of these positives in you/in your life.

Now, knowing that 2016 wasn’t complete rubbish, how can you cultivate and strengthen those good qualities that are already inside of you? Did it feel good to think of that time when you made a friend or family member smile/laugh when they were having a bad day? How can you create more of that?  Did you feel “on top of the world” after accomplishing that fitness goal? Make a detailed plan of how to get to that feeling again. Everything that you want to change is already within you. You and I are capable of tremendous things when we believe in ourselves. Let’s see what our inner superheroes can do, shall we?

So, Happy New Year and Cheers to the Same You, because you are beautiful and complete just as you are.

Enjoying the Holidays!

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The holidays can be a time of stress for many, especially when it comes to money, family, and sugar cookies staying healthy.

Here are some ways I plan to enjoy this season. Maybe some of these will work for you, too.

  1. Check out holiday lights. Sparkly things tend to make me happy.
  2. Attend some (but not too many) of the events in the community. Have you seen Orlando Weekly’s Holiday Guide? It’s a good time to catch up with folks and spend time at your favorite places, but be careful of not over-booking.
  3. Get gift giving done early so that it can be thoughtful. Honestly, nobody really needs that terrible, last-minute impulse buy. Maybe you agree with family and friends to not do gifts, and instead spend some fun time together. Whatever you decide, try to avoid the impulse to spend on everything (set a budget) and avoid situations that you know will cause you unneeded anxiety.
  4. Check out your cheery-spirited friends and family! Look at them donating to good causes, volunteering their time, helping their neighbors. Look for the good in folks.
  5. Resist the temptation to eat ALL.THE.FOOD. Yes, there is balance in life but mood, energy, health can suffer from getting too caught up in all the foodstuffs.
  6. Of course, let’s all remember to use our coping skills…Breathing while stuck on I-4, Positive/Calm Thoughts while in that Wal-Mart line, Visualization of a happy place while your 3-year old loses it in the store, Grounding when our old friend anxiety starts to creep in.
  7. Need more tips or help dealing with ye olde holiday triggers? Pop in for some counseling sessions! We counselors are everywhere, especially throughout Central Florida.  I’d be happy to help you work through your stress, finding joy this season, and dealing with Aunt Franny’s fruitcake (eek!).