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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by photojenny on March 23, 2003, at 14:44:38
HiDo any of you fellow Brits know of any UK insurance companies that are OK with insuring people with mental health problems, specifically depression?
I`m going abroad on holiday in June (Portugal), and I`ll need holiday insurance. I know that getting insurance is very difficult when you`re on long-term medication or if you have m/health problems. I was hoping that someone out there has some advice or pointers - maybe someone`s been in the same position?
All advice gratefully received,
Anna.
Posted by NikkiT2 on March 23, 2003, at 14:55:30
In reply to Medical Insurance - UK Members, posted by photojenny on March 23, 2003, at 14:44:38
My replies above were for holiday medical insurance.. just not permanent "within UK" medical insurance!!!
Also, I believe Portugal is in the EU.. if it is you need to get Form E 111 from your postoffice. This will give you free medical care in all EU countries.
Nikki
Posted by photojenny on March 24, 2003, at 11:37:55
In reply to Re: Medical Insurance - UK Members » photojenny, posted by NikkiT2 on March 23, 2003, at 14:55:30
Hiya Nikki
I`m sorry - I must sound like a broken record ... I`m just very anxious about all this.
Thanks once again for taking the time to reply.
Anna.
Posted by NikkiT2 on March 24, 2003, at 14:57:45
In reply to Re: Medical Insurance - UK Members » NikkiT2, posted by photojenny on March 24, 2003, at 11:37:55
Form E111 is free too.. you shouldn't need any other medical cover for the EU..
Nikki
Posted by cybercafe on March 26, 2003, at 1:20:04
In reply to Re: Medical Insurance - UK Members » photojenny, posted by NikkiT2 on March 24, 2003, at 14:57:45
> Form E111 is free too.. you shouldn't need any other medical cover for the EU..
>
> Nikkianyone want to talk about getting medical insurance for inside the UK?
private seems like the only way to go
Posted by photojenny on March 27, 2003, at 7:12:28
In reply to Re: Medical Insurance - UK Members, posted by cybercafe on March 26, 2003, at 1:20:04
> anyone want to talk about getting medical insurance for inside the UK?
>
> private seems like the only way to go
Do you mean for things like getting a mortgage?On another subject, I was really worried about car insurance. I took on my mum`s car a couple of years ago, but we kept it in her name as I had 'lost' my no claims bonus (it gets wiped after 3 years), and the premiums were therefore really high. However, I realised that I would only be able to re-build the no-claims by having the car in my name. Obviously this meant getting insurance (rather than being a name on my mother`s insurance), and I was extremely nervous about this. I did this through People`s Choice, and had absolutely no problem at all - even when I meade it clear that I suffered from depression and was taking medication.
As for your question - I really don`t know the answer (and I`m not sure that I understood what you were asking).
Anna.
Posted by cybercafe on March 27, 2003, at 16:40:40
In reply to Re: Medical Insurance - UK Members » cybercafe, posted by photojenny on March 27, 2003, at 7:12:28
> > anyone want to talk about getting medical insurance for inside the UK?
> >
> > private seems like the only way to go
>
>
> Do you mean for things like getting a mortgage?
>
> On another subject, I was really worried about car insurance. I took on my mum`s car a couple of years ago, but we kept it in her name as I had 'lost' my no claims bonus (it gets wiped after 3 years), and the premiums were therefore really high. However, I realised that I would only be able to re-build the no-claims by having the car in my name. Obviously this meant getting insurance (rather than being a name on my mother`s insurance), and I was extremely nervous about this. I did this through People`s Choice, and had absolutely no problem at all - even when I meade it clear that I suffered from depression and was taking medication.
>
> As for your question - I really don`t know the answer (and I`m not sure that I understood what you were asking).
>
> Anna.heh... sorry.. no... i was talking about medical insurance...
i don't think depression would effect normal insurance
Posted by fi on March 28, 2003, at 16:29:44
In reply to Re: Medical Insurance - UK Members » photojenny, posted by NikkiT2 on March 24, 2003, at 14:57:45
Form E111 is certainly free (you need your NI number to fill it in). I've sometimes seen warnings tho that the standard of care can be particularly basic in some countries, and you may have to pay up front. So it can be a good idea to get private medical insurance too (which can also include bringing you home, if a doctor thinks it necessary).
