Medicaid doesn’t cover marriage counseling, but I wish it would.

Kind of a weird post for Valentine’s Day, but then again, wanting the strongest relationship possible for me and my husband is maybe the most romantic thing I can think of. So here are my thoughts on marriage counseling and its unavailability through Medicaid.

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When we got accepted to Medicaid coverage I was beyond relieved. Between my struggles with mental illness and my husband’s chronic illness we desperately needed access to health care. A huge reason why we left his hometown in Idaho in favor of mine in Colorado was the issue of access. And although the change in administration has us wondering how long that access will last, we attempt to continue on as if it will.

Once our handbook from Rocky Mountain Health Plans arrived I flipped through the thick pages quickly, occasionally noting what was and what wasn’t covered as I skipped through. Eventually my eyes fell on Mental Health Care and before I could read the information provided about coverage I zeroed in on the list below. Topping the section of counseling services not covered was: Marriage Counseling. 

I’m pretty sure dismay was leaking out of every pore in my body. If that seems weird coming from someone who has been happily married for just under a year, let me explain. 

Even before we were married I knew that I wanted us to try counseling early. I’ve researched a lot about how to keep a marriage (or any relationship, really) happy and healthy and most advice seemed to boil down to a few main conclusions, one huge point being: communication. 

I’ll preface the rest of this by acknowledging that my relationship with my husband is relatively great. We enjoy each other’s company and have an easy time respecting and relating to one another. In general, our ability to communicate is pretty good. And especially after the stress we’ve faced the last two years I’d say we’re closer to each other than we’ve ever been.

But pretty good communication isn’t great communication, and our closeness could drift at any time as we continue taking difficult steps towards getting well and building our lives together. 

Essentially, I’d like to strengthen the bridge between us while it’s fairly sturdy and stable, rather than waiting till it’s wobbly and ready to fall into the sea before taking action.

I know I’m not alone in this notion because I got the idea from one of my favorites, Kristen Bell. (If you don’t know her make IMDB your friend after reading this. You won’t be sorry.) In a couple different interviews she’s mentioned her support for therapy and cited her own marriage counseling sessions as one of the reasons her celebrity marriage to Dax Shepherd has faired so well. Here’s a clip with quote from Bell about therapy and if you’re so inclined, I’m sure Google could help you find full articles on the subject. 

My point is that I’d like to be proactive in my relationship and for some reason my health care provider does not find that necessary. And that frustrates me.

For a lot of people the image of marriage counseling involves cheating spouses, or maybe someone spending their way into considerable debt, perhaps a marriage at the end of its rope and an attempt to stave off likely divorce. But that’s not what I’m seeking counseling for. I want to further strengthen a good relationship that is being put through the wringer because of my mental illness.

The truth is, living and loving with mental illness is really, really hard. It’s hard on the individual with the illness, it’s hard on their partner, and no aspect of the relationship is left untouched by this struggle. And that’s quite a burden to bear, especially when you’re a new wife who just wants to do things right and make your marriage last a long time. 

I suspect that many don’t realize what a lifeline a partner can be to someone going through a mental health crisis. There have been plenty of times when my husband is the only person I can stand to see or speak to all day. He’s the only one that can get me to eat after twelve hours of being too stressed to think about food, he helps me fall asleep when I wake up early sick with worry. He’s the one making calls about student loans, finding doctors to treat me, and giving me the courage I need to attend appointments. He’s what tethers me to this world when my strength is broken down and I just want to let go. 

It’s undeniable that the health of our relationship directly correlates with my own health, mental and physical. If we have struggles within our relationship then I will be struggling with my own wellness on every level. What sense does it make for me or my health care provider to invest in counseling for myself as an individual, but not to invest in counseling for the relationship that keeps me well enough to work on myself? 

Obviously I’m lucky to have such an understanding and supportive husband, lucky that we have helpful and loving family members, and damn lucky that through our struggles thus far we’ve only clung harder together rather than pushing each other away.

But luck isn’t going to hold things together forever. And it’s so damn hard to know, to truly KNOW, that outside help would be life changing. To have an educated, unbiased third party to help teach us as a couple how to have those hard conversations and to not avoid the conflicts we can’t stand to face would make this whole getting well thing a hell of a lot easier. And yet, for now that assistance is out of our reach. At least until we find another way to afford it.

Until then we’ll make do with individual therapy and try to practice mindfulness in our relationship.


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