During the week of the Republican National Convention, Kim opened the doors to her new loft in Minneapolis to host a house party for the Cover America Tour and supporters. When party-goers started talking about their experiences with the health care system, we were surprised to hear that Kim – who’d already endured the worst kind of tragedy – had an entirely new chapter to her story.

In the interest of full disclosure, Kim already has a place in the hearts of many of us at Consumers Union. A tireless advocate for drug safety, Kim has made over 40 trips to Washington, D.C. to tell the story of her late husband, Woody, who took his own life at age 37 after five weeks on antidepressants – sample packets given to him by his doctor to help him sleep better as he faced the anxiety of starting a new company.

Kim’s testimonials in Washington have helped convince Congress to pass stronger drug safety laws, including last year’s legislation requiring the disclosure of clinical trial results and tighter regulations on drug advertising.

Looking towards the future Kim has made some recent life changes, including a fresh start in her new home and leaving a company she’d been with for ten years to go out on her own as a freelance ad producer.

Enter the insidious individual health insurance market.

Kim maintained her coverage via COBRA until it expired after a year and half, and then decided to purchase an individual policy through the same company for the sake of ease and consistency. After all, she’d had insurance with them for over a decade.

She was denied coverage.

The company decided she had “mental illness” and rejected her for having had the audacity to use the 20 annual visits to a counselor that were included in her previous coverage. She explained that it was grief counseling after the sudden loss of her husband. They said that’s how it starts for people with mental illness.

Incredulous, she called another company. They rejected her on the same basis. After rounds of phone calls, arguing, and talking to managers she was finally able to get them to sell her health insurance … but the counseling is excluded for two years.

Now in order to continue to see the therapist she’s spent years building a relationship with, Kim has to pay out of pocket or not go at all. The therapist feels terrible that the visits nearly cost Kim her health insurance. Kim is outraged that she now has to pay for the visits – one of the only things she’d actually used her coverage for.

During a summer of listening to health care stories from people all across the country, we thought we had heard it all when it comes to heartless maneuvers by insurance companies. In fact, we heard about a nearly identical situation when we visited Janne in Norman, OK.

But the injustice of Kim’s circumstance seemed to take it to a new level. She was denied coverage by an insurance company because she had actually used the coverage it had previously provided her and told her she was entitled to use.

An insurance company behaving this way no longer shocks us, but it does make us mad as hell. It’s cruel and callous. Going through what Kim has experienced with her insurance company would no doubt make most people depressed, maybe even to the point where the healthiest thing to do is seek some professional help. But take it from Kim, you don’t want something like that showing up on your record.

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comments (3)

Comments

1 Posted by Nancy at 09/16/08 04:28 AM

A friend of mine was denied coverage when she applied for health insurance because she was on antidepressants and was undergoing counseling. The insurance company said they wouldn't cover her because of mental illness.

2 Posted by Don Eliason at 09/24/08 08:40 PM

I was under the impression that insurance companies could not denie coverage using a pre-condition sympton.Am I wrong or does not using coverage for grief counciling constitute a pre-condition.Also,did Kim file a complaint with the insurance commision in her state or call her local representative,most of them were probly in town for their convention.I would appreciate a response to any or all of my questions if you could,thanks.

3 Posted by Cherie Lyon at 10/08/08 05:15 PM

Some insurance companies will not even cover MH medication.
I just finished paying Aetna back after they retroactively rejected claims for my ADD medication AND the meds to counteract the side effects. Under the new bill, can I sue Aetna to get the money back?

I can't pay $500 a month on medicine and also another $300-$400 for health care! It's insane. But I can't focus on my job without the meds, and insurance is reluctant to let me have them.

So... I pray I don't get sick or injured.

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