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ADHD a pre-existing condition ?

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February 21st, 2010
I am about to turn 23 (Student), and am about to be kicked off dad's insurance (Tricare). I just started getting help with some ADD issues, and realize this often constitutes as a pre existing condition. I am looking for health insurance, but none of the online materials state directly whether ADD counts as preexisting; but i am going to assume so. I realize there is normally the 12 month period of insurance with new isurer before they will cover the ADD appointments and medications...
Here is the issue... I read online about HIPAA and how it protects people with pre existing conditions if they go from credible coverage to another GROUP plan, but does it help with me going to an individual plan? I could join my jobs (part-time plan) but to be honest... it is a limited-benefits plan and is terrible)...

Looking for advice:
option 1: go with work's plan (not a good one) and likely still have ADD stuff covered ( I think)
option 2: go with individual coverage and not have ADD things covered for 12 months... unless someone knows something I don't..
Option 3: you suggest.

Time is of the essence,

Thanks
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michiganhealth
replied April 7th, 2010
Hi Insurancehelp,

If you have the opportunity to take a group plan (even one that doesn''t seem that good) it will most likely be better than any individual plan you could get. Plus you don''t have to worry about not getting coverage due to pre-existing.

In the individual market, some carriers will deny coverage for ADHD. It depends on how severe and the treatment that is taking place. Of course, nothing is for certain unless it is reviewed by and underwriter.

If you were my kid, I''d tell you to take the group plan. But alas, you are not. Therefore the final decision is up to you.

Regards,

B
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ADHDboy
replied October 4th, 2011
ADHD a pre existing condition?
I am 31 and just recently took a new job where I had to find my own insurance coverage. I just got a huge surprise when I found out that I was denied coverage due to me admitting that I had ADHD. I am lost for words and can not believe how I could be turned down for insurance for having ADHD! What do I do? I am hoping I will try to find another company, but I am nervous that some how other companies won't insure me either. Does anyone have any advice to give? Next time I apply I just won't put down that I have ADHD......
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MyrahU
replied October 24th, 2011
Extremely eHealthy
Unfortunately, all that information goes into a databank called the Medical Information Beureau (MIB). Which means, even if you don't say you have ADHD on the next application, the insurance company is going to look you up and see you were previously denied and reject your application based on the MIB report.

Also, if you intentionally leave off information, even if they don't catch it, that's called misrepresentation, maybe even fraud. Very bad. Very very bad. Don't do it.

How long ago did you have insurance coverage before? Were you able to get COBRA after that or has that period passed? If you are able to get COBRA still, I would jump on that right now if I were you, regardless of the cost, then worry about converting that into an individual health plan tomorrow or whatever.

If that's not an option, I found a website with some great information about this subject that might help you, but I'll have to send it to you in a Private Message because otherwise the moderators will take it down.

I hope this helps. Best of luck to you.
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JenSMP
replied April 27th, 2012
ADHD is a pre-existing condition
I know this is an old post, but just in case it helps someone else, I wanted to point out that you might be able to get an individual policy and just pay a higher premium b/c of the ADHD diagnosis. Or, you could get a rider where you'd be covered for everything except ADHD related medical issues (given that's the only pre-existing condition). It's the cost of the medications that usually send the red flags to ins companies insuring an individual. I am in the same boat right now trying to get insurance for my family. We are currently covered under a group policy, but because of an upcoming job change will likely be seeking an individual policy. Both my son and I have ADHD, so we've been advised that we'll pay about 25-40% more for our monthly premium. Yikes!
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artee
replied December 3rd, 2012
ADHD pre-existing condition
What are my options?
If anyone is still looking at this thread...I have ADHD and I'm about to turn 26 which means my dad's work plan won't cover me. I'll be in school overseas till 2 months past my b-day and i don't have any other u.s. coverage as of now. How do prevent being denied reg/reg cost insurance coverage when i return? Any info on this will be appreciated. Thanks in advance!!

p.s. I live in NY if it makes any diff.
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