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Health & Life Insurance


What have been your experiences obtaining health and life insurance after an ADHD diagnoses?

I’m very reluctant to seek proper treatment because I’m concerned it will affect my ability to get affordable health insurance for my family in the future when I don’t have it through a job (it is possible we may be able to leave the traditional workforce soon and support ourselves with our own business, and, of course, with the Affordable Healthcare Act, it is also possible my employer will decide to no longer offer insurance coverage). Also, I am concerned about life insurance premium. Our term life policy is up in a couple of years and we will be looking for life insurance again.

I’d like to seek regular treatment and intervention. As it is, I pay out of pocket and haven’t seen a doctor in about 2 years and have been carefully doling out my medicine on an irregular basis so it will last until I decide what to do. None of my regular doctors know about my ADHD because I’m concerned about the ramifications for insurance (as well as, still feel “responsible” for my ADHD even though I know it’s ridiculous- and don’t want to be judged).

I’ve reached the point where I’m ready to get out of my own way and take a leap and get serious, and work through my issues, but the insurance bias has me paralyzed.

Replies

Amelie,

I can only speak to my situation, so draw your own conclusions.  My health plan does not cover ADHD, but does cover other conditions as part of the mental health portion of the plan.  Some co-morbid conditions qualify and psychologists and psychiatrists know what “condition codes” to enter to get coverage.  My plan does cover meds so I see my doctor out of pocket and use my FSA.  He doesn’t even take insurance so he charges market based prices (that’s another debate).

Life insurance is all about mortality.  A personal or family history of diabetes, heart disease, cancer, etc. is more of a problem than ADHD.  I took out a 30-year term policy a few years ago before diagnosis, but I didn’t recall any mental health questions.

Before taking your blood work for your next policy, disclose all medications, including over the counter meds.  They are more interested in your cholesterol and BP anyway.

I hope this helps.

Posted by bobinator on Feb 15, 2014 at 10:49pm

Hi Amelie,
I’m a licensed health and life agent and can speak about these things.  I am no longer actively selling insurance but give honest advice when asked.
As far as health insurance goes, the Affordable Care Act has a provision that insurance plans cannot deny or exclude coverage for pre-existing conditions. As long as you are paid up on premiums and have to change insurance because your employer plan is cancelled, COBRA benefits allow you to continue coverage up to 2 years until you find another plan.  You are responsible for the premiums, however and can be expensive..

On Life insurance you should first ask. Do you still need life insurance?  The reasons you bought life insurance 30 years ago have probably changed, like maybe having young children, a lot of bills, mortgage, etc. may not be there now.  If, God forbid, you should die, is there anyone that would come into hardship without your income.  If not, then you may not need life insurance.  A lot of TERM policies have a conversion clause that you can convert to a whole life policy with no medical questions asked however the benefit amount will be much lower.  But again your need for a large payout may not be the same today as it was 30 years ago.  Look at your policy and see if there is a conversion clause.  Life insurance underwriters have been denying life insurance to individuals diagnosed with ADD because there is a risk pool where behaviors such as impulsive actions and distractions while driving have a higher mortality rate then those without ADD.  Until there is a shift in the data of morality rates, this will not change.  Some insurers will offer coverage at a higher rate, also known as a TABLE rate.  Table A-G where A is lowest risk and G the highest with premium cost higher per rate.

FYI:  If you have a formal diagnosis of ADHD or ADD than that information is recorded in your MIB file so not disclosing it on a life insurance application will raise a red flag when the underwriter pulls the MIB.  Best be honest and disclose everything and if the insurance company declines coverage than shop around. There are a lot of insurance companies. ..  You can see what is in your MIB by requesting it at http://www.mib.com/

Posted by spage_hasADD on Feb 16, 2014 at 2:42am

I wonder if untreated ADHD is considered more of a flag than treated… I wouldn’t want the tractor trailer driver behind me with ADD to NOT be taking the meds that will help him or her focus!  I never considered this issue before - my policy is up for review too. I got it before my diagnosis…

Posted by Juggler on Feb 16, 2014 at 8:13pm

Thanks, bobinator and spate_hasADD. I have not had a formal diagnosis that involves my insurance company for this very concern. We will be renewing our policies as we have several minor children.

spage_hasADD- prior to whatever ACA has changed, was an ADD diagnosis a consideration in coverage or rates?

Posted by Amelie on Feb 16, 2014 at 10:20pm

Just a note regarding truck drivers operating big rigs with or without ADD/ADHD…  These drivers must undergo periodic testing for substances in addition to undergoing a full DOT physical.  There is far less risk from a truck driver with ADD than the operator of a 4-wheeled vehicle.  They must have a Class A license to operate the tractor-trailer.  Did you take a physical and have to pass more than six written examinations to get the license to drive your car?  No?  I didn’t think so…

My husband and I owned our own trucking business.  Before judging an occupation or a person with or without ADD/ADHD, perhaps you should know something about from whence you speak…

Insurance carriers look for the risks before they issue a policy because they want to avoid having to pay out on a policy “too soon”.  Why do you think that your auto insurance carrier asks about your driving history?  BTW, they also order a copy of your driving records.  Insurance companies can take risks, but the risks they take are calculated and based on statistical data to support their position.  The higher the risk, the higher the cost to the insured.

My husband and I now carry only enough insurance to take care of final expenses.  Our children are well established and have their own income.  They do not need our money despite what they may want.  Our estate is what it is…

Posted by Dianne in the Desert on Feb 17, 2014 at 3:46pm

Dianne in th Desert - my apologies… if you were referring to me, I must clarify.  I just realized that I had two threads open at once ... (ADD? ya think?).  I inadvertently mixed my responses and put them both in this thread here.

The other post had to do with someone fearing they would not be able to keep their driving job if they started taking meds for newly diagnosed ADHD.  I was trying to say was that I hope licensing rules for CDLs don’t scare off people who are helped by ADHD meds.  I agree there is more risk from operators of 4-wheel vehicles; but since that other thread was about CDLs, I mentioned tractor trailers in my comment, I was trying to show support that a prohibition of stimulants shouldn’t be applied across the board when there is a medically necessary reason for them.

Posted by Juggler on Feb 17, 2014 at 4:55pm

Amelie,  to your question…  Yes,  Life insurance applications are asking the question if you have been diagnosed with ADD or ADHD.  Some applications will go on to ask if you are taking medications to treat it.  The underwriters use this to determine eligibility, rate, and face amount.

For Health Insurance, having ADHD does not affect rates but the benefits can be confusing as a primary care DR. can write out a prescription for stimulants and is covered under general medical but counseling and testing is covered under Mental Health benefits and may not be covered under some plans.  I have found that most MH providers, counselors, psychiatrist, ect… do not file insurance for their patients.

Posted by spage_hasADD on Feb 18, 2014 at 7:47am

One note about Truck Drivers.  If a driver does have ADD like what I have, I’m fine with that.  When I make road trips ( by car) I am hyper focused on the driving and can drive for hours and hours without getting tired or board.  Two hours of driving will seem like 30 minutes . I have a safe driving record by the way.

Posted by spage_hasADD on Feb 18, 2014 at 8:00am

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