"Description"
What do they want to know? Weights, etiology, behaviors? Would it be to my benefit to tell them that the disorder has most recently been skewed to overexercise instead of severe food restriction (although the two remain inextricably linked)?
"Date of onset"
Hmm, this will be the 10 year anniversery. Thus far Hallmark doesn't appear to make cards for that.
"Treatment"
That one is easy, outpatient therapy. But do I also mention the cardiologist, endocrinologist, and orthopedist visits I have made, if those did not result in medications or specific "treatments"?
"Was recovery complete?"
Hell no. But I actually haven't decided if I'm going to stay in therapy once I'm on my own policy, because all of the plans I can afford pay nothing for mental health services until you meet your deductible, and only 50% after that. I cannot shell out these outrageous premiums for basic insurance in addition to monthly therapy bills. So if I'm not being treated for it anymore, is it safe to just tell them I'm recovered? How do they check these things, anyway?
I really do consider myself to be an honest person, and I get incredibly uncomfortable when I am not sure the best way to answer things, and when I have to do cost-benefit analysis to fudging the truth. I'm not sure how checkable these things are, how much these people know about EDs, or how all of this will weigh on me getting coverage. If they deny me, I can't very well go back and reapply with no mention of the ED.
Argh, does anyone out there have advice/comments from their own experiences with these types of applications? If you don't want to comment here, please feel free to email me privately.
8 comments:
I have some thoughts on this subject as the company I was laid off from was one of the huge insurance companies.
First of all, I wouldn't lie. If you lie on your application, the insurance company may not care initially. They'll give you a policy. However, if something happens to you, they have people whose job is to find lies on your application so they can rule your policy fraudulent from the start, therefore negating any claims (and leaving you with huge medical bills). They aren't likely to do this if you just have a visit to the dr. or something, but if you have a surgery or other somewhat expensive procedure, you could get screwed over.
What's unfortunate with our health system is that if you are honest, they will decline you right away. When I tried to apply for health insurance, I fessed up to my anorexia, thinking that the last time I had recorded treatment for it was 2001 (and I thought that 8 freaking years would be enough time). I've always paid for therapy out of pocket to avoid having my ED on my record. However, I got declined the second I submitted the application online. Anorexia is one of those conditions that insurance companies stay far, far away from.
In short, the system sucks. Your best bet is to try to get on a group plan. With these, they can't ask you about your medical history. You're protected by the group. Most people get on a group plan via their school or their employer, but I've heard there are more group plans popping up for people who are self-employed, etc.
I wish you luck with this. I had lots of tears about this subject when I couldn't get health insurance. I felt like I was being punished for a disease I didn't ask for in the first place. Like I said, you can take the risk of lying, but they are likely to negate your policy if something big happens. They're more than happy to grant you a policy now (because they'll collect money on your premium payments), but if you have a high-cost medical bill, they'll suddenly find that your application was dishonest. It's a bind.
This is why I'm all for universal health care!
Wow, thanks. Unfortunately my school doesn't offer any kind of group plan right now, not even for graduate students. I guess, with not being able to honestly even claim full recovery, I am pretty much screwed...I'll try it, but won't pin my hopes on anything. At least if I'm rejected I save monthly premiums, ha...may e-mail you later, if that's ok.
Hey chick,
I'm not in the US, and the system in Australia is different so I'm NOT going to make any statements to that effect. I know that Kim has had lots of experience with plans and I liked her advice above. Also, might be worth sending an email to Brie and ask her?? I'm pretty sure she's had a whole host of issues.
I was going to say, as far as Tx goes, you could potentially state something like: "Appropriate/Routine health checks with x, y, z demonstrating no underlying pathology or need for ongoing treatment or monitoring."
Something that demonstrates that you DID follow through with appropriate care but that it did NOT demonstrate anything alarming and thus hopefully demonstrate that you're not as much at risk. However, I think that like what Kim said, as soon as they see the AN dx they're gonna freak :(. Stupid.
Also, this going without treatment long term is not okay, so I'm gonna have a think and a pray (and its okay that you respect Christianity but don't follow it... but i hope its not too "out there" for me to say - if it makes you uncomfortable, just let me know k??) and see if I can think of alternatives.... humm....
*hugs*
Good luck and I hate medical insurance in Australia but its far easier than the US! So I don't envy you at all.
xox
I'm sorry I can't help you with this, we're in different countries! But I hope it all goes well for you. Good luck dear.
