Q: Coverage denial and divulged mental diagnosis
asked by:
robsok
on February 2nd, 2008
New User
Hello, I am a bit troubled by what has occurred to a close friend of mine when she was recently denied coverage by Pacific in California. She had been attending university while covered under her parents policy and in late December her parents tried to help her set up individual coverage with their current insurer. Earlier that same December senior year anxiety and relationship issues prompted a session with a doctor at her university's mental health clinic. During her years at school she visited with counselors on campus twice because of stress/anxiety. Her insurer needed the doctor's information for her Dec. visit to determine coverage but he was not very prompt with the needed form and her coverage under he parents' existing plan ended on Dec. 31st. Early this January after not hearing back from their insurer my friend called Pacific to be told that due to pre-existing conditions they were denying her coverage because of depression, general anxiety and obsessive compulsive disorder. I was blown away with how they could just give this information to her over the phone and she was devastated to hear about the diagnosis first from some stranger on the telephone. She had previously received psychotherapy for depression when she was 12 but had not experienced nor needed professional help for any disorder for many years outside of the two visits to free counseling available on campus as mentioned above. Also, how can a mental health professional come to such drastic conclusions from one hour long session? She's currently stuck with very pricey insurance options now and she is at a loss of how to appeal the denial of coverage or how to proceed with receiving the treatment she may need. If anyone has had a similar experience with being denied coverage, please, I'd like to hear from you.
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