<p>What’s a symptom? What’s a disorder? if my kid saw a counselor 3 times for teenage angst I would check the no box. But, I dislike counseling as a rule so it didn’t happen. And, I’m biased in this area.</p>
<p>Tough, actingmgt. maybe you have to have “been there” to know that not all issues can be wished away. when it comes to our kids, the fact that we got through something or “we” have a bias, may not be good enough, Nor do all counselors abuse the trust. </p>
<p>LM- “for symptoms of any mental, emotional, or behavioral disorder?” Yup, I didn’t consider it a “disorder,” so answered my own job apps that way. </p>
<p>LF- I’m not sure what you are responding to and it sounds like we agree on the box. In any case, I’m admitting that I have seen more bad than good come from therapists and meds. That’s just a fact so I’m never going to run to one or encourage my kids to, either. That doesn’t mean if there’s a serious situation it might not be the right call. We did watchful waiting and thankfully it worked. </p>
<p>We pondered those questions too. But the fact is she WAS having symptoms of depression, which is one of the disorders listed on the application. And she WAS getting counseling for it. Answering that question No would have been a flat lie.</p>
<p>Well, there are Obamacare navigators on tape advising smokers to check no in the box for the only health question currently being asked. Premiums will be lower if you say no was the official explanation. It was filmed at one of those early sign-up events.</p>
<p>Your point is we should have lied?</p>
<p>LasMa, it’s kind of irrelevant now. I don’t know. There was a question that got me denied once because of how my husband answered it. When I reread it carefully I came up with a no, reapplied, and was accepted three weeks later. I don’t think I lied. But, clearly people lie on these forms. Or spin positively. Or forget stuff.</p>
<p>I do think it’s a little odd to even call counseling medical treatment since counselors are not physicians by far. Or to call a non-diagnosed whatever a pre-existing condition. Surprisingly, I may be agreeing with CF on this one. </p>
<p>Prior to ACA, insurance companies typically used the insured’s failure to disclose previous medical history, or false statements as to such history, as grounds for rescission of policies – whether or not the condition that was not disclosed had anything to do with the medical claims that prompted the insurance company to investigate the insured’s medical history. So there were two types of people who lied on insurance apps: those who got away with it, and those who didn’t. But it was always kind of a dumb choice --though if it was a choice between disclosure and no insurance at all, I can see where the incentive to lie came from.</p>
<p>My point is more nuanced than Flossy’s, I think. I support insurance coverage for counseling for medical conditions, like anorexia or autism spectrum issues. Usually, that kind of counseling wouldn’t be delivered by MDs, but by other mental health professionals: licensed family therapists, psychologists, social workers, other professionals.</p>
<p>But I don’t support insurance coverage for all counseling. There are some issues that call for counseling, but that don’t seem to me to justify insurance coverage. For example, marriage counseling can be a great thing, but if I were insurance czar, insurance wouldn’t pay for it. </p>
<p>I assert there is a line between counseling that ought to be covered by insurance, and counseling that is justified and worthwhile but shouldn’t be covered by insurance. I don’t know the details of dietz’s daughter’s case, so I can’t say what side of that line I think she would have been on. </p>
<p>I don’t even know were we’re going with this. I looked at the DSM discussions of “disorder” and am comfortable I answered legitimately, in the past. But I was referring to job apps (since someone mentioned a job that wouldn’t like past therapy.) No question the insurer denied my neighbor reasonable pricing.</p>
<p>Any time someone brings up something like “navigators on tape,” I have to wonder how legit or how widespread. All they have to do, as with life insurance, is later see the history on the medical records. Poof, you got some 'splainin to do.</p>
<p>Exactly, calmom. Even leaving aside the moral question, not disclosing treatment which she received, and which they clearly asked about, could have gotten her rescinded down the road. Not just her, but also DH, since she was on his policy and he signed the application. </p>
<p>Fang, I see your point about the line. I’m not saying D’s counseling should have been covered, just that it shouldn’t have been held against her. </p>
<p>LasMa, I was addressing dietz’s point about the S who had counseling, but since he didn’t have a mental health diagnosis, the counseling wasn’t covered by insurance. I argue that some kinds of counseling shouldn’t be covered by insurance, and further that many kinds of counseling associated with a mental health diagnosis SHOULD be covered by insurance.</p>
<p>I’m glad that pre-existing conditions no longer prevent us from getting insurance. </p>
<p>I hope people are not following the bad navigator’s bad advice about saying that they don’t smoke when they do smoke. If their smoking causes some expensive health condition, their insurance will be cancelled. Fraud is still a justification for cancelling insurance.</p>
<p>To clarify: Insurance covered the first 3 visits with a counselor. After the first 3 sessions a diagnosis was needed in order to have the sessions covered by insurance. The LMFT could not issue this diagnosis and thus was sending S to a psychiatrist. The first 3 sessions were only covered at 50% anyway. Arguably covering sessions for the ‘ain’t it awfuls and my life sucks’ could very likely prevent a slide into depression or suicidal thoughts down the line.</p>
<p>CF – you are mistaken about the consequences of nondisclosure of tobacco use under ACA:</p>
<p>
</p>
<p>From Federal Register, commentary on final rules governing tobacco use premium surcharge under ACA: <a href=“Federal Register :: Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review”>https://www.federalregister.gov/articles/2013/02/27/2013-04335/patient-protection-and-affordable-care-act-health-insurance-market-rules-rate-review</a></p>
<p>Of course it is possible that a person could lose their insurance because of inability to pay – but there would probably be a strong incentive for people who needed expensive treatment for smoking-related illness to come up with the extra premium dollars. </p>
<p>“Prior to ACA, insurance companies typically used the insured’s failure to disclose previous medical history, or false statements as to such history, as grounds for rescission of policies”</p>
<p>The only problem with this statement is using the word, “typical”. Although the issue got quite a bit of attention, they happened very rarely - probably less than .00000001% of the people were rescinded.</p>
<p>I am not defending the previous system but that doesn’t mean we should exaggerate the problems with it. </p>
<p>Not much difference between one’s use of “typical” and then responding with a “rarely” and “probably.” And a number.</p>
<p>In California they could not rescind you after 2 years…even if they found evidence of lying on the application.</p>
<p>Interesting update on the husband/wife group issue. As per my two broker contacts…Turns out that ACA forbids new H and W groups. However, it doesn’t demand dropping existing ones. Or maybe it is one of those features that has been chosen for future or ‘soft’ implementation.</p>
<p>So, it looks like it’s up to the companies. Two slightly different explanations/approaches. Supposedly Anthem has decided to just keep those members as a group. BS will keep you unless you are one of the (randomly?) chosen policies who are pulled for re-certification.</p>
<p>Will be interesting to see how much/if US stats improve. </p>
<p><a href=“Rating a Health Law’s Success - The New York Times”>Rating a Health Law’s Success - The New York Times;
<p>Dietz, that’s great news. It looks like you’re grandfathered; now we got to hope they keep the old networks for small business group plans.</p>
<p>GP: I wish it were that simple. I’m not grandfathered. I think what is happening is the companies won’t go though each and every two person policy to determine if they still qualify. Probably way to much work and they will just renew small groups. Somewhere in the recesses of my brain I remember something about 10% of policies being audited each year. I’m hoping I’m in the 90% that’s not pulled for that audit and we’ll slide by for another year. Recovering from the ACA is like a 12 step program … one day (renewal cycle) at a time… :)</p>