Could a visit to a psychiatrist jeopardize my health insurance?

[ContinentalOp]

I have to pay for my own private insurance plan. Say I went to a psychiatrist, got a diagnosis, and was prescribed some medication, would I be jeopardizing my future health coverage? If I wanted to switch plans in the future would that make it difficult? Or is it not really a big deal? Should I just wait to see what happens with health care reform?

[lindisfarne]

1. If you pay in cash, you can see a psychiatrist under any name you wish - just tell the psychiatrist

you're doing this up front. Also, tell the person you don't want any official diagnosis; just that you want help dealing with problems, and tell him it's because of concerns about future health insurance. (Some might not be willing to see you, but there are many who will).

If you never get an official diagnosis, you never have to tell an insurance company that you've been diagnosed with depression, OCD, or whatever.

Seeing one under your own name and esp. if you file for insurance reimbursement could prevent you from getting insurance or significantly raise your costs.

[ContinentalOp]

2. Thanks for the advice.

Since the situation isn't life or even health-threatening, I think I'll just wait. Even if you pay cash, the information will go on your medical records if you use your real name, right? Which I would need to do if there were a prescription involved.

Does the diagnosis itself matter? Like for example, clinical depression might lead to other health issues and therefore cause problems getting insured, but something else might not? Or is pretty much any diagnosis going to be a problem?

[lindisfarne]

5. Psychologists don't have to give an official diagnosis. Insurance coverage often requires one so

they are used to thinking of them.

However, they don't have to produce them.

If you're concerned about the impact on your future ability to be insured, I'd be cautious. Insurance companies often ask "have you had a diagnosis of X". If you haven't had an official diagnosis, you can honestly say No. If the question is "have you ever seen a psychologist/counselor/psychiatrist", then you'd have to say Yes (to be honest). You'd have to look at what kinds of questions are on applications for individual insurance.

Psychologists have 2 sets of notes. One which the insurance companies can request before covering you for insurance (with your permission). The second set is for the psychologist's personal "thinking process" and is not supposed to be provided to the insurance companies.

For a prescription, you'd have to use your real name (I think). Then it would get more complicated because I think they'd have to keep notes as to why you were given the prescription. But, you could see a psychologist anonymously, and if they decided a prescription was necessary, you'd have to decide whether you wanted your anonymity. (You can be prescribed a drug without an official diagnosis, although the prescriber would likely keep notes describing why it was prescribed (such notes would not equate a diagnosis).

Since you mentioned depression: there is good evidence that mild to moderate depression is not really help by prescription drugs. The drug companies did a good job of picking & choosing what studies they publish. But, there is strong evidence that the drugs are really not any better than therapy alone, or even time - a lot of mild to moderate depressions resolve themselves over time, esp. if you have supportive friends (but therapy can be useful as well).

[county worker]

11. I am not trying to pick a fight with you but I would like to say that the reason people feel so

strangely about mental illness is because there are a lot of anecdotal stories that when some people hear them they do not seek professional help when they could live much more healthy and productive lives.
Just saying this out of personal experience.

[lindisfarne]

18. I'm not basing what I'm saying on "anecdotal stories". There is plenty of evidence for what I've

said in various scientific studies.

[ContinentalOp]

13. I was just using depression as an example.

I didn't want to get too specific.

[county worker]

4. How do you get a prescription without a diagnosis? Isn't that illegal for prescription drugs?

I don't know any doctor who is going to see you and not have a diagnosis unless there is nothing wrong with you.

[lindisfarne]

7. Why are you assuming a drug is necessary? Also, a diagnosis is NOT required to give a

prescription, although a diagnosis is generally required to get insurance coverage.

Many mental health issues can and are treated without prescription drugs.

The professional should document in his/her notes why the drug is being prescribed, but that doesn't equate a diagnosis.

The real issue is if you see a professional anonymously, the professional probably won't issue a prescription to an anonymous name. So, see the person anonymously, and if the professional thinks a prescription drug is appropriate, you'll have to decide how to proceed.

[ContinentalOp]

14. The end goal of this would be to get a prescription.

I know that sounds shady, and self-diagnosis is not a great thing to do, but I may as well be honest ;)

[lindisfarne]

20. If you honestly believe you have a serious enough problem to need a prescription, I would suggest at

least seeing someone anonymously, paying in cash, and seeing if that person agrees with you. They can express their opinion without giving you an official diagnosis.

[county worker]

3. I think you have to be referred by your regular physician. If you are referred there is nothing

that an insurance company can do but to not pay the full amount of the charges.

