Insurance For Mental Illnesses

In 2005 I had met a very renowned orthopedic surgeon (who had treated Mr. Sachin Tendulkar). Why did I go to a celebrity doctor? I did not know at that time and I was desperate. I have had a perpetual back problem which no doctor had been able to treat; till date I suffer from that pain – on occasions it is so severe it leave me no choice but to stay in bed.

So Mr.Doctor said, “On the surface all looks ok, but we must do all the advanced tests and it will cost you X thousand rupees.” I was 25, had left home and did not have that kind of money. The thing about going to a doctor is they ask for a complete medical history. Fair. But I had a bad experience with Mr. Doctor. So I had mentioned everything including my treatment for depression (at that time we had not diagnosed the problem as Bipolar). No big deal. Ortho is supposed to deal with bones and anti depressants had already done its damage that he needs to repair.

Kind Mr. Doctor asked me if I had medical insurance? “If yes, why don’t we admit you to the hospital and complete the tests and make the insurance claim?” What a considerate doctor, I thought to myself and got myself admitted.

So when the doctor came to visit me of course I complained and mentioned how the place had no empathy for people.

The bill was 25K and the doctor’s diagnosis sheet said, “All ok, the patient suffers from depression”. And the insurance company had no obligation to pay.

At 25, someone who had left home, salary of 6k of which 3 I paid as PG accommodation I had no option but to request my middle class family to cough up the money. I went pillar to post, hospital to insurance agency but to no avail. I lost 25K because Mr.Doctor decided that I may just spoil his reputation and that of his hospital by calling them non empathetic and so I must be taught a lesson.

At 25 I did not need a lesson like that.

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My back pain was later diagnosed as caused by osteopenia just a level below osteoporosis. No wonder my back could not take that kind of stress and work hours.

Anyway, the point I want to make is, why do insurance agencies not cover depression? As a result how easy it was for a doctor to ensure I lost 25K.

The fact that insurance companies do not cover depression makes it worse for people who need treatment.

The stigma attached to the diagnosis of a mental illness can lead to hundreds and thousands of dollars being spent at a later date on severe treatments like in-patient costs, intensive drugs and psychotherapy, ECTs and other expensive treatment. And guess what NONE of it will be covered by your insurance. So if you know someone who may have signs of depression, do make sure they see a doctor.

Coming back to the insurance companies. Any one who has had even a small spell with depression makes them untouchables for these insurance companies. My medical health insurance company does not know about my mental illness and so far, my agent insisted I keep it out of the disclosure document, else the rates would sky-rocket.

But I am going to do this today. I may not be eligible for the cover I want and deserve but I may not be excluded altogether. I wonder how it is in India but in the US it takes at least 2 years of treatment as sufficient information/evidence of post coverage; if one shows good response to the treatment the rates can also go down.

Pic credit: chasingbutterflies (Used under a Creative Commons license)

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