This has been the most difficult article I have written to date. It is such because there are countless scenarios that could occur to make this article make sense to some and way off the mark to others. I also have a limited space in which to write so I hope I can cover at least a part of this issue thoroughly.
Anonymity is something that has made recovery possible for millions of people whether they are in Alcoholics Anonymous or in any other 12 step recovery program. We can make personal decisions about anonymity as far as family, friends, business colleagues and anyone else that might come across our path usually without any repercussions. But what about health care providers? What do we tell them? What do we not tell them? How does information about our addiction affect our insurance? Do we become a health risk? Are there any other consequences in being upfront and honest with our health care providers?
The hard part is that no one can answer those questions for you. I have heard it said at meetings that you should always tell a health care provider of your addiction especially if you are to be given certain drugs or painkillers. I disagree. (As a matter of fact, taking medication, even prescribed, is one of those controversial subjects I will address at a later time). I cannot speak for any of you nor can I speak for any medical personnel but I can tell you what I have learned from first-hand experience. I also asked my very Noble Friend, Dr. M, very specific questions about what is written in the patient’s records as well as confidentiality. He gave me some very helpful information but did mention it would be easier to explain how a dialysis machine worked! That is how difficult this subject is.
Let me make it clear that this honestly isn’t about health care providers as much as it is about insurance companies. This also might not make a difference to you if you presently have health and life insurance. The problem is when you have no choice but to find a new health insurance and life insurance provider. If you have insurance benefits with your employer or a spouse’s employer what happens if and when the job ends? This is where the nightmares begin! And these nightmares do not happen only to those of us who are admitted addicts. They can happen to anyone.
When you need new health or life insurance, you must provide a list of your health care providers as well as a release for these companies to secure your health records. If you leave something or someone off of the application you may be denied based on the fact that you also signed something that said all of the information you gave was true and complete. Everything in your medical record is looked at and interpreted by these companies and in the case of life insurance, the information is sent to the MIB (Medical Insurance Bureau). The MIB is powerful and although each insurance company you apply to is supposed to make their own judgments about you as a prospective customer, many insurance companies do not make their own decisions and immediately go to the MIB. In other words, what the MIB says is the way it is even if your own doctor disputes their findings.
I mentioned that I asked my Noble Friend, Dr. M. a few questions. Some of my questions involved way too many scenarios as well as the individual style of a doctor. But I did ask him if physicians thought about what they were putting in a patient’s file as it might later be an issue for health or life insurance. His answer was, “I honestly do not think that a physician thinks about potential disclosure to an insurance company when he is charting progress notes”. I totally get that. He also went on to say that when the physician writes down conclusions from subjective and objective information as well as the diagnosis, he/she may also record “some soft concerns that he may want to pursue and follow up”. In other words, the physician may write that although you did not disclose the information, he believes you may have a problem with alcohol or drugs. This is NOT a diagnosis but “one that an insurance company might flag”.
Here is a real life example of the above. During a routine visit to the doctor, “Ann” said that she was feeling depressed. The doctor delved a little deeper and then asked if she had ever had thoughts of suicide. Her response was “absolutely not”. But the doc wrote down information on “Ann’s” chart that when looked at by the MIB, denied her life insurance as she was a “risk”. She received the denial from the insurance company but it was the MIB who denied her first. Knowing full well she did not say she was suicidal, she decided to contest the whole thing. She contacted the insurance company and her physician. Her physician said he was very willing to write or speak to anyone on her behalf and he did. She also called the President of the insurance company and with her physician on her side was given life insurance. But it is NOT over! The MIB refused to change anything in their records. They said they were standing by their interpretation of the information and that was it! If there is any time in the future that “Ann” needs insurance, she is going to go through the same thing.
I said in the beginning that there were many scenarios and I have only given you one that is real. What prompted me to write this was that a woman in a meeting shared she was denied insurance because she was an alcoholic. Think about it. Alcoholism is a disease and it cannot be cured. We know that which is why we keep coming back! To insurance companies it is a pre-existing condition. Even if you get the insurance, the premiums are so outrageous that you may have to try to justify why you even need it.
Please understand that this is the tip of the iceberg to me as far as anonymity, health care providers and insurance companies go. Each of us has to make a personal decisions as how best to handle any of this. I would never tell a person not to see a doctor or discuss health issues. That would be foolish. What I would say is know what is in your medical file(s) and if there is anything at all that you might be uncomfortable with, talk to your doctor. If “Ann” had done this, she would have been spared a lot of anxiety and even anger. You can’t eliminate the truth in your records but if the information is not a diagnosis and what my friend calls a “soft concern”, take care of it before it ever becomes an issue. Thanks to Dr. M for his help. I love you, my Noble Friend!
Namaste’. May you walk your journey in peace and harmony.