But of course its weighing up pros and cons, and you can get a really hefty excess due to depression (even if, like me for my last holiday, the meds are just to keep you well and you hadnt had any problems for ages). I found Direct Line comparatively reasonable.
The kind of insurance that companies include as part of package holidays usually excludes lot of things, including existing medical conditions. So its worth shopping around and not just taking it.
Fi
Posted by photojenny on March 29, 2003, at 5:17:59
In reply to Re: Medical Insurance - UK Members, posted by fi on March 28, 2003, at 16:29:44
> Form E111 is certainly free (you need your NI number to fill it in). I've sometimes seen warnings tho that the standard of care can be particularly basic in some countries, and you may have to pay up front. So it can be a good idea to get private medical insurance too (which can also include bringing you home, if a doctor thinks it necessary).
>
> But of course its weighing up pros and cons, and you can get a really hefty excess due to depression (even if, like me for my last holiday, the meds are just to keep you well and you hadnt had any problems for ages). I found Direct Line comparatively reasonable.
>
> The kind of insurance that companies include as part of package holidays usually excludes lot of things, including existing medical conditions. So its worth shopping around and not just taking it.
Hi FiThanks for that info. I had actually forgotten all about E111 (so long since I went on holiday), and thanks for telling me the drawbacks of this. I know that Direct Line have a good reputation - I`ll give them a try.
This isn`t a package holiday, so inclusive insurance isn`t an option (in some ways it would be easier). Anyway, thanks very much for your help.
Cheers,
Anna.
Posted by photojenny on March 29, 2003, at 5:23:33
In reply to Re: Medical Insurance - UK Members, posted by cybercafe on March 27, 2003, at 16:40:40
>
> heh... sorry.. no... i was talking about medical insurance...
>
> i don't think depression would effect normal insurance
cybercafeMy sister was planning to buy a house a few years ago, and it was all going fine until it got to the insurance part. She doesn`t suffer from depression (i.e. isn`t a long-term sufferer and on continual medication), but has had a couple of periods of depression where she was taking anti-depressants. She was then turned down by insurance company after insurance company ... this is what I was on about.
Anna.
Posted by cybercafe on March 30, 2003, at 19:42:58
In reply to Re: Medical Insurance - UK Members » cybercafe, posted by photojenny on March 29, 2003, at 5:23:33
> My sister was planning to buy a house a few years ago, and it was all going fine until it got to the insurance part. She doesn`t suffer from depression (i.e. isn`t a long-term sufferer and on continual medication), but has had a couple of periods of depression where she was taking anti-depressants. She was then turned down by insurance company after insurance company ... this is what I was on about.
strange.. how is depression relevent to house insurance?
Posted by photojenny on March 31, 2003, at 7:17:26
In reply to Re: Medical Insurance - UK Members, posted by cybercafe on March 30, 2003, at 19:42:58
> strange.. how is depression relevent to house insurance?
Well, the problem is with life insurance (which of course is essential for securing a mortgage). People with other illnesses find it extremely difficult - if not impossible - to get mortgages for this reason. So illnesses like HIV/AIDS, cancer, etc. are really dicey. I`m guessing that the assumption is that someone with depression is likely to end their life, and therefore insurance is denied.Problems that mentally ill people have with getting insurance (or what insurance companies would categorise as `mental illness`) are well-known and well documented.
My post was as a result of an article in the Depression Alliance magazine, where a survey was carried out for holiday insurance. This was the script they used: "I`m off on holiday to Spain ... and I`m just ringing around to get quotes on holiday/travel insurance ... I should also probably mention that I have a history of depression - does that make any difference to the price or level of cover? Yes I am taking anti-depressants"
Churchill - would not accept any claim relating to a pre-existing medical condition (i.e. depression).
Prudential - said that the condition was 'very high risk' and that no cover would be available for anything relating to the depression.
Direct Line - said that the price would be significantly higher.
Eagle Star - said that depression was not covered.
Options Travel Insurance - said that they wouldn`t be able to cover any claims relating to depression.
.... it`s not fair at all, but that`s just an indication of the ignorance out there.
