Here's the situation: I changed health insurance plans about two years ago ago. I have a good plan, based in Californa, that costs me about $250 a month. Since starting the coverage, my major medical expense - for about a year - have three monthly medications which I take for recently-diagnosed bipolar disorder. I have never claimed these expenses on my insurance, nor have I ever put any of my psychiatric costs on a claim. The reason is that I've been advised not to do this, especially with a bipolar diagnosis, since, in the words of my psychiatrist, "once that's on your record, you'll have a very hard time if you need to change insurance plans." (I should add that the diagnosis, while scary, and the resulting treatment, has changed my life so much for the better that I'd sell pretty much sell a kidney to keep paying for the meds, if I had to.)
posted by soulbarn to health & fitness (6 answers total)
I do want to keep the option to change plans open to me - if I move, or take a job that has group coverage, or for whatever reason.
However, my medication is expensive. Of the three that I don't claim, one costs about $30 a month, because it is available generically. The other is about $125 a month, and is not on the insurance company's formulary, so I wouldn't get reimbursed for it until meeting a (high) deductible. But the third one retails for $150 a month, and is on the formuary, which means I could get it for $25...
The expense, with my premium, is getting so high that I'm very tempted to put the third medication only on my insurance. It is for Lamictal, which is used for bipolar, but is more often used as an anti-convulsant. My question is whether just putting this one - not the other two - on the policy, at a different drug store (I buy my other meds on a cash basis), will constitute that "black mark," considering that I will likely continue to take that medication for the forseeable future. Does the insurance company care or know what the purpose of the medicine is (I could get my family doc to prescribe it, rather than my psych, if need be.) Am I being paranoid?
Just one more bit of background: I've been continuously insured for about ten years; I did claim an anti-depressant for a while, on my old policy, and it did lead to me being rejected by a couple of companies when I switched insurers - though I was accepted by my current company, of couse. I also just had what is probably te first major medical claim of my life (I'm 40 years old) - I had to have surgery on my sinuses, after a year of chronic sinus infections and related asthma attacks, neither of which I'd had earlier. I take two asthma medications, one of which is non-formulary, and the other of which is costly, and which the insurance company only covers about 10% of the cost until my deductible.
So, is the savings of about $100 a month worth exposing the private part of my medical history to my insurance company?