Tuesday, June 3, 2014

Health Insurance Coverage For Bipolar Disorder

Bipolar disorder is a unique affective syndrome marked by severe pathologic mood swings from hyperactivity and euphoria to sadness or depression. Some patients suffer from acute attacks of mania only. In many patients, manic episodes emerge over a period of days to weeks. Untreated episodes can last as long as 8 to 12 months, with some having an unremitting and unpredictable course.

Bipolar disorder is surprisingly common, affecting 3 million people within the United States, however it is difficult to diagnose. The disease is equally prevalent in both females and males. Females are more prone to have depressive episodes while males experience more manic episodes comparatively speaking. Approximately half of all patients with this disorder have difficulties in work performance and psychological functioning.Onset of the conditions usually occurs or manifest between the ages of 20 through 30, however symptoms have been reported in late childhood and early adolescence.

Contrary To Popular Belief Not All Applicants With Bipolar Are Turned Down For Health Insurance.

There is sufficient evidence statistically proving that insuring a patient with Bipolar Disorder does comprise a higher medical loss ratio for the insurer, negatively impacting its financial prowess while retaining assumed liability by absorbing the cost of an expensive regime of healthcare treatment divided equally between prescription medication usage and behavioral lifestyle contingencies.

Problem Number One: The Drugs.

Widely used to treat Bipolar Disorder, Lithium proves highly effective in relieving and preventing manic episodes. The drug curbs accelerated thought processes and hyperactive behavior without the sedating effect of antipsychotic medicine. In addition, it may prevent the recurrence of depressive episodes, however it is still ineffective in treating acute depression.

Lithium has a narrow therapeutic range, so treatment must be initiated cautiously and the dosage adjusted slowly. Therapeutic blood levels must be maintained for 7 to 10 days before effects appear; therefore, antipsychotic medications often are used in the interim for sedation and symptomatic relief. Because lithium is excreted by the kidneys, any renal impairment necessitates withdrawal of the drug.

Valproic Acid is an alternative to Lithium for those who do not tolerate it. It is especially helpful in rapid cycling courses of Bipolar Disorder. Carbamazepine is helpful in the treatment of mania but it is not formally approved by the Food and Drug Administration for Bipolar Disorder. Anti Depressants occasionally are used to treat depressive symptoms however these drugs may trigger a manic episode.

Medications to treat Bipolar Disorder are expensive and constitute a lot of contraindications that can lead to many co-morbidities leaving the insurer to pay the tab.

Problem Number Two: The Uncertainty.

As far as the behavioral contingencies there is only one plausible way to evaluate the risk assessment appropriately which is to utilize a questionnaire screen against electronic medical records.
Applicants diagnosed with Bipolar Disorder are sometimes insurable but require careful screening to determine the extent and severity of their condition. Here are some useful tips on answering underwriter questionnaires successfully to get approved without inevitable riders and exclusions.

Health Insurance Underwriting Questions.

(1) When was the applicant diagnosed with Bipolar Disorder?

Answer: As a general rule the date is not as important as there is no definitive period of medical clearance for this condition as a guideline. What underwriters are really looking for here is if there was an incidence requiring hospitalization. If being hospitalized was not documented then most likely there will be no formal request for medical records from the physician who made the diagnosis official. In this case the farther back it was diagnosed the better.

(2) When was the applicant's last acute episode?

Answer: The insurer is primarily concerned on gauging or measuring estimated probabilities of inpatient and outpatient stay. If there is such a medical history on file then there is a frame of reference to go by as far as calculating cost and determining an appropriate rate. If there was an incidence call the physician and ask him or her to document notation in the record of progress before submission of the application.

(3) What medications are being used to treat the applicant and how well are they working?

Answer: Pharmaceutical databases have a registry on file with prescription medication usage, dosage, and frequency consumed on each patient so a good idea is to terminated the prescription and have the physician give the quantities during the office visit.

(4) Is the applicant gainfully employed and living independently?

Answer: The underwriter wants to know if there are any other factors affecting the applicant's insurability. A simple employment verification will usually be all that's required to confirm an applicant is responsible enough to pay premiums and not indulge to often in deviant behavior. Prior notice to the employer of a possible interrogation from the health insurance company is a prudent measure.

These techniques have worked many times to get approved for a major medical heath insurance plan with applicants diagnosed with Bipolar Disorder. If you or some one you know has been diagnosed with Bipolar Disorder and is facing difficulty in obtaining quality health insurance, please visit our website at http://www.health-insurance-buyer.com and leave your contact information. One of our licensed agents will contact you at your discretion and help you with all your needs.

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