Posted by NikkiT2 on March 31, 2003, at 8:37:38
In reply to Re: Medical Insurance - UK Members » cybercafe, posted by photojenny on March 31, 2003, at 7:17:26
My friend has similar problems and she has asthma.. she finds it virtually impossible to find health insurance. I don;t know about life insurance though.. though I do know that in the vast majority of cases, suicide would remnder the policy useless.. ie, they don't pay out if the death is caused by suicide.
I was lucky and didn't have to get life insurance with my mortgage.. I just signed that my house could be sold to pay off mortgage, and proceeds after that count as my estate.
Nikki
Posted by cybercafe on March 31, 2003, at 23:49:22
In reply to Re: Medical Insurance - UK Members » cybercafe, posted by photojenny on March 31, 2003, at 7:17:26
> > strange.. how is depression relevent to house insurance?
>
>
> Well, the problem is with life insurance (which of course is essential for securing a mortgage). People with other illnesses find it extremely difficult - if not impossible - to get mortgages for this reason. So illnesses like HIV/AIDS, cancer, etc. are really dicey. I`m guessing that the assumption is that someone with depression is likely to end their life, and therefore insurance is denied.you need life insurance to get a mortgage? sorry that wasn't intuitive to me... i thought if anything happens to you, the bank can just re possess the property, so there is no risk for them
hmmmm...
> Options Travel Insurance - said that they wouldn`t be able to cover any claims relating to depression.
>
>
> .... it`s not fair at all, but that`s just an indication of the ignorance out there.
>hmmm... my doc said it was very popular for people to just say that they don't have the condition, either a flat out lie, or due to the fact that the diagnosis is still technically in progress (he was suggesting this for medical insurance in fact)... but it seems like this activity is not as popular as i had thought from what you guys are saying
Posted by noa on April 1, 2003, at 4:27:04
In reply to Re: Medical Insurance - UK Members, posted by cybercafe on March 31, 2003, at 23:49:22
Why couldn't the insurance company just disallow cancellations due to depression? I mean, statistically, how many people submit travel insurance claims due to their depression? Mostly, I would assume, these days especially, that cancellations would be due to events, like war, or acute illnesses, like the flu. It seems like blanket discrimination to me.
It used to be quite the norm here in the US for health insurance companies to deny coverage for pre-existing conditions, so when person left a job and tried to get new insurance either on their own or through a new employer, they could be denied insurance altogether, or denied any coverage for such conditions, like diabetes or depression, etc. Even pregnancy, only they weren't allowed to say so. For example, I once had insurance where only dire emergency (and they gave a list! heart attack, traumatic wounds, etc.) care was covered for the first 260 days of being on the plan. Hmm....
But during the Clinton years, a law was passed to protect people from being denied health insurance for pre-existing conditions.
Life insurance is a whole other story. You can be denied life insurance and they don't even have to tell you why they denied it. There was a man a few years ago who died of AIDS. Neither he nor his wife even knew he was HIV positive. Well, it turns out that he had been denied life insurance a while before he became ill, only they didn't tell him why. But it was because the life insurance application required a medical check up, which included blood tests, which included an HIV test, which led to the insurance denial, but no one bothered telling the person that his blood test came back HIV positive!
I had never heard that you have to have life insurance to get a mortgage. I guess the laws are quite different from country to country. What would be the reason for life insurance to get a home loan? Isn't the home security enough? Like cybercafe said, they can just reposess. Plus, statistically, suicide is probably rather rare compared to how many people have depression.
Over here, they are so eager to get people to buy houses that it is rare to be denied a mortgage--where they get you is how much interest you have to pay. So if you have not so good credit, you can usually still get a mortgage, only you are not going to get a good rate.
But even more strange to me is the travel insurance.
Sorry you have to deal with this hassle. It seems very discriminatory to me.
Posted by photojenny on April 1, 2003, at 4:51:35
In reply to Re: Medical Insurance - UK Members, posted by cybercafe on March 31, 2003, at 23:49:22
> hmmm... my doc said it was very popular for people to just say that they don't have the condition, either a flat out lie, or due to the fact that the diagnosis is still technically in progress (he was suggesting this for medical insurance in fact)... but it seems like this activity is not as popular as i had thought from what you guys are saying
Well, that`s probably what I will end up doing. I can`t imagine a scenario where my 'condition' would cause a problem on holiday. I just don`t like lying that`s all ... but I also don`t fancy the emotional stress of being turned down by loads of insurance companies either. The other thing is that I have a feeling that you have to 'declare' any medication - I haven`t checked this out, but I know that it`s happened to a couple of people I know. I can`t be doing with any of this - I just want to go on holiday and forget it all for a while (hopefully).
