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Why is it impossible for a Bipolar I diagnosed person to get health insurance?

I am a 26 year old, fully functioning, working, female adult who just happens to have a Bipolar I diagnosis that I got at the age of 21 while still in college. It so happens that I was on my parents healthcare until the age of 23, and then was uninsured. I have had several high paying jobs with group benefits since then, but I recently quit the last one to return home to help an ailing family member with a family business. Because it is a company of under 6 people, there is no group insurance plan. I have money and am proud that I earn my own wages. I have NO problems paying ridiculous amounts for health insurance, provided that they will cover prescriptions and everything but co-pays. My current insurance plan is crap and will not cover any psychiatric treatment, will only cover regular medical expenses (broken arm, stitches, etc) after I've paid $500 out of my own pocket, and no prescriptions. I have applied (and been denied) for health insurance already from: Blue Cross Blue Shield, Humana, United, and a couple of other major health insurance agencies. They all reject me immediately because of the Bipolar I diagnosis. I have appealed this rejection a few times because I have never been hospitalized as an inpatient, I have never hurt myself, etc. It seems very unfair to me that they randomly reject me without viewing my case file. My psychiatrist is even willing to write a letter on my behalf and I have had insurance agents personally appeal to underwriting, to no avail. I have had NO problems with my disorder since I've been medicated, which was December of 2003. Any suggestions here? I really need health insurance... at some point I'd like to have children, and nevermind the fact that I just want to be covered in case of emergency. Thanks! Some additional details: I *did* qualify for COBRA and paid it, the last payment they did not receive in the mail so they cancelled me. I appealed it several times and lost it. My state does have a high risk pool but I was told I did not qualify. Any more information on this is appreciated. I make too much money to qualify for Medicare or prescription assistance. Thanks!

Public Comments

1. Welcome to the wonderful world of "Pre-Existing Conditions". I have a seizure disorder, and have also been turned down by all the major health insurance companies. You're going to end up paying twice for all your medications if you get insurance anyway because they won't cover what you need it for in the first place. I have been suffering for 2 and a half years with no medications because of this. I'm sorry. Good luck, and never stop trying!
2. try Aetna, i am bipolar, and when a company i worked for had them there was no problem going for outpatient psychiatric care but it only covers so many visits a year, they cover in patient psychiatric care for up to 7 days have a good prescription plan and even offer discounts if you enroll in their wellness program consisting of going to a gym and submitting your monthly log of dates and time, flu shots, blood screenings for cholesterol and such. also if it did effect your work you would qualify for disability, and get a state medical card as well as medicare and disability check. i'm not that bad yet, but if it ever comes to that then i will denfinately do it. you always get turned down the first time you apply for disability, but with a disability lawyer you should have no problem on appeal. i know a lawyer here that specializes just in disability cases and he said he has never had to go in for a 2nd appeal on bipolar cases.
3. You're going to have to find a different job with group health insurance, qualify for Medicaid, or enroll in your state's high risk pool (which will be very expensive...premiums can very well be several thousand dollars a month). If you were eligible for COBRA coverage when you left your previous employer, you should have taken that coverage immediately. Once your COBRA eligibility exhausted, you may have been eligible for a conversion policy. (Yes, COBRA is expensive, but for someone in your position its still one of the better options.) Unfortunately, you are quite unlikely to be accepted for an individual policy. Group insurance would be the best way to go, if you can get it. Insurance companies view your condition as a financial risk. Even if you haven't been hospitalized yet, a bipolar person has a higher than average risk of racking up some significant medical bills. And then there are the medications that your insurer will have to pay for every month. Check to see if you qualify for Medicaid in your state or get a different job that comes with group health benefits. That's the best advice I can give you. Sorry.
4. OK, starting at the problem... 1. They are not denying you because of your current condition (which is under control), they are denying you because of "future claim dollars". Right now, there really isn't any long term data available on bipolar and the meds used. Insurance companies aren't nice. They are in business to make money. 2. You need to investigate and see if your state has a high risk pool, that may be your only option (but confirm the maternity coverage) 3. If you have Cobra still as an option (60 days from the date you received the letter), get on it. Quickly. You do not want to have a gap in group coverage. Ever. Even you go with the high risk pool after 18 months of Cobra, they can apply pre-ex exclusions to your bipolar treatment and meds. Unfortunately, you will need to always try and have group coverage or live in a state that offers a high risk pool.
5. With mental health issues it's not always the issue so much as it is the medications. Had a friend decide that it would be really smart to jump on a moving car and smash the windshield with his forehead. The medications can impair judgement and lead to more accidents and other things. AND, even though you may be fine you're unfortunatley pigeon-holed with everyone else with the same condition. I can't imagine why you wouldn't qualify for your state high risk pool. That's ridiculous. You should also qualify for a HIPAA plan (potentially).