Will my mental health treatment preclude me from future insurance coverage?
May 23, 2011 3:02 PM Subscribe
I don't currently have health insurance but might be seeking prescription help for depression from a GP, which I will pay out of pocket. Might this preclude me from health insurance coverage at a later date?
And if so, how should I handle it? As this would be the first time I've visited this doctor, should I refuse to give my social security number to the doctor's office and pay in cash? Or is that a waste of energy because getting the prescription filled will still it get tied to my identity? Should I order a generic prescription from outside of the country to be completely private?
I'm not sure how paranoid to be about this information being used to deny me coverage, or at least put me in a high risk pool, which would effectively deny me coverage by jacking up my insurance rates.
I'm in California, if it matters.
And if so, how should I handle it? As this would be the first time I've visited this doctor, should I refuse to give my social security number to the doctor's office and pay in cash? Or is that a waste of energy because getting the prescription filled will still it get tied to my identity? Should I order a generic prescription from outside of the country to be completely private?
I'm not sure how paranoid to be about this information being used to deny me coverage, or at least put me in a high risk pool, which would effectively deny me coverage by jacking up my insurance rates.
I'm in California, if it matters.
This previous question might be useful to you.
FWIW, I was able to get private medical coverage even though I had used SSRIs and seen a psychiatrist. However, at the time that I applied for coverage I was no longer on meds and had not seen any sort of mental health professional in 1-2 years.
posted by needs more cowbell at 3:12 PM on May 23, 2011
FWIW, I was able to get private medical coverage even though I had used SSRIs and seen a psychiatrist. However, at the time that I applied for coverage I was no longer on meds and had not seen any sort of mental health professional in 1-2 years.
posted by needs more cowbell at 3:12 PM on May 23, 2011
If the Health Care Reform Bill remains in effect, then you 'should' be protected from exclusion based on pre-existing conditions (by 2014).
posted by AlliKat75 at 3:13 PM on May 23, 2011
posted by AlliKat75 at 3:13 PM on May 23, 2011
Yes, you likely won't be excluded- SO many people are on these!- but they can charge you more. Basically, it seems like they'll use any excuse they can to charge you more.
posted by small_ruminant at 3:19 PM on May 23, 2011
posted by small_ruminant at 3:19 PM on May 23, 2011
Not if you don't tell. If you apply and are not on the meds when you apply, how can anyone know? Pay your MD in cash.
posted by Ideefixe at 3:52 PM on May 23, 2011
posted by Ideefixe at 3:52 PM on May 23, 2011
The pre-existing clause is usually worded something like, "any condition for which you have received treatment in the last 18 months, or any condition that a reasonable person would have sought treatment for." In other words, they've worded it so that you really can't just hold out until you have insurance, then magically come down with something. Whether or not they can catch you is questionable. I suspect if you were diagnosed immediately after getting insurance they would investigate and try to determine if you had the condition prior to being covered, or had reason to suspect that you had it.
It won't preclude you from insurance, but they won't pay for anything connected to the condition for up to 18 months.
That is the general rule, CA may have state specific differences.
posted by COD at 4:50 PM on May 23, 2011
It won't preclude you from insurance, but they won't pay for anything connected to the condition for up to 18 months.
That is the general rule, CA may have state specific differences.
posted by COD at 4:50 PM on May 23, 2011
Not if you don't tell. If you apply and are not on the meds when you apply, how can anyone know? Pay your MD in cash.
It is not in his best interest to leave out this information when applying in the future. They will ask for medical records (and see they were prescribed whether he pays cash or not) and omitting information is an excellent excuse to deny coverage.
posted by cecic at 4:51 PM on May 23, 2011
It is not in his best interest to leave out this information when applying in the future. They will ask for medical records (and see they were prescribed whether he pays cash or not) and omitting information is an excellent excuse to deny coverage.
posted by cecic at 4:51 PM on May 23, 2011
Cedric--he doesn't have to turn over medical records that fall outside of the time perod. If he takes the meds now and applies 24 months later, no body's business. One benefit to a noncentralized database of medical records.
posted by Ideefixe at 9:10 PM on May 23, 2011
posted by Ideefixe at 9:10 PM on May 23, 2011
Not really answering your question, but ScriptSave can help save on prescriptions if you don't have insurance. I've never used it, but it is indeed a legit company.
posted by Atom12 at 5:47 AM on May 24, 2011
posted by Atom12 at 5:47 AM on May 24, 2011
he doesn't have to turn over medical records that fall outside of the time perod.