Posted by photojenny on April 1, 2003, at 5:05:23
In reply to Re: Medical Insurance - UK Members, posted by noa on April 1, 2003, at 4:27:04
> Why couldn't the insurance company just disallow cancellations due to depression? I mean, statistically, how many people submit travel insurance claims due to their depression? Mostly, I would assume, these days especially, that cancellations would be due to events, like war, or acute illnesses, like the flu. It seems like blanket discrimination to me.
Yes that`s exactly what it is - it seems totally illogical to me.
> It used to be quite the norm here in the US for health insurance companies to deny coverage for pre-existing conditions, so when person left a job and tried to get new insurance either on their own or through a new employer, they could be denied insurance altogether, or denied any coverage for such conditions, like diabetes or depression, etc. Even pregnancy, only they weren't allowed to say so. For example, I once had insurance where only dire emergency (and they gave a list! heart attack, traumatic wounds, etc.) care was covered for the first 260 days of being on the plan. Hmm....
!!!! That's absurd in the extreme.
> But during the Clinton years, a law was passed to protect people from being denied health insurance for pre-existing conditions.(yes, where is he now we need him??)
> Life insurance is a whole other story. You can be denied life insurance and they don't even have to tell you why they denied it. There was a man a few years ago who died of AIDS. Neither he nor his wife even knew he was HIV positive. Well, it turns out that he had been denied life insurance a while before he became ill, only they didn't tell him why. But it was because the life insurance application required a medical check up, which included blood tests, which included an HIV test, which led to the insurance denial, but no one bothered telling the person that his blood test came back HIV positive!I`ve heard stories like that too. I honestly cannot comprehend what`s going on in these peoples` minds.
> I had never heard that you have to have life insurance to get a mortgage. I guess the laws are quite different from country to country. What would be the reason for life insurance to get a home loan? Isn't the home security enough? Like cybercafe said, they can just reposess. Plus, statistically, suicide is probably rather rare compared to how many people have depression.
This is what happened in my sister`s case - I don`t know much about mortgages as I`ve never owned a house. But there are loads of hoops that you have to jump through.
> Over here, they are so eager to get people to buy houses that it is rare to be denied a mortgage--where they get you is how much interest you have to pay. So if you have not so good credit, you can usually still get a mortgage, only you are not going to get a good rate.
>
> But even more strange to me is the travel insurance.
>
> Sorry you have to deal with this hassle. It seems very discriminatory to me.Thanks for your sympathy - I just want a holiday (which I haven`t had for 5 years because I`ve either been in hospital or too depressed to function), and now I`m extremely anxious about the prospect of this. Still, I absolutely refuse to let this spoil things for me.
Anna.
Posted by noa on April 1, 2003, at 19:41:45
In reply to Re: Medical Insurance - UK Members » noa, posted by photojenny on April 1, 2003, at 5:05:23
>>>Still, I absolutely refuse to let this spoil things for me.
You go girl!!
Posted by cybercafe on April 5, 2003, at 23:22:08
In reply to Re: Medical Insurance - UK Members, posted by noa on April 1, 2003, at 4:27:04
> Why couldn't the insurance company just disallow cancellations due to depression? I mean, statistically, how many people submit travel insurance claims due to their depression? Mostly, I would assume, these days especially, that cancellations would be due to events, like war, or acute illnesses, like the flu. It seems like blanket discrimination to me.
i guess making accommodations (like making their plans more and more complicated) just isn't feasible
> It used to be quite the norm here in the US for health insurance companies to deny coverage for pre-existing conditions, so when person left a job and tried to get new insurance either on their own or through a new employer, they could be denied insurance altogether, or denied any coverage for such conditions, like diabetes or depression, etc. Even pregnancy, only they weren't allowed to say so. For example, I onceyeah how do people deal with this problem???