I hope this doesn't come across as rude, but I definitely think it is ill-advised for you to discontinue therapy. If you look at any treatment guidelines for AN, therapy is supposed to continue even after weight restoration and you aren't there yet. However, are you able to get therapy somewhere cheaper if cost is prohibitive? E.g., my campus offers pretty cheap counseling and my undergraduate university let you have 6 free sessions before charging an amount suitable to your ability to pay. Can you look at options like that?
I second Kim's advice not to lie. My brother in law is an insurance claims adjuster and he has had some totally wicked stories about the investigative work he has done to track down lying customers. You have probably left a trace somewhere and you will be totally screwed if your insurance company drops you with the "lying" excuse as that could prohibit you from getting insurance elsewhere in your life. Aren't you working as a TA? Why doesn't your university give TAs health insurance?! That's crazy!
I bank and use USAA insurance-I'm so sad they don't do health insurance :( luckily, I am covered by D's policy with Blue Cross Blue Shield.
I share your frustration with our health care system. Despite living in California (where the Mental Health Parity Act is in effect), insurance for mental health still sucks. I have appealed grievances against my health insurance company all the way to the state level, only to receive rejections written by people who didn't seem to have even read my letters/arguments.
Both of my parents are Australian and raised me to view universal health care as a superior system. However, I've recently started questioning my long held beliefs. When I come across things like this America's Health Care Crisis video, I wonder whether universal health care is the answer. My boyfriend advocates making health insurance like car insurance. At first, I thought this was ridiculous, but now I wonder whether it really is. My biggest frustration with the current system is that I feel like I have no say in my insurance. I am limited to the plan (or if I'm lucky, plans) that my company offers. I used to work for a company that offered a pretty good insurance plan, but the plan I have through my current company is awful. If health insurance was like car insurance, I'd shop around and find a plan that fits my needs. I'd be willing to pay a higher premium for a plan that actually covers the things I need. Contrarily, those who have few health needs could purchase cheap disaster plans. Granted, mental health parity laws will need to be in place (and actually enforced!), but I still think increasing competition among health insurance providers may be the answer, rather than consolidating everything under a government-run program. As we all know, government-run programs (e.g., the DMV) aren't always the most efficient and can sometimes be extremely frustrating :-)
These are just thoughts ...I still haven't been able to make up my mind.
As someone who has had to do this several times, it can definitely be tricky.
As Kim suggested, I wouldn't lie on the app. They would likely find out anyway. Insurance companies try to deny often and can deny people easily. I know for me even w/o the ED on there, depression and arthritis were enough to deny me. Even for some injuries, like when I had that bad dog bite which had healed, they still wanted to use that against me. They also use time of duration or how long ago something happened against you. I also know now some companies will deny a perfectly healthy person if they have been in therapy for a year and prescribed one med. It's ridiculous!
Group plans are probably the best way to go, though I know a lot of states are letting people get health insurance even as a plan of 1 or 2 people.
Are you staying with the same company, just as an individual or are you completing switching companies? I ask, because even though I was denied, since I was applying w/same insur. co. my parents (and I) had been on, they wound up doing a transfer policy. Though it pigeon-holed me, it was really the only way I could get insur. The mental health portion is still less than stellar but it was something, though a headache for C.
I also agree w/Sarah that I think you should continue therapy. I'd see if your current T. Or another T.will do a sliding scale fee.
I'm also concerned about when you are out of the country and will not have access to your tx team. Have you thought how you are going to handle that?
Hi Cammy,
Ugh!!! I hate the insurance dance! I'll keep my fingers crossed and hope that we have a public option soon that could bypass a lot of this, but...
During the worst of my battle with anorexia, I was technically applicable for Medicaid. Being approved involved obtaining a form from my local welfare office, and having a therapist or physician agree that anorexia nervosa is a life-threatening condition, and sign off on that. Regulations vary from state to state, but generally, the less money you have and the more severe your condition is, the more likely you are to be approved.
Once I was approved, I was able to see therapists, psychiatrists, and physicians for little to no fees, and had incredibly reduced co-pays on medicine. Yes, Medicaid and being on (medical) welfare comes with a lot of stigma...but if you're severely ill and just barely making ends meet...you have to do what you have to do. There shouldn't be any shame in being ill or not having a lot of money.
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