Pre-Existing Hypochondria

My sister is a hypochondriac and has been in and out of doctor’s office for years. She is currently exercising her COBRA rights under her ex-husband’s health insurance plan which is due to run out at the end of the year. I am worried, given her history and the amount of medication that she currently takes, that she will not be able to acquire individual health insurance through the private market. Does she have any options?.

Once she has exhausted her COBRA benefits, she will be eligible for guaranteed issue coverage under federal HIPAA laws. Given her health history, she will not likely qualify for standard individual health insurance. Hypochondria, also referred to as health anxiety, is a somatoform disorder in which no explaining diagnosis has been found for the symptoms that the patient is describing to the physician. This condition is often associated with OCD’s and anxiety, and physicians are cautious about making this diagnosis. What usually ends up happening, as appears to be the case with your sister, is the physician prescribes a medication for the condition that the patient thinks they have. Many do this because for a hypochondriac, the medication can often have a placebo affect that reduces the symptoms.

When you sister loses her COBRA and tries to get private health insurance, she will most likely list all of these conditions that don’t really exist. The insurance company will view her as high-risk, which she definitely is, and decline her application. In California, every insurance company that offers individual health insurance must offer at least two of their health plans under guaranteed issue HIPAA regulations. The premiums are high and coverage may be limited, but she will have access to health insurance. Given her frequency and desire to visit a physician, it might make sense for her to select a plan that has a lower deductible and higher premium. Or, if available, find a guaranteed issue HMO plan.

3 Comments

  1. Yes HIPAA, i do understand that the premiums are high vary on state location, but does cobra healthinsurance vary with other policies that are out today. Or is it just the same insurance hidden under a name, thanks and love the blog page.

    Comment by Jeff McClendon — November 8, 2007 @ 3:29 pm

  2. COBRA is a continuation of the group health insurance that you are losing as a result of leaving a job that provided you with health insurance. Under COBRA, you will remain covered under the same insurance policy that you had while you were employed. Guaranteed issue health plans under HIPAA regulation allow you to move to a permanent and private health plan with a different carrier once you COBRA has been exhausted.

    Comment by admin — November 8, 2007 @ 3:38 pm

  3. Hi, I have another question for you: What stops the insurance companies for kicking off customers they deem to be hypochondriacs? Let’s say they have a customer who has been healthy their entire life, but suddenly begins to feel ill somehow and then goes to the doctor. Maybe he or she really has an illness or maybe he or she is an hypochondriac, but the test show nothing while the cost keeps on growing. This would be common in some diagnosis such as CFS (Chronic Fatigue Syndrome). That can be a very costly affair, when a person goes from specialist to specialist. Is it possible for a health care insurance company to kick someone of their plan because they suspect them of being a hypochondriac?

    Comment by Dean — June 6, 2009 @ 7:08 am

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