Mental Health Exclusion- options going forward?

[TraumaSurg85]

Been a longtime lurker, and am so thankful for this forum. This is a more personal question, but after a lot of research I decided that Guardian fit my needs the best for disability insurance and filled out the application. After going through my medical records, the only exclusion they had for me was "mental health benefits". They said that since I take medication for ADHD, that I would be excluded for any disability pertaining to mental health or substance abuse.

For a little more detail, I have been on the same medication for over ten years, and am on the minimum dosage that could actually be prescribed. I only take it when I have 3 or more hours of paperwork to do. In medical school and beyond it has been extraordinary helpful, even to this day. They say that all companies would put this same exclusion into the contract during the underwriting process. The only way to get this exclusion removed would be to have 4 years without treatment, and then I could apply to have the exclusion removed.

My questions are: 1) Is my best option to accept the exclusion and go forward with the contract? 2)Is this an exclusion that every company would give me, and is there any way to negotiate this? and 3) In general, is there any other manner of going forward that is not covered by my first two questions?

It seems silly that they would exclude me from a whole area of coverage because of a condition I have been successfully treated for more than a decade for. But I guess that is the way sometimes that insurance works.

Thank you in advance for any help you can offer

[Scott at MD Financial Services]

If you are currently on meds for that then most carriers will exclude coverage until you are 3 years post not taking the meds. There maybe some options which give a better solution / benefit options so check with your rep to carrier shop every carrier for you.

[Lordosis]

General question.
when you are excludes from a category like this do you still have to pay full freight for the policy or it it discounted. Especially since mental health and substance abuse is likely one if the biggest offenders for younger people.

If so can you opt out and take the discount?

[Scott at MD Financial Services]

Some carriers will give a discount to limit benefits to 2 years but if the carrier determines that a mental nervous exclusion is in order then there are no further premium discount allowed beyond that The exclusion is typically ICD9 tables of 290-319.

[billy]

Have any carriers changed this exclusions for certain specialties that were automatically excluded, like anesthesia?

[Scott at MD Financial Services]

Anesthesia and Emergency Med are typically hard to get benefits on M/N beyond 24 months but that is starting to change. I would think with new product rollouts that are happening in 2021 you will have more opportunities based on what I have seen of the new product designs.

[hebel]

Depending on your personal and family mental health history, I don't think opting out of the mental health benefits in general is a bad idea. I purposefully did it to save money, and I'm a psychiatrist.

A lot of us are purchasing the bulk our long term disability benefits at or after we turn 30. By that time, developing one of the few psychiatric conditions that could cause long term disability is statistically unlikely (e.g. you probably would have already developed schizophrenia by age 30).

Depression, anxiety, substance use absolutely can happen to people in our field, but those conditions are unlikely to keep you from working for more than the typical elimination periods in these policies. So basically I'm saying I wouldn't sweat it, and it fact would consider requesting the mental health benefits be removed anyway to save money.

[Scott at MD Financial Services]

Hebel,
I agree, we have never had a single client exhaust their M/N benefits and that is over the last 27 years....