[dillpickle1983]

My company sponsored insurance won't cover me because I have a pre-existing mental conditon. I've tried going it on my own to find out everyone will not cover me because I am bi-polar and have a track record of being suicidal etc etc etc. I have tried all the big companies and have been denied over and over again. Is there hope for people like us? Do I have to just go without insurance, and if I could get insurance, how affordable would it be?

I'm 28, smoke and have a whole littany of mental illnesses.

any insight is appreciated.

[Perna]

Insurance is for in case one gets ill (or has a car accident, or a tree falls on your house in a storm, etc.). They are able to charge you a reasonable amount each month because you usually do not need it. You get 10 people in a work group, say, and year-to-year the plan changes, depending on how much it is used. If the group is relatively healthy, the plan costs less but if there happened to be lots of claims last year, this year the price will go up.

So, you can see why dental and mental health insurance can't work very well; it costs X amount to go to the dentist and therapist/psychiatrist but all the people who want that particular insurance, need it; if you don't go to the dentist, don't have a mental health problem you aren't going to want to spend money on that; for example, I don't have vision insurance, another elected insurance that only those who want to use it elect it. So, there is no way the "extra" amount needed to pay the office people for managing the insurance can be there, the insurance company can't make any money to run the business and pay its workers, even if you had to pay premiums exactly as much as necessary to pay the doctor or provider.

It's the same problem if you have a wholly medical illness when you apply for insurance, a pre-existing condition; how can an insurance business take you on if you are a known cost? With you working for a company; you would make the company's insurance go up for everyone, in order to cover you.

But that is why company insurance is having to get out of the mental health coverage area because the new laws are making it not possible for them to carry that kind of insurance because there is no profit in it and a business has to have profit, if only to pay its workers and its rent, etc. The Obama care ideas sound good but you can't legislate the statistics of who gets ill and how much it will cost. It is like a few years ago when the idiot California legislators tried to regulate the power companies; you end up with the rolling blackouts they had. Politicians trying to tell a business how to run, how to do its business, you can't get there from here.

My state has rules and a state insurance I'm on that has to take people with pre-existing conditions or who otherwise can't get insured elsewhere (I'm obese and retired but not yet 65 so can't buy Medicare yet) but it is very expensive and that's with a $1,500 deductible. In a sense they have to charge me what statistics says it will cost if I get sick, even though I am relatively healthy. I have to have the insurance though in case I have a major illness; like my husband points out, we can pay for a broken arm but not a heart transplant :-) But that's why one buys "insurance", in case. I am able to pay so I have to pay more for only slightly better insurance (more choices of doctors, etc.) so that some of my premium can pay for those who are not as able to pay in my state. The "group" I am in is the already ill or in-betweens, like me, who aren't working or who are self-employed, etc.

I would talk to your company's insurance person and see if they have suggestions of what you can do; they know the business and what's out there and regulations and what your choices might be or who to ask to find out.

The company's insurance may cover you for everything but mental health issues. Double check with the insurance rep. We ran into this issue when my husband's worker's comp insurance ran out. We were able to put him on the insurance from work, but they wouldn't cover treatment for his pre-existing condition. After a waiting period (2 years I think it was), they agreed to cover his medical condition. It was a VERY expensive couple of years without insurance for that. Since then he has been constantly covered by insurance, so when we changed insurance, they continued to cover him because he had had documented insurance coverage for a long enough period. So now, we will ALWAYS make sure he is on full medical coverage (either his or mine) so he won't be denied due to pre-existing condition.

[horseontheloose]

Blue Cross has coverage that people can get if they have been turned down by three different other companies. Your denial letters are your proof. But you do have the premium to pay, possibly a co-pay at the time of the visit, and a percentage. Or it may be simply a percentage and not a co-pay. It isn't great, but most medical offices have a contract with Blue Cross, therefore there is a write-off amount the office must take. For instance, the office charges $200, Blue Cross allows $125.00. The office must write off the $75 dollar difference before billing you. This really only helps you for major medical since you have to look at how much your premium is to have the insurance. The other catch is just what you are up against now, pre-existing conditions.

[Perna]

Yes, I would check with your State's insurance office since things vary from state-to-state; here's horseontheloose's Oregon plan, for example:

http://www.oregon.gov/OHA/OPHP/OMIP/index.shtml

and my Maryland plan that I'm covered under:

http://www.marylandhealthinsuranceplan.state.md.us/

[Amazonmom]

How big is the company that you work for? Large group corporate insurance (or even self insured companies) cannot deny you coverage for mental health if they offer mental health coverage to the rest of the group. Usually you have to sign up for coverage when you are first employed. Even if you sign up for coverage late, usually you have to wait a period of time to be covered for a preexisting condition; not be rejected completely. Small businesses probably cant afford to do so and that is why they aren't included in mental health parity along with individual plans. Most large groups dont let you reject coverage, its mandatory to be a member of the group or they are violating the terms of their contracts with the insurance companies.

If you have that many illnesses you may try to get on Social Security disability to eventually qualify for Medicare or Medicaid.

Im so sorry this is happening to you.