Can Insurance Cover Post Partum Depression?


Even golden moms get the blues.

That's the confession Oscar winner Gwyneth Paltrow reveals in the latest Vogue, in which she describes her postpartum depression after the birth of her son, Moses, who is now 2. "I felt really out of my body. I felt really disconnected. I felt really down," Paltrow says in the May issue. "I didn’t know I had it until after it was over. I just didn’t know what was wrong with me."

Paltrow, who took time off from acting after the birth of her daughter, Apple, 4, believes that the cause of her depression may have stemmed from her cutting back on her pre-baby acupuncture and massages. The actress, 35, will make her return to the big screen in Iron Man (VIA) (MVL) which is scheduled to hit theaters May 2.

Paltrow is not alone in the feelings she had after the birth of her second baby. According to Mental Health America, 80% of new mothers experience postpartum blues, and 10%-20% experience postpartum depression, or PPD.

Generally postpartum blues, which are also known as “baby blues,” go away by themselves and do not require professional help, according to Susan Dowd Stone, president of Postpartum Support International. She says that if the “baby blues” do not go away in a month however, mothers should seek out help from their healthcare providers because they could be suffering from PPD.

While PPD can be very serious, it has different levels of severity all of which are treatable. “There is no reason for a mother to suffer needlessly when there are treatments available,” says Stone. Does insurance cover PPD? Many do, but it is worthwhile to check to make sure.

Robert Zirkelbach, a spokesperson for America’s Health Insurance Plans, agrees that the health of the mother and baby are important in both pre-natal and post-natal care. “In general, if a mother has mental health care coverage as a part of their healthcare plan, treatment for postpartum depression will be covered.” There is however, some variety across plans as to the structure of the plans and how much is covered. For example, Medicare covers only 50% of outpatient psychiatric care.

Plans like this can sometimes cause financial strain on a mother who is already suffering emotionally. For some women simply attending group meetings and having the chance to talk about what they are going through and the emotions that they are feeling with each other is help enough. Others, who are generally suffering from a more serious case of PPD, require psycho-therapy or medication. Dr. Nada Stotland, president-elect of the American Psychiatric Association, estimates the cost of psycho-therapy at $100 to $150 per session and most patients require between 8 and 16 visits. Medication can also run up high bills, Stotland says, but there are generic drugs available to mothers. (It is very important to remember, however, that many mothers suffering from postpartum depression are also breast feeding, and therefore should be taken into serious consideration when choosing medication.)

In an effort to provide all mothers with the help they need, advocates of mental health care are petitioning the government to take action. Currently both the Melanie Blocker Stokes Mothers Act and the Paul Wellstone Mental Health and Addiction Equity Act of 2007 are bills in the process of being passed by both the U.S. House of Representatives and the Senate. The Melanie Blocker Stokes Mothers Act is pushing for more postpartum depression research and education, while the Paul Wellstone Mental Health and Addiction Equity Act of 2007 is working to require equal health insurance for mental and physical illnesses when policies cover both.

No matter what kind of coverage a mother has, however, Stotland says that seeking treatment for PPD is critical. “It is very important to seek treatment because un-treated depression will hurt the baby as well as the mother," says Stotland. "A mother’s love and affection is crucial to a baby’s development.”


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