> But during the Clinton years, a law was passed to protect people from being denied health insurance for pre-existing conditions.
really? this sounds too good to be true (though i'm not in the us).... so you're telling me if i needed a $100,000 surgery i could apply for insurance and they couldn't turn me down? ... nah i must be misunderstanding
Posted by noa on April 5, 2003, at 23:32:22
In reply to Re: Medical Insurance - UK Members, posted by cybercafe on April 5, 2003, at 23:22:08
The key is that you have to not have a gap in insurance. Here, insurance is purchased through employers. So, let's say I change employers and my new employer doesn't have the same insurance as the old. I transfer to the new plan. It used to be that the new insurance could exclude anything related to a pre-existing condition. With this relatively new rule, they can't do that, they have to cover it.
If, however, I had let my insurance lapse, then it might be different. The way we can keep our insurance going between jobs is through a law, also from the Clinton era, which allows us to continue buying the group insurance through our old employer up to 18 months. Only it can be expensive, because rather than just paying a portion of the cost (most employers cover the larger portion), we have to pay the entire cost. But it keeps you covered continuously, which is important.
Someone who is uninsured would have a harder time. Individual plans are very expensive, and I am not sure but it might be that the rules about covering everything might not apply for individual applicants, only for people getting insurance in a group plan.
The other caviat is that a lot of companies use HMO's, or managed care, where what services and procedures are covered can be restricted. So, while they wouldn't be able to say they won't cover anything related to say, one's diabetes or depression, they would have limitations on what types of treatment or how treatment is delivered.
Posted by photojenny on April 6, 2003, at 5:47:40
In reply to Re: Medical Insurance - UK Members, posted by noa on April 5, 2003, at 23:32:22
So how does the whole US hospital/medical care system work? Really all I know is that one needs to have medical insurance to enable satisfactory medical care, but I don`t know how this works - e.g. how much are you required to pay; how comprehensive is this; how do you cope if you are unemployed etc.
As I`m sure you`re aware, here (in the UK) we have the National Health Service which, although flawed in certain areas, is free to everyone. We also have private health companies (e.g. BUPA), but these are in addition to the NHS facilities. I do feel that we are lucky to have this system. I`m just interested to know how the US system works.
Cheers
Anna.
Posted by noa on April 6, 2003, at 13:37:31
In reply to Re: Medical Insurance - UK Members » noa, posted by photojenny on April 6, 2003, at 5:47:40
Generally, most people get their insurance through their employers. It is considered a "benefit" like paid vacation, etc. It used to be that employers paid all or most of the insurance premiums. Nowadays, the amount that the employee has to pay seems to have grown.
The type of plan you get depends on what options your employer offers, and what you can afford to pay for. Often, the better the plan, the less the employer chips in.
Many plans have some kind of "managed care" (or as one advocacy organization calls it, "managed cost"). This can be a Health Maintenance Organization (HMO) which in its "purest" form is like a self-contained clinic. Ie, you cannot choose which doctors or hospitals to go to. Also, usually managed care means that many treatments and procedures require pre-authorization. There is a lot of controversy about this, of course, as many patients and doctors say it gives too much power to the executives and not to the doctor and patient.
Because of the controversy, many managed care programs are not as severe anymore. Many are a network of doctors and hospitals you can go to, and the participating doctors and hospitals agree to take a reduced fee from the insurance company, when they sign up. Only with some insurance companies, the fees are really low and don't keep up with the real fees (and sometimes not even with the costs!), so then many doctors and hospitals decide not to renew their contracts. Around here, many pdocs no longer participate in managed care insurance.
So, if you have one of these network programs, you have a little more choice, but usually you still have to get a lot of pre-authorization. If you want to see a specialist, you might have to get a referral from your primary doctor, which can be a bit of a hassle, and you have to go to the specialists on the list.
Some of these programs also limit mental health coverage, although there are states that have "parity" laws (interestingly, though, this info is not always made that public, so a person may read the insurance information and think they are only entitled to 3 or 4 emergency sessions/year, though they may live in a state where covereage has to be on par with other medical coverage, but they may not know that because the insurance companies don't tell them!). I know that there was a parity law introduced in congress but I don't know what happened with it. Maybe someone else can say.
