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I think I've messed up my health insurance.

Posted by tabitha on June 24, 2004, at 1:08:53

So my therapist has been billing my insurance, and due to some fluke of my plan and my state's mental health parity legislation, it's been paying a huge amount, like 50%, with no limit on the number of sessions billed per year. My prior insurance only paid like $1000 per year tops, then it got reduced to $500/year. My T asked me whether I wanted her to bill under my bipolar II diagnosis, which is a parity coverage diagnosis (under state law), rather than the less severe one (dysthymia?) she had been using, and I said sure why not! Milk those b***tards for all you can! She also asked whether I wanted her to bill group sessions along with individual, and I again said why not, so there was a while when she was billing 2-3 sessions per week for me. It's not like she's making it up-- I got the bipolar II diagnosis from a psychiatrist.

So, now I'm self-employed and getting insurance under COBRA. That runs out in 6 months, but I thought, oh, no big deal, I'll just buy insurance myself after that. Well little did I know, the insurance companies can just refuse to sell you a policy if you have health problems. I knew about pre-existing condition, but that's only for 6 months, so it's not horrible. I can pay for 6 months if I have to. But I talked to BlueCross today, actually thinking of just buying it now, since my COBRA plan provider changed to BlueShield, and my therapist isn't in their network. The agent sounded quite discouraging-- I couldn't discuss my health details since I was at work, but she made it sound like you can get refused pretty easily if you have any health problems at all. She strongly recommended I maintain my COBRA policy while applying.

I also noticed the individual plan doesn't appear to cover mental health care at all-- which I don't understand how they can do that, due to the parity laws in my state-- but it didn't look too good.

So now I'm kinda freaking that I won't be able to buy insurance from anyone when my COBRA runs out, due to all the therapy billing. After all, my monthly therapy bill has been way more than my insurance premium-- so if they have a choice and they really evaluate you on an individual basis, I don't see why any company would sell me a policy.

I don't know if reducing the therapy billing, or having her change the Dx code would even matter now, since it will still be in my insurance records forever.

I'm mainly concerned about being totally without insurance-- if worse came to worse I can pay for therapy myself, as long as I'm working.

Does anyone know anything about this stuff?

 

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poster:tabitha thread:359667
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