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Health Insurance California Companies Question & Answers

2013 July 16
by Sarah Fields

Ruth asks…

If a diagnosis of Clinical Depression allows insurance companies to deny coverage, where do you go ?

A friend has gone to therapy and was prescribed medication by an M.D. Now Anthem, Blue Shield, Blue Cross have denied her health insurance. She lives in California and would like the luxury of being covered by a health insurance policy. Anyone have any suggestions ? Thanks.

Sarah Fields answers:

Group plans do not have the same stringent clauses that private policies have. Since there will be (on an average) a equal number of healthy people covered as those with chronic, preexisting or mental health related issues they figure the profits off those who will not need medical coverage will cover those who do make claims.

The only thing your friend can do is to shop around. There may be some companies willing to overlook the clinical depression. If worse comes to worse, she will need to look into PPO’s or HMO’s. The coverage may not be as liberal as a private policy but at least she will not have to go uninsured.

Lisa asks…

Does any health insurance company cover someone who was diagnosed clinically depressed?

A friend of mine was depressed, had some therapy, and is now taking medication. She is now uninsured, being declined by Anthem, Blue Cross and Blue Shield. Does anyone have any ideas on how she can get health insurance? She lives in the formerly great state of California.

Sarah Fields answers:

The information given by Stephen looks pretty good. She might have to pay a lot but she will be insured. She can always go to a community health clinic which is on a sliding scale if she does not have much money.

Why doesn’t she apply at Kaiser?

Jenny asks…

Want to help with CA legislation to make sure health insurance provides maternity/pregnancy coverage?

I am working on a bill in the California State Legislature to close a loophole in the law that is allowing some health insurance companies to sell policies that don’t provide pregnancy care. If you’ve been in this situation (insured and pregnant without maternity coverage) and would like to share your story and help pass the bill to help other moms and families, please get in touch. Thanks!

Sarah Fields answers:

I think this is wonderful frankly. I quit a job when I read the health insurance policy. The owner of the small company was done having kids so saw no reason to continue carrying maternity coverage for his employees. 5 other employees quit after I did for the same reason (one had a wife who was already pregnant- big surprise for HIM).

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