Can the mentally ill get health insurance?
by Mahita Vas
IN OCTOBER 2015, my husband and I contacted one of the participating insurance agencies about signing up for the Integrated Shield Plan (IP). We were keen on a better coverage than what was offered on our MediShield Life plans. Within days, we heard that my husband’s application had been approved. Mine was rejected, but the agent said she would appeal. Less than a week later, I was told the appeal was also rejected. No other option was offered.
I tried all the other agencies. At that time there were five – AIA, Aviva, Great Eastern, NTUC Income and Prudential. I was rejected by all of them. Great Eastern told me not to bother applying because my application would definitely be rejected.
Disheartened, I pointed out that I was fit and healthy. I exercised regularly and was careful about what I ate. Neither a smoker nor a drinker. Minimum eight hours sleep. But the answers were all the same – nope. Not approved.
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All because I share one thing in common with these people – Catherine Zeta-Jones, Graham Greene, Winston Churchill, Nina Simone, Lee Joon, Demi Lovato, Carrie Fisher and Eason Chan. The list goes on: Mel Gibson, Stephen Fry, Edgar Allan Poe, Abraham Lincoln, Virginia Woolf, Ernest Hemingway, Amy Winehouse, Vincent Van Gogh, Friedrich Nietzsche, Ludwig van Beethoven, Charles Dickens, Isaac Newton, Florence Nightingale. The list does go on but I’ll stop here.
They are amongst the greatest artists, musicians, performers, writers and thinkers who ever lived. I cannot, dare not, compare myself to any of these leaders in their respective fields, being nowhere nearly as accomplished as any of them. Great as their achievements have been, they are also, first and foremost, people. Just like me. And like about 2 per cent of the world’s population, including Singapore’s.
People with a dreadful illness once known as manic depressive illness, now known as bipolar disorder. An illness marked by extreme mood swings, where patients go from feeling overly happy to feeling empty. Bipolar disorder is indiscriminate, incurable and requires lifelong medication. With diligent medication and visits to the doctor, it is possible for patients to function as normally as anyone.
When I appealed to the insurance companies, I provided them with a doctor’s report from the Institute of Mental Health, which stated that I was compliant with medication and in full remission. Still, my appeals were rejected. I questioned the discrimination – after all, they could simply provide exclusions for any psychiatric treatment or injuries arising from my condition, for instance, injuries sustained in a failed suicide attempt. Some of the agencies raised the issue of two other minor and common ailments but when challenged, agreed that without bipolar disorder, I would get an IP with exclusions for those ailments. The rejection was blamed squarely on bipolar disorder.
Discrimination forces people to keep fighting for equitable treatment. So, on a friend’s advice, I went to see my MP at a Meet-The-People Session armed with an appeal letter, along with all the rejection letters. I didn’t get to meet my MP but his team of volunteers who looked into my case were very helpful. They said it was unlikely that any of the international agencies would bother about a letter from an MP, and advised focusing on NTUC Income as it was my best chance. I left feeling hopeful because my MP was none other than Minister Chan Chun Sing.
Several weeks later, I received a letter which said this, among the usual official phrases:
“We hope you understand that it is our duty to underwrite each case according to our underwriting guidelines consistently so as to be fair to the others who contribute to the risk pool.”
Please help me understand how I could be at a greater risk than someone who drinks and smokes heavily and may even be obese? Risk of what, exactly?
Followed by this:
“Moving forward, we are willing to assess your coverage in future, when you have fully recovered and have been discharged from your follow up for your bipolar disorder condition without the need for medication.”
Brilliant. The day I am discharged from my follow up, when I no longer need medication, will be the day I die. Bipolar disorder is incurable.
Mental illness has no known comorbidity with physical illness. By rejecting my application and appeals, these insurance companies are deliberately denying me coverage for illnesses such as cancer, heart disease and diabetes, all of which have no relation to my mental state.
I made a random check with the overseas offices of two of the international insurance agencies which rejected my application. All offered critical illness plans for psychiatric patients, though with exclusions. Some plans offered supplementary coverage for psychiatric care. So why exclude psychiatric patients in Singapore? Because they can?
If I could bring Isaac Newton, Beethoven or Charles Dickens back to this future, living in Singapore and requiring an IP, I wonder if these companies would deny them coverage.
I also wonder why NTUC Income thought it fit to use me, specifically my condition, on their first Future Peek campaign, and yet think I am unworthy of their insurance policy. Use my condition for marketing but spit me out when I want to buy an IP. Such hypocrisy.
NTUC Income’s website states “Insurance Made Simple, Made Honest, Made Different” and with great emphasis, “People. First”. I wonder what they really mean by those claims.
Mahita Vas is the author of ‘Praying To The Goddess Of Mercy: A Memoir Of Mood Swings’. She spends her time on advocating mental health issues and pursuing personal interests including reading and writing.
Featured image by Sean Chong.
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