Posted by Stephan on April 23, 2001, at 1:23:27
I am 30, male, and in the process of trying to find a doctor to diagnose and treat my adult A.D.D. with standard medications. I only just recently realized (through research and putting the pieces together) the extent to which my unrealized and untreated ADD has affected the course of my life thus far. I believe I have a strong and legititmate need for stimulant type medications. (Also, I have difficulty holding a job for very long to have a better health plan, and therefore don't have much money to spend on doctors visits...a catch-22.)
I have individual PPO insurance with Blue Cross California, and they will not cover me seeing a psychiatrist ("mental health") until after I have met a $2500 deductible, so that is why I am looking for a neurologist, general practioner, or endocrinologist ("physical health") to treat me. The only claim I have ever submitted to this insurance company is below.
A couple years ago, I made the mistake of asking a Dr.'s billing dept. to see if I could get a doctors visit, in which I was prescribed a permit to use medical marijuana, covered by the same insurance co. The insurance co. declined, but has the request on record/file now.
However, I recently spoke to their representatives and they told me that, specifically in regards to Adult A.D.D., there is a review process to determine whether or not they will cover any expenses once a claim is submitted. They also said that it depends how the doctor words the diagnosis and suggested treatment protocol...ie. if he/she states the ADD is deemed to be a "medical condition". Still, I am unsure if they will cover costs incurred, and I don't even have the money to risk playing with in an attempt to get diagnosed and treated, since I could end up having to foot the $150-300 for a single initial office visit consultation being billed to me. (Even with a positive ADD diagnosis, which is not certain, though the bill will be. Plus, I may have to check out more than one doctor to get an affirmative ADD diagnosis.) So I am looking for some feedback as to my situation, as well as possible options or recommended protocols.
I am worried about how this previous claim for a request to cover a medical marijuana prescription is going to make me look when asking them to cover the necessary doctors visits, and any Schedule II stimulant medications needed by me, to my insurance company. I worry that it might look to them that I am on round two of simply trying to get another kind of scheduled "drug" for illigitimate uses perhaps, given my age in relation to ADD, compunded with the marijuana issue. (BTW, there is no other record of anything else having to do with drug use in my life record.) I am thinking that if this marijuana issue delegitamatizes my claim further in their eyes, I dont have much of a chance for being treated so I can live a more productive and rewarding life. If so, aside from any other (unknown) resources, my only chance for treatment seems to be to manage to hold down a job with my untreated ADD until the health benefits kick in, before I can begin* treatment.Any feedback, information, suggestions, or links to resources is appreciated. Also, links to avenues of low cost / community resources appreciated.
P.S. A related question, is if I switch* insurance companys, via an employee plan or self-purchased, will the new co. be able to find out about this previous medical marijuana issue as well? If so, how?
Thanks in advance,
Stephan
poster:Stephan
thread:5767
URL: http://www.dr-bob.org/babble/social/20010417/msgs/5767.html