Podcast Summary: Tony Mantor: Why Not Me?

Episode: Joe Feldman: Overcoming Mental Health Insurance Roadblocks
Date: December 17, 2025
Host: Tony Mantor
Guest: Joe Feldman, Founder & President of Cover My Mental Health

Episode Overview

This episode centers on the challenges individuals and families face in accessing mental health care due to insurance denials and bureaucracy. Joe Feldman, founder of the nonprofit Cover My Mental Health, shares his personal journey navigating these obstacles, practical strategies for overcoming insurance denials, and resources available to patients, families, and clinicians to fight for necessary mental health care. The conversation dives into actionable advocacy, real-life success stories, and a call to empower both patients and providers.

Key Discussion Points & Insights

1. Joe Feldman’s Personal Journey & Genesis of Advocacy

• [03:35] Joe describes how his family's struggle to obtain necessary residential mental health care for his child led to a wrongful insurance denial, draining their savings and culminating in a successful federal lawsuit—three years later.
  • Quote:

    “Litigation, while we were successful at it, is a really terrible way to access the kind of care that you should naturally get.” – Joe Feldman [04:31]

• This experience motivated Joe to create Cover My Mental Health, a nonprofit dedicated to helping others avoid similar ordeals.

2. The Mission and Reach of Cover My Mental Health

• [05:33] Resources are designed for use in all 50 states and are relevant for anyone with private insurance.
  • They provide accessible tools on their website, letting people find help for denials or difficulties finding in-network clinicians quickly.
• The tools are meant for individuals, families, and clinicians, empowering them to immediately challenge insurance denials.

3. Practical Resources & Their Impact

• [06:27] Central resources include:

  • Template medical necessity letters (crafted with input from clinicians, legal professionals, and ex-insurance execs).
  • Guidance for documenting efforts to find care when directories are incomplete or misleading.

• These templates help clinicians clearly justify a treatment’s necessity in language insurance companies recognize.

  • Quote:

    “It’s a way for clinicians who have never written a medical necessity letter—which, by the way, means pretty much all—to see a common sense explanation...” – Joe Feldman [07:22]

• [08:14] For cases where suitable in-network care is unavailable, Joe’s tools enable patients to “show their homework” and prompt insurers to act.

4. Mobilizing Support & Avoiding Burnout

• [09:54] Patients can and should authorize trusted friends/family to help navigate insurance red tape through plan-specific authorization forms.
  • Quote:

    “The answer could be, for the right friend or family member...do we authorize you to help us a little bit with the insurance?” – Joe Feldman [10:44]

5. Universal Application Across Conditions

• [11:30] These resources and principles apply widely to conditions like OCD, ADHD, bipolar disorder, psychosis, and more—not just mental health, but physical health claims too.
  • An estimated 15 to 22 million mental health claims are denied by private insurers each year.

6. Proactive Strategy: Medical Necessity Letters

• [12:46] Clinicians can anticipate insurer resistance and use these letters to preempt delays, especially for urgent cases like psychosis.

  • Quote:

    “Physicians know from their experience when an insurance company is about to get in the way. Very often a medical necessity letter can anticipate that and hopefully preempt the delay...” – Joe Feldman [13:23]

• [14:34] Real-world results: A psychiatrist used their template to get ADHD medication approval for a patient in 12 hours instead of weeks.

  • Memorable Moment:

    “She used our template medical necessity letter...and she got approval in 12 hours. That takes the delay out…” – Joe Feldman [15:09]

7. Systemic Change Through Empowerment & Persistence

• [15:52] Empowering clinicians and patients makes insurance companies more likely to comply, knowing they can’t “walk over” informed advocates.

8. Advanced Tactics: Formal Complaints and Political Leverage

• [16:52] Filing a formal complaint with the insurance company is distinct from appeals, compelling them to report to state/federal regulators and accreditation bodies (like NCQA).

  • Quote & Candid Tip:

    “Saying ‘I want to file a formal complaint’ is potentially more effective than saying, ‘I’d like to speak to a supervisor’.” – Joe Feldman [17:22]

• [18:35] Success story: An OCD clinic in Texas was immediately paid after threatening a formal complaint, after previous denials.

  • Memorable Moment:

    “They said, ‘Are you going to pay the bill?’–‘No’–‘Okay, in that case, we’d like to file a formal complaint.’...The checks in the mail. And they got paid.” – Joe Feldman [19:20]

• [20:22] If needed, contact the constituent services office of a state or federal elected official. Such interventions often resolve insurance disputes within days.

  • Quote:

    “She said, within a day or two, almost all the time, I get the insurance company to cut it out.” – Joe Feldman [21:31]

9. Overcoming Discouragement & Spreading the Word

• [22:50] Empowerment is the antidote to feeling powerless. Joe frames his resources as igniting clinicians’ and patients’ “common sense,” not teaching something new but revealing their “inner wizard of Oz.”

  • Quote:

    “You have the ability to do it all along. Now we’re going to get to it.” – Joe Feldman [23:10]

• [23:36] CoverMyMentalHealth.org is free to all, and users are encouraged to share resources widely since “half of adults in America will encounter a mental health issue in their life.”

10. Closing Encouragement

• [24:23] Key takeaways:
  • Don’t accept ‘no’ as a final answer.
  • Reasonable expectations of health insurance are valid: access to directories, clinicians’ decisions respected, continuity throughout treatment, and disputes resolved with patient needs in mind.
  • Quote:

    “You are your own best advocate. So a little bit of encouragement, maybe help from a friend or neighbor, but you are your own best advocate.” – Joe Feldman [25:05]

Notable Quotes & Memorable Moments

• “Litigation is a really terrible way to access the kind of care that you should naturally get...” [04:31]
• “We don’t guarantee that [the resources] work every time, but they work.” [07:40]
• “Filing a formal complaint...it can be more effective than speaking to a supervisor.” [17:22]
• “The checks in the mail. And they got paid.” (After threatening a formal complaint) [19:20]
• “You have the ability to do it all along. Now we’re going to get to it.” [23:10]
• “You are your own best advocate.” [25:05]

Timestamps for Key Segments

• Joe’s advocacy origin story: [03:35–04:49]
• Resources available nationwide: [05:33–06:27]
• Medical necessity letters explained: [06:27–07:57]
• Mobilizing support from family/friends: [09:54–11:19]
• Application across mental health conditions: [11:30–12:13]
• Proactive strategies for urgent cases: [12:13–14:17]
• Real-world success stories: [14:40–15:34], [18:35–19:39]
• Using formal complaints: [16:52–17:32]
• Leveraging elected officials: [20:22–21:40]
• Empowering clinicians & patients: [22:50–23:31]
• Contact info & sharing resources: [23:36–24:11]
• Final advice & encouragement: [24:23–25:26]

Resource Links

• Website: covermymentalhealth.org
• Contact Email: contact@covermymentalhealth.com

Episode Tone & Closing Messages

The episode’s tone is realistic yet empowering, mixing practical legal/insurance guidance with heartfelt encouragement. Joe’s empathy for families comes through, as does his emphasis on actionable hope and the importance of community. The overall goal: No one facing a mental health crisis should be alone or powerless against insurance barriers.