The other kind of option is more expensive (which is not a problem if your employer pays the whole thing or most of it, but is a problem if you have to pay a lot of it). It is one where you can basically go to any doctor or hospital. You pay less if you go to one in their network--usually only have to pay a small fee when you go. If you go out of their network, you pay up front and submit a claim to get payed back. It is a bit of a pain, but if you need care that requires choosing the right doctor who might not be in the plan, it is the best option (it is the one I have).
If you leave your job, you have a right to continue purchasing the group insurance for up to 18 months. This is called "COBRA" (I forget what it stands for). But you have to pay the entire premium yourself. But it gives you coverage until you get new insurance.
If you are on welfare there is insurance called Medicaid. Usually medicaid uses a managed care network, and they are notorious for paying ridiculously low fees so there are lots of doctos who don't take medicaid.
When you are older, you are elegible for Medicare, which is funded through payroll taxes that we all pay. This covers most health care, but not much, if anything, for prescriptions.
People who are unemployed, and many people who work but don't get medical benefits through their employers, are uninsured (I think the latest stat I heard is about 40 million + Americans are uninsured). They either go without, or use free clinics, or show up at the hospital (the public hospitals that won't turn them away) which of course, drains the funds of those hospitals. Many uninsured people don't get preventive care or early diagnosis, so when they do show up at hospitals, they are quite sick.
One of the bad effects of managed care is that many doctors' practices have become these huge bureaucratic group practices, becasue time has been taken away from care and given over to administrative tasks. I left my previous doctor because I did not like the way the practice was going--it grew huge (mergers) and each doctors visit was maybe 3 minutes and felt very rushed like I could not ask any questions. With the insurance I have, I am lucky to have the option of going to a smaller medical practice where the doctors (a young couple, actually) are respectful and take the time to discuss things.
A new thing on the scene, for the wealthy, is doctors who offer "concierge" service. This means, you pay a really hefty yearly fee, and the doctor only takes on a certain number of patients, and you are basically assured easy access to your doctor at any time. I think you still have to pay for the care you use, though. The yearly fee is just to reserve the space in the exclusive practice. But obviously this is only an option for people with substantial means.
I hope some other American will jump in to correct me if I described anything inaccurately, or to add info.
I'd also like to hear more about the British system, and the Canadian system, too.
Posted by cybercafe on April 6, 2003, at 23:31:14
In reply to Re: Medical Insurance - UK Members, posted by noa on April 6, 2003, at 13:37:31
> I'd also like to hear more about the British system, and the Canadian system, too.The canadian system is probably better than the british ... though it could be a lot better ...
the british is really bad for waiting... uh.. queueing.... one thing i did like about the british system was the ability to go private... in canada i find once you are doing okay they sort of lose interest in you ........... and the doctors don't really seem to care too much about you... or feel like they are accountable.. or want to keep you happy...
in the UK, at least if you have money you can go private ... where the doctor will try to please you ... and address all of your concerns... until YOU are satisfied .. and 100% better (not just not depressed, but able to hold down a good job) ... unfortunately this costs money... but i find the NHS waiting to see a doc is quite long (what 3 months? someone correct me please) in canada it's maybe a month and a half ? for a non-emergency case .... and in canada you can see a pdoc quite often.... once a month? or a few times a month? ... in the UK it was more like once every 2 months....
(on the other hand, in the UK when i went private i could see a new, good - i called around to find a doc who had prescribed gabapentin and that eliminated most - pdoc within 2 or 3 days!!!!)i feel bad for canadians, we have it bad, but the NHS is absolutely horrible... i mean it's really pathetic... (no offense) ... i feel really really bad for people in the UK
Posted by cybercafe on April 6, 2003, at 23:35:52
In reply to Re: Medical Insurance - UK Members » noa, posted by photojenny on April 6, 2003, at 5:47:40
> As I`m sure you`re aware, here (in the UK) we have the National Health Service which, although flawed in certain areas, is free to everyone. We also have private health companies (e.g. BUPA), but these are in addition to the NHS facilities. I do feel that we are lucky to have this system. I`m just interested to know how the US system works.
i'm curious about one thing... what percentage of people go private? .... it's not too expensive is it? i think i was seeing a "senior research fellow" and was paying about 45 quid a visit ...
is that not affordable? ... any idea how much .... income support? ... the government gives people suffering from mental illness?i think it's like ... DSS is rent + 55 quid a week ... and then... if you are disabled you can get another 50 quid a week, is that right?
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