When I've applied for an individual policy I've been asked for 5-10 years of records. It is worded so that even if you didn't get treatment but someone might have you can get in trouble for not disclosing it. I've never had doctors in the U.S. agree to see me without my SSN, some won't see you without insurance in my experience. Will a doctor treat someone totally anonymously these days? Not in my experience, even when paying cash, but you can try. Call up a doctor before you go and see what they say. Do what you feel comfortable with but there is no agreed upon easy way to beat the system.
Yes, you likely won't be excluded- SO many people are on these!
People have been denied for far less for individual policies. If you do apply for an individual policy, apply for a few at the same time in case you are denied by one. Once you are denied you have to disclose you were denied when applying in the future which is an automatic red flag. Tread carefully.
posted by Bunglegirl at 7:29 AM on May 24, 2011 [1 favorite]
When I've applied for an individual policy I've been asked for 5-10 years of records. It is worded so that even if you didn't get treatment but someone might have you can get in trouble for not disclosing it. I've never had doctors in the U.S. agree to see me without my SSN, some won't see you without insurance in my experience. Will a doctor treat someone totally anonymously these days? Not in my experience, even when paying cash, but you can try. Call up a doctor before you go and see what they say. Do what you feel comfortable with but there is no agreed upon easy way to beat the system.
Yes, you likely won't be excluded- SO many people are on these!
People have been denied for far less for individual policies. If you do apply for an individual policy, apply for a few at the same time in case you are denied by one. Once you are denied you have to disclose you were denied when applying in the future which is an automatic red flag. Tread carefully.
posted by Bunglegirl at 7:29 AM on May 24, 2011 [1 favorite]
Paying out of pocket to see a physician, and paying for monthly medication out of pocket is ridiculously expensive in the US. PM me, and I can try to find you a physician in your area who works on a sliding scale. Planned Parenthood and many LGBT centers work on a sliding scale, and have physicians who can treat much more than sexual health issues.
See if you use a discount card at your pharmacy to get the drugs for less, and make sure to mention to your physician that you are uninsured when they are prescribing your medication. They may be able to give you samples, or hook you up with an effective low cost treatment.
posted by ladypants at 4:03 PM on May 24, 2011
See if you use a discount card at your pharmacy to get the drugs for less, and make sure to mention to your physician that you are uninsured when they are prescribing your medication. They may be able to give you samples, or hook you up with an effective low cost treatment.
posted by ladypants at 4:03 PM on May 24, 2011
I've always been able to negotiate a private-party rate with every MD I've had--from my neurologist to my GYN to my internist. Some even have cash rates, at least here in Southern California. And I've never had anyone refuse to take a non-insured person for ordinary office visits. Yes, it's more expensive than the co-pay, but it wasn't thousands of dollars. Costco is pretty cheap for Rx and they'll discount on top, if you join their in-house club thing.
I don't think that catastrophizing this helps. If you need to see someone for depression, do it now and don't worry about what might happen with some insurance co. in the future. Your mental health now matters more.
posted by Ideefixe at 6:10 PM on May 24, 2011
I don't think that catastrophizing this helps. If you need to see someone for depression, do it now and don't worry about what might happen with some insurance co. in the future. Your mental health now matters more.
posted by Ideefixe at 6:10 PM on May 24, 2011
Ideefixe is right. Most physicians will negotiate a private-party rate. My suggestion is to let them know ahead of time, so that you aren't surprised when the bill arrives. Some physicians cater to uninsured patients more than others, but it shouldn't be too hard to find someone understanding. A visit can cost anywhere from $30 - $400, so don't be afraid to ask the cost of a visit over the phone, and ask if they charge on a sliding scale.
posted by ladypants at 10:07 PM on May 24, 2011
posted by ladypants at 10:07 PM on May 24, 2011
This thread is closed to new comments.
posted by small_ruminant at 3:11 PM on May 23, 2011 [1 favorite]