How Does Having a Bipolar Diagnosis Affect My Insurance?

How Does Having a Bipolar Diagnosis Affect My Insurance?

People with bipolar disorder will benefit due to the Affordable Care Act

Health insurance is an important consideration for anyone who suffers from a chronic mental or physical health problem. A primary concern for people with health problems is whether or not an ongoing condition will make it more difficult to purchase insurance. Whether and to what extent an insurance policy will cover a condition like bipolar disorder is also a significant question, but you can answer these questions with the right help.

How Pre-Existing Conditions Affect Health Insurance

Health insurance companies define “pre-existing conditions” in one of two ways. It may apply either to a medical condition for which a patient has received previous treatment, or to a condition for which symptoms are present, regardless of whether treatment has been sought. It has been common for health insurance companies to deny coverage to applicants due to pre-existing conditions, as they have frequently issued policies which exclude treatment related to a health condition that existed before the policy was purchased. They have also charged higher premiums to people with such conditions. Some states have issued regulations that limit the amount of time for which a condition can be excluded, ranging from a few months to many years. In other states, the exclusion period is unlimited.

People with ongoing medical needs must retain health insurance coverage, because pre-existing condition exclusions have generally been in play when there is a lapse in treatment. Policies differ in the amount of time for which an individual can avoid treatment before exclusions apply, but 30 days is a common measure, even though shorter periods are also common.

How to Avoid Health Insurance Exclusions Due to Pre-Existing Conditions

Some people without health insurance are eligible for COBRA policies. The United States Department of Labor explains that COBRA provides certain former employees and their dependents the opportunity to purchase health insurance at group rates for a limited period of time. Generally, the policies are in effect for no more than 18 months. Furthermore, the Department of Labor notes that the policies are generally more expensive than those offered to active employees, but they are less expensive than those available for individual purchase.

The Affordable Care Act (ACA), which is currently in the process of incremental implementation, addresses the problem of pre-existing condition exclusions. The HealthCare.gov website states that most policies covered by the ACA will not be allowed to deny coverage to individuals with pre-existing conditions, nor can they charge such patients with higher premiums. The site notes that this is true even for applicants who have been denied coverage in the past.

Health Insurance Coverage of Mental Health Disorders

Whether and to what extent a health insurance policy will cover treatment for bipolar disorder is another important consideration. Coverage varies greatly between policies; these differences may be related to the general type of insurance (public or private, individual or group), to state regulations and to many other individual factors. Coverage for bipolar disorder and other mental health conditions has improved over the years, which is due in large part to a series of regulations. The laws state that insurance policies that cover mental health conditions cannot cover those conditions at a different rate than what is applied to other medical disorders. Co-pays, deductibles and financial caps must also be equivalent.

The ACA also addresses coverage of mental health issues. A brief issued by the Department of Health and Human Services states that the ACA builds on the previous laws by requiring equity in policies issued through ACA markets. The ACA also designates ten essential health benefits that must be covered, including mental health conditions.

Find Treatment for Bipolar Disorder

Mental health conditions and substance abuse disorders commonly coexist, and the best treatment for these issues addresses both problems at the same time. People with co-occurring disorders may find that their insurance covers both addiction treatment and treatment for conditions like bipolar disorder, especially if the conditions are treated together.

If you suffer from both bipolar disorder and substance addiction, we can help you find integrated treatment. Our toll-free helpline is open 24 hours a day, so there is never a wrong time to call. Our admissions coordinators can check your insurance coverage for you at no cost or obligation, so call now to begin your journey of recovery.

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