Insert worried question about U.S. health insurance here.

September 30, 2009 6:54 PM

Best U.S. insurance company for a pre-existing condition (depression) - advice please!

Yet another question about U.S. health insurance. I'd like to have some basic health insurance that's not tied to an employer - I'm unemployed and don't know when I'll find work. The catch is that I have a pre-existing condition (well, two - chronic unipolar depression, and ADHD, both of which I've had since my teens). It means for me (at least) that I go through periods of unemployment, including right now. My coverage (under my ex-husband's plan) is about to end, and I'm panicking. AskMe has been invaluable about the topic, but I'd love some actual 'I have x company, and they're good/bad/good enough' testimonials. I've seen Tonik mentioned a few times on here and will be looking into them, although they don't cover mental health.

I'm primarily looking for basic physical health coverage (i.e. catastrophic, so that if I get hit by a truck I have *some* kind of coverage). While I'd love to have a plan to include mental health, I know that's going to be hard to find. I'm worried about even finding any basic physical coverage considering the pre-existing condition thing. I'm on medication (Zoloft and Adderall - prescribed through a psychiatrist covered by ex-husband's coverage) and am otherwise healthy (a few minor surgeries as a kid) in my mid-30's. The past year has been hell (for a number of reasons - let's start with divorce, death of a parent and losing my job), but hopefully qualifying for insurance won't be...impossible (she says, crossing her fingers hopefully).

I'm in California, a permanent resident (if it helps) and am willing to look around for community therapists etc. and already go to the local NAMI affilated support group, do the 'exercise, eat right' etc. etc. thing and have a therapist I'm willing to pay out of pocket for - and maybe get the meds via Walmart etc., if I have to. What I want is the basic coverage, since waiting for the folks in Washington to decide on health insurance is NOT an option. Basically, is there a way to have the physical insurance and mental health insurance be separate? When do I have to tell them about my mental health history?

Has anyone had any experience trying to get group insurance via things like the Freelancer's Union or AIGA? I'm a designer, and I'm open to suggestions. What about going through an individual insurance broker - any good experiences? Any advice is appreciated. I'm going through all the info I can find (on AskMe and elsewhere) and really appreciate any help, as my head is spinning and I'm worried to death.

posted by anonymous to health & fitness (4 comments total)

I'm sure it varies by state but I looked at the insurance AIGA is linked to and it was a worse deal than buying an individual policy on your own. As far as I can tell it offers no better guarantee of coverage for pre-existing conditions since its not a group policy. If AIGA offered a group policy I think its membership would explode seeing as its a huge issue for so many designers. I looked at Freelancer's Union but it seemed to only be good in a very limited number of states (like NY).
posted by Bunglegirl at 7:37 PM on September 30

If you get turned down, the Major Risk Medical Insurance Program (MRMIP) is California's risk pool--you can sign up for a plan through them. Several plans are available, but I think they all cover mental-health services.
posted by tellumo at 7:53 PM on September 30

I think you should choose 2 insurers (I am with Blue Cross so I can recommend them) and then call them anonymously from a pay phone and ask your questions. The reason I say two is because, at least for me, trying to research every single insurance provider and then trying to compare their apples to oranges is daunting and paralyzed me for quit some time. Then I just said screw it and applied to Blue Cross and they accepted me even though I had to tell them that I was treated for anxiety within the last 5 years and that I had taken anti-anxiety medications. (you must be honest or it will come back to you later - they won't pay, I'm sure you have heard those stories.)

I am a self employed artist, I am 48, they are charging me $200 a month with $5000 deductible. It is a Health Savings Account. I think it has a cap of a million dollars for a lifetime. You need to be wary of that because some insurance providers may be cheaper but if you read the fine print it may say "lifetime cap $250,000" which, from my understanding, may not even be enough to cover treatment for something like breast cancer. I read that Roger Ebert has gone through 2 insurance plans as he exceeded the 1 million dollar cap

I tried to look into insurance for artists but always came up with nothing and wasted a lot of time on that.

I have this for emergencies, I get my actual health care in other ways, out of pocket.

Can you find some kind of free support group like "family of alcoholics" (who doesn't have an alcoholic in the family: ) ?

I have heard some success for people who freelance forming a corporation and getting "group rates" for their business. And I don't think they can deny a group rate customer for pre-existing conditions. But don't incorporate in California because the annual fee is $800 compared to Idaho which, I think, is $15 annual renewal fee. I think Nevada also has cheap renewal fees.

My advice is to pick two insurers, call them anonymously to ask questions, then apply to both of them. Then at least you will know where you stand instead of being in this limbo.

Mefi mail me if you have any other questions I may be able to answer.
posted by cda at 9:22 AM on October 1

Good luck. I've had six applications for health ins. denied over the years, all because I take medication for depression and asthma.

The last time I looked into the MRMIP there was an 18-month waiting period, the premiums were over $1000/month, and it only covered catastrophic issues - not regular doctor visits and meds. This was maybe six years ago, so it may be different now.

I really do wish you well.
posted by shifafa at 11:11 PM on October 1