Thursday, May 8, 2014

Health Insurance - Bipolar Patients


A diagnosis of bipolar or manic depression is often thought of as an automatic denial when it comes to health insurance, even if the diagnosis comes long after the health insurance policy has been purchased and put in place. While is can be very complicated to get coverage for bipolar disorder related treatment, it is not impossible. This is especially true if the bipolar diagnosis is not a pre existing condition, but was discovered and diagnosed after the health insurance policy has been in place for awhile.

Bipolar is a mental health disorder that is characterized by wild mood swings that alternate from extreme happiness and elation to severe depression and sadness, even suicidal. Once the diagnosis is made and treatment is to begin, there are a few specifics that the health insurance company will likely require before they will cover any bipolar treatment. The first thing that will be verified is the employment status of the bipolar patient. Health insurance companies must be sure that the patient is able to pay for the policy premiums as well as any out of pocket expenses that will be left after applicable costs are covered.

The insurance company will also likely ask the exact date of the bipolar diagnosis, who diagnosed the patient and when was the last manic episode. Typically all of these questions can be fully answered in great detail by the medical records, so the insurance company will likely request copies of all available medical records. If the patient has not had any hospitalization, either in patient or outpatient in recent months, that alone may serve to answer the question of how often hospitalization may be required. The health insurance company has to weigh the risks of insuring such a huge risk, that is the reason for the exhaustive research and questioning.

The last thing that will be checked into is medication for the bipolar patient. The effectiveness of the current medications will be weighed against the medical history. How often have new medications or a change in medications been needed? This type of information is indicative of how much medical care the patient needs and if the current treatment plan is working or if it appears that doctor visits and medication changes happen often and therefore the cost of the patient's medical care will be higher. Bipolar patients have to jump through many hoops to secure insurance coverage, but it can be done.

No comments:

Post a Comment