Bipolar Disorder: Is there room for it in health insurance? Author:    Posted under: Health InsuranceHealth Insurance questions answered

According to the National Institute of Mental Health, bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year.*

These men and women, like you and me are in need of health insurance, and they require medical attention more often than the average person. People suffering from bipolar disorder who do not have health insurance have only two options: they either pay for their medical needs in cash, or they do not seek medical attention at all since they cannot afford it. Those who belong to the latter group are putting themselves, and potentially others, in danger especially when they go through the down phase of their disease where they may experience anything from depression to psychosis. In this phase, they may do something irrational but completely harmless, such as spend large amounts of money on useless items. In the extreme, they may pose a risk to others and to themselves. Other times, their depression and psychosis can even lead to suicide. With proper medical attention, these can be prevented by regularly taking psychiatric drugs and participating in therapy.

On the other hand, those who do seek medical attention by paying for their treatments and medication out of their own pockets are avoiding the ravaging effects of their illness, but their finances are sure to take a big hit. Pretty soon, the cost of managing their disease on their own could put a strain on their finances that is more than what they can bear.

For more than a decade mental health parity, which is the requirement for health insurance companies to cover mental illnesses at the same level as physical ailments, has been a topic of debate. Many states have enacted their own laws, and in October of 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was enacted by President Bush. However it has not been in full force until January 2010 – and even then some stipulations still remain. So if you’re one of those who have bipolar disorder, this would mean you have health insurance, but have very little coverage for psychologist visits and other needs associated with your condition – and that would be frustrating at the least.

For someone who does have health insurance, it is important for you to note the “continuous health insurance” clauses which state that if you’ve had a period (typically more or less than 30 days) wherein you have not had uninterrupted insurance coverage then any condition that you’ve been diagnosed with is considered as a pre-existing condition and will no longer be covered. Depending on the circumstance that caused you to lose your insurance coverage, you may be eligible to receive continuous group coverage rates through COBRA for a limited period of 18 months.

If you’re looking for health insurance, an option available to you is to obtain individual health coverage with companies that offer behavioral health insurance. One advantage to this type of coverage is that you will be able to tailor-fit your coverage to your specific needs. Still, another option is to find out whether the state you live in is one out of the 31 that operate high risk pools. These high risk pools are designed specifically for those whose health condition makes it nearly impossible for them to obtain health insurance coverage. Both of these options will be more expensive than traditional health insurance policies but it is better than not having any health insurance coverage at all.



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