But I don't understand why you think seeing a psychiatrist would jeopardize anything. Your insurance company's plan that you are under should spell out what it pays for psychiatry.

I see a psychiatrist every six months and I have no problems for insurance companies.

[SoCalNative]

6. I believe the OP is concerned about getting insurance

should they need to change plans in the future. If there is a pre-existing condition set in motion by a diagnosis by the psychiatrist, they may be denied a new policy.

[county worker]

10. As long as you can prove there is prior coverage that was uninterrupted there is no prior condition.

If you let your policy lapse then the prior condition may have a waiting period of some months. The key is to always be insured if you can do it and not for a short period of time. When you end one carrier you get a letter in the mail stating that you had coverage with them and the length of time.

[lindisfarne]

17. They can raise the premium based on previous medical & mental issues. There are few limits

on what they can do with respect to raising premiums. Some states limit how much the premium can be raised annual, but the "limit" is quite large, and if applied every year, the premium quickly expands.

I don't believe your statement applies in all states with respect to individual insurance.

Also, the laws vary from state to state - some states have more regulations on insurance companies.
So, before you assume a person that they have some protections, tell them to check whether their state provides such protections.

[ContinentalOp]

21. Apart from denial of coverage due to preexisting conditions, I'm also worried about the premium.

If I were diagnosed with "D.U. Syndrome" couldn't the insurance company suddenly decide that people with that affliction are x% more expensive to cover and therefore raise my premium?

[Sgent]

27. Depends entirely on the state

In the two states I've lived in recently, a dx of major depression or a more serious disorder would prevent you from buying any insurance in the individual market -- rated or not.

[lindisfarne]

9. Have you ever applied for individual health insurance? I can assure you, see a psychiatrist will be

of interest to them.

[ContinentalOp]

16. I'm not sure, it's why I was asking.

With all of the health care horror stories I want to be very cautious about these things. My wife and I are both self-employed so I wouldn't want to do anything that might get us dropped from our coverage or make it impossible to ever switch to a different plan if we wanted.

I have a PPO though so I think I can see a specialist without a referral. I'm not sure if that applies to psychiatrists too though.

[lindisfarne]

8. By the way, you realize you may not need to see a psychiatrist? They're the most expensive

of the mental health professionals.

A psychologist or even counselor is who most people see. If they think you need meds, they can refer you (or some work under the supervision of professionals who do their prescribing).

[SCRUBDASHRUB]

12. I don't understand why seeing a mental health care specialist,

such as a psychiatrist, would be viewed any differently than, say, going to a specialist such as a gastroenterologist.

I have Anthem under both a former employer and through my husband's, and go to a psychiatrist for anxiety (he prescribes the meds I take). I haven't had problems with continuing coverage. Maybe I'm confused by the question.

[lindisfarne]

15. People are denied coverage over medical as well as mental care. Headaches, diabetes, back pain, it's

all been the basis for denials or riders or increase in premium.

This is an important reason why we're all fighting for health care reform

[ContinentalOp]

19. Because it's not strictly necessary in my case.

I think there's a medication that may help me with some certain issues, but I can carry on without it. On the other hand, if I were suddenly having heart problems I would definitely that checked out without worrying about future insurance problems.

Also, if you're getting your insurance through an employer I think that's an entirely different story.

[Why Syzygy]

24. Your primary care physician might be able to help.

Many do. It would still go on your records, but there wouldn't be a psychiatrist notation.

btw, from the above posts, I don't know if it's been made clear: psychologists cannot prescribe.

[lindisfarne]

26. Many psychologists work with physicians (incl. psychiatrists); the physician does the prescribing

but can do so based primarily on the psychologists' notes (although many want at least 1 meeting with the patient before prescribing; patient can also talk to family physician who may prescribe based on psychologist's recommendation and own (relatively) brief assessment).

(NM allows psychologists to prescribe; nurse practitioners and physician's assistants can prescribe drugs independent of physicians - details depend on state).

[SCRUBDASHRUB]

25. Hope everything works out with your situation; good luck.

:)

[tinrobot]

22. What has this country come to...

...when someone has to even ask this question?

I totally understand why the OP is asking it, and the reasons are valid.

It just saddens me that we are now to the point where we have to hide our medical conditions from the companies we're paying to help us with them.

[YewNork]

23. I know exactly what you mean. I've asked my doctor not to write certain things on my chart because

I don't want a future insurance company to be able to deny me insurance on the basis that the doctor said something