Declined for Medical Insurance

Discussion in 'Fibromyalgia Main Forum' started by Yucca13, Jun 19, 2003.

  1. Yucca13

    Yucca13 Member

    I posted this subject on the Arthritis Board also because I think it is relevant to both fibro and arthritis - I have both.

    Recently, I applied for a PPO with Healthnet and was told that because I take Effexor for pain control that I am high risk for 'mental illness'.

    I explained that they are not up-to-date on the uses for SSRIs if they think they are only used for depression. I was really shocked by their reasoning and think I will go further with the decision by contacting the Insurance Board of CA or whoever governs them.

    Has anyone else run into this?
    Val Branch
  2. schnoodle

    schnoodle New Member

    Not exactly the same problem, but can't get health insurance. I had COBRA, now I am paying for HIPPA which is costing me a fortune I don't have. I am trying to hold on to the HIPPA because I have been told that I will not be able to qualify for any insurance because of the fibro. I don't know what to do. The Effexor reason that they gave you sounds rediculous. I would certainly try to fight it. What have you got to lose.
  3. jann1033

    jann1033 New Member

    I have been declined over and over and over for health insurance, lost originally when I had to stop working ( 15 yrs ago,back when cfs only lasted " 5 yrs" supossedly). it seems the insurance industry is one of the few who take cfs seriously. tried to get disablity for insurance, failed twice(niavely thinking the gov. Drs. would give a true evaluation, must have been really foggy to belive that one) and the health care system does not want you if you are self pay no matter what they try to tell you. now I am stuck with little to no care cause I can't afford 50 bucks to hear them say my illness is nonexistent (or see them totally ignore CFS when I know it is causing what ever symptom I am going in for)and waste time and my money on treatments that don't work cause they refuse to see the real problem.
  4. 6ftfromedge

    6ftfromedge New Member

    The medical insurance that my husband has is a crappy company that only covers accidents and you can only go to the doctor if something is wrong with you, and of course they do not cover mental illness of any kind. I haven't had to try with the precriptions yet, because my doctor gave me zyprexa, but she gave me samples. But next week I will be going on a different med that I have a prescription for, so I'm supossed to go only to their list of certain pharmacies and show them my card and they are supossed to give me a discounted price, I pay that price and keep my receipt and send it into the company for more of a reimbursement. But if it's a drug that is used in a mental capacity, they probably won't cover it. I've sent them one claim already (and I know they take their time) but it was over a month and a half ago and still nothing, even on the phone they couldn't tell me if my deductible had been met, becauase I had to call because I had to get my bloods done. Also this company only has a $1000.00 limit for sickness and injury for the year, anything over that, oh well, your paying out of pocket. Between my 2 different doctor appointments and lab work, I probably already went over that amount.

    So sorry for rambling, but yes I have heard of insurance companies now that won't cover any sort of anything having to do with mental illness. That's why I went to see a regular doctor (who I found by the grace of God) and is treating me for the mental part of my disease, so this way I try and submit her claim for coverage. The insurance says that I can go to any licensed physician, but not a psychiatrist. That is pure bull. That makes me so mad, I hope I get approved for SSD, so I have some money to pay for the med's and appointments I'm going to need.

    Good Luck to you.