Aspies For Freedom

Diagnosis and Insurance

I was diagnosed with AS by a psychologist (although AS was not the reason I initially went to a psychologist).

He told me the diagnosis, gave me information on the syndrome etc ...

However, I recently found out that he did NOT put that diagnosis in my records.
He says this is due to insurance?

Should I be concerned?

I am NOT the only one who has had a similar experience (I ran into someone in another forum who mentioned a similar experience).


What are the advantages/disadvantages of having the diagnosis "official"?
(besides the fact that people, in various forums, hesitate to believe that a person really has AS, if they don't have that "official" diagnosis).

I don't know. I am 18 and the director of special services was working on changing my classification to Autism FOR the purposes of insurance.

I am not aware that Asperger is a problem for car insurance, life insurance, short- or long-term disability insurance (60% of income if unable to work), or health insurance.

My depression is under control, so I do not consider it a problem for driving purposes.

I have actually heard that it can be an issue.  When I was calling around looking for a specialist that was on my insurance plan, they often recommended that we choose someone and self-pay to keep it out of the records.  

We did, but because I did not like any of the people that I called that were on the insurance plan.

I don't think you have much to fear even if your dx is "official", mine is, and it is on record, I have rehabilitation, computer programming training at public expense.

I think the advantages outweigh the disadvantages.  
With a diagnosis, you might get public support for treatment of comorbid conditions, esp. depression, job training, and if necessary, legal protection.

If you don't have a diagnosis forget it.  In the USA we are less quick to help "somebody" who "just needs it" than a person "who needs it because of a disability".  

The question is asked, "do you have a disability?"  
Bad luck is not a disability.  Being poor is not a disability.   Being a minority is not a disability.   You might get aid because you are poor or a minority, or you might not.  

Now, it is possible that some private health insurance plans might jerk you around, especially if they do not have a lot of members.  I asked a co-worker about the movie Sicko.  He said larger insurance plans cannot do that because of the number of people who would complain.  Smaller plans could get away with it.  I have been fortunate with my employer health insurance.  We seem to be in a big plan because they don't jerk us around.

Anthem Blue Cross/Blue Shield.  Before that we were with Mid-Atlantic Medical Services Inc. (MAMSI, an HMO located in Rockville)

I don't think it makes too much difference whom the insurance plan sponsors as long as they are reasonably competent: the world is full of people as good as each other and diversity is a good thing, I don't ask for any gender or ethnicity requests.  

Primary care doctor: female, African American, with Caucasian female Physician Assistants
Psychotherapist:  Caucasian, female.
Psychiatrist: female, possibly Middle Eastern.
Dentist: male, Islamic.
Optometrist: Male, Chinese.
Pharmacists: Female African American, female Asian

Maybe if my life depended on it.... I'd ask.

Wow, Chris, you are observant!

I rarely notice!

Maybe what the doctor meant is that your insurance wouldn't cover treatment for AS (many don't) so his records have to say that he is actually treating you for something else it does cover, presumably the other issue you went to him for.  Doctors do this sort of thing though insurance companies sometimes accuse them of fraud for it.

hmmm,

So if I went to the psychologist, because my primary care dr would not give me ADHD medication (which I thought might help me focus on work) and through discussion we discovered that I was depressed, over a lack of ability to do my job, which had changed from a job which was highly technical to one requiring a lot of communication, so now he is supposedly treating depression, is it fraud to not put the AS on the record, if that is the diagnosis?

So treatment for AS is not covered, if it means communication therapy to help me overcome issues with communication, which are a result of AS.
What about coordination therapy?
Why would it not be covered?

Everything that is wrong with us is a result of who we are.  Some sets of symptoms have names (because someone with a name figured out that the group of symptoms tend to go together).

My employer has paid far more out in premiums to the insurance company than the insurance company has paid out on my behalf.
So if now they get to pay someone to help me improve certain skills, that I am weak at because of AS, I am in favor of them having to pay.
But I don't want to be part of any sort of dishonesty or fraud.

You might not want to compromise the possibility of getting insurance later.  Some individual policies exclude people with an autism diagnosis.  It might vary by state.

For private health insurance, if you have a pre-existing condition (meaning you have it before applying for insurance), they will automatic deny you coverage and even treatment sometimes. The only way to get coverage because of a pre-existing condition is through your employer. Also, many do not cover any autism treatments because they say that autism is a mental disorder and that the treatments are experimental. In fact, the ABA have been around for 40 years with stats.

I think that the insurance companies are like that because they want to use the money for their staff rather than helping people out, in fact the insurance companies are really practicing medicine without a license. If I need treatment on something, I would want me and my doctor to pick the best one, not the insurance company.

Indiana law defines autism as "neurological" and prohibits denial of coverage on the basis of it being "mental".

I've read websites advising parents of children on the spectrum to seek "whichever diagnosis will get your child the most services".  So, they seek an official Dx of ADHD or whichever flavor Dx that the government, insurance, program or school is willing to offer funds or services to support.

I wouldn't worry about it too much if I were you.

Like other people have said, it might be that treatment for AS isn't covered, but that treatment for co-morbids is, i.e. ritalin for ADHD, or anti-depressants for depression or whatever.

I'm originally from the UK and the main problem with getting an official DX over there relates not to medical insurance, but to car insurance.  Asperger's Syndrome is a 'notifiable' medical condition to the driving licence authorities and this means that car insurance might be more expensive, as in hideously more expensive.  I haven't tried to insure a car there, because I'm not living there at the moment, but I think the difference might be hundreds of pounds.  It's a battle I'm going to need to fight if/when I return to the UK.

Where I'm living now, I recently had a problem trying to get some medical treatment because of insurance company rules about what's covered and what's not.  I have a gynaecological condition and needed a hormone injection and got into loads of arguments, because the drug is more often used in fertility treatment, which isn't covered by our policy.  But it is covered for the reason I need it.  It's the same drug, it has the same effect.  But depending on the diagnosis it might or might not be covered.

So unless you have a large disposable income and lots of spare money to pay for medication you need, I wouldn't argue the toss about the diagnosis if it makes the difference between having medication paid for, or not paid for and having to pay for them yourself, especially if the difference in Dx is very nuanced.