Is there a reason to not go through insurance for behavioral health?

[Globetrotter]

My friend wants to consult a child psychologist (and possibly a child psychiatrist, if needed) but she is concerned about it getting on her record.

I guess one way to avoid the insurance issues is to pay out of pocket, as I've heard some people do. Is there any good reason to go through the hassle and expense? Could this information be used against her dd eventually, either through insurance or otherwise? (I'm hoping health care reform will at the very least resolve these problems..)

I had considered consulting a psychologist in the spring, before we knew that ds was reacting to Claritin, and at that point I was going to pay out of pocket but never got around to it since he was okay after we stopped the meds!

[dcmom2b3]

I don't know, seems like if she were going to switch insurance at some point she'd have to disclose any of the child's pre existing conditions, whether or not she had sought coverage for their treatment.

I know that adults are frequently concerned about employment/security clearance consequences, but I can't think of any analogous concerns for a child.

Wait, I did see one preschool application last season that asked if the child had sought psych/behavioral health services. And asked for a picture. Why was I not surprised that their classes were filled with perfectly coiffed stepford children with no joy in their eyes?

I'm interested in what others have to say, b/c I'll be consulting a therapist for Bunny at some point.

[crl]

Some people have reported being excluded from insurance coverage because of an autism dx. And the US military does not take people with autism dx. Whether that kind of information follows someone from childhood all the way to applying for insurance, etc as an adult, I do not know. I also don't know if other dx have similar consequences.

Catherine

[C99]

You could go through your EAP instead and it is completely anonymous.

[Globetrotter]

You could go through your EAP instead and it is completely anonymous.

Thanks, but is this true for their child, though?

[Globetrotter]

Wait, I did see one preschool application last season that asked if the child had sought psych/behavioral health services. And asked for a picture. Why was I not surprised that their classes were filled with perfectly coiffed stepford children with no joy in their eyes?
.

:shake: Does that mean they will reject anyone who dares to admit their child's problems???

[C99]

Thanks, but is this true for their child, though?

Of course. Depending on who your EAP is, you don't even have to give your name.

[sste]

I think pre-existing condition is the only issue. Sometimes prior mental health treatment comes up in life insurance applications but presumably not an issue for a DC!

I am a REALLY big proponent of not getting hung up with this "on your record" business. We have had some friends who did not get their toddlers/preschoolers help (severe speech impairment for one and autism spectrum for the other) for years because they were paranoid about this on the record business. That is years of valuable early intervention lost and in at least in one of the cases it either created or exacerbated a situation where the child is now starting public school two years behind her peers.

If anything, my feeling is you want to get things on their record so that way you can qualify for free special services and individualized education plans when the DC is school-aged.

[let73]

She could also try their county mental health center if one is available. The one in our county provides services on a sliding scale. They may fall into the full fee category but it would not be reported to their insurance provider.

DH had some mental health services for depression. When we tried to purchase private insurance (in between employment) he was denied coverage. We now have insurance through my employer and he was not denied that coverage.

I just hope that health care reform is also going to include no pre existing conditions for mental health care.

[Globetrotter]

I am a REALLY big proponent of not getting hung up with this "on your record" business.

I'm with you. Back in the Spring, she was concerned that I was going to seek a psychologist eval. for DS, but I feel it is critical to take care of behavioral problems, just as I would take care of their asthma. I was happy that she is considering it now for her DD because I can see it's causing their family a lot of grief. It's not a question of finances as they can afford to pay out of pocket, but more a question of pre-existing condition issues if they use insurance or somehow getting on their record and causing problems down the line. The girl is only six, btw! I'm going to direct them to EAP to see if that will work, though I looked on the website and didn't see anything about covering children. It's worth a shot!

[sste]

Often a pre-existing condition either has no effect or creates a waiting period before the new insurance can be used for the pre-existing condition. States have different laws and I believe a few states don't allow insurance companies to alter coverage or deny based on pre-existing conditions.

She should call her insurance and discuss. It is most likely not going to cause any problems and she may as well use the insurance she is paying for!

[dcmom2b3]

:shake: Does that mean they will reject anyone who dares to admit their child's problems???

Yep, that's what I gathered. Or who doesn't look/dress a certain way. :mad: I didn't let the doorknob hit me on the way out of that open house. I knew my hippy-dippy happy child would NOT fit in.

[kozachka]

One of DS' friends had speech issues and got help. His mom told me that in CA child's record gets wiped out at the age of seven so she is not concerned.

ETA: I believe that you are supposed to disclose any and all doctor visits/treatments no matter who paid for them. I am in the process of applying for an individual policy and have to disclose everything, even if it were done outside of the country.

[dcmom2b3]

Often a pre-existing condition either has no effect or creates a waiting period before the new insurance can be used for the pre-existing condition. States have different laws and I believe a few states don't allow insurance companies to alter coverage or deny based on pre-existing conditions.

:yeahthat: I think this is especially true in group ins. situations. There's also federal legislation (HIPPA i think) that addresses the situation. But if individual coverage is involved, that can be a whole different story. If they're family situation is such that they'd ever need to buy individual coverage they might want to think about it, but ultimately, so long as there's a dx made, whether it was covered or paid out of pocket is probably irrelevant.

And ITA with PPs, delaying/avoiding a dx is probably the worst thing that one could do for behavioral services.