Golden Rule Question

[thedonumd]

Hello, thank you for reading my post.

I am self-insured, 30 y.o. with GoldenRule, UHS Choice Plus, with an HSA plan, 5k coverage and pay about $400 quarterly, in MD. I was diagnosed with ADHD after being with them for 2 years, and do not receive any help with the out of network physician, but my discount prescription card keeps costs "reasonable" for the Type 1 prescription I have. I have friends with Blue Cross Blue shield with a very similar situation except they do have their physician visit on copay, because its in the network, AND they have help with the prescription. They do pay slightly more monthly. I see that the plans of goldenrule called PLan 80 and Plan 100 are better suited to help with my large costs associated with mental health. I plan on choose an in-the-network provider, however, on the website I have had great difficulty searching their database for mental health providers. After trying several keywords I gave up for the day. I am thinking about switching completely over to blue cross blue shield but fear it will be a very high incoming premium because of this condition I am coming in with. I was going to ask goldenrule more questions about changes to policy, etc, but I wanted to have some 3rd party advice before talking to them. Any help for the following questions would be very appreciated:
(1) Are their a significant percentage of doctors that accept my provider, but are not located in the database, or are most that accept located in their online database? Do mental health providers exist in their database?
(2) Is my condition a significant red flag to an underwriter, those of a brand new insurance company, like BCBS, and those of my current provider
(3) Do you have any advice on the steps I should take to perform a cost benefit analysis, I am sure any advice here would save me a lot of time.
(4) Is it always better to go with a "broker" than approach a new insurance company without one
(5) Does anyone know how this mental health issue, ADHD, specifically effects the underwriting of a policy, or know where I can investigate how underwriters view this health issue?

Thank you for reading. any feedback is appreciated.

 

[hunting101]

wait till 10/01/2013 and the so called expert ObamaCrap navigators should be able to help you

 

[insuranceconceptscindy]

I apologize for my colleague's snarky comment.
You are going to have a tough time with your condition. It depends on when you were diagnosed, and what your treatment is. If you are continuing psychotherapy, you may not be able to get a policy. Blue Cross seems to have loosened up their underwriting recently, but you may still be declined.
To answer your questions:
1) typically what you see online for providers is the most up to date information. More than likely, the providers listed may NOT take your plan. There isn't a secret list. Many mental health professionals do not take insurance at all, especially psychologists.
3 & 4) a great broker will help you with the cost analysis. Sometimes it's not worth it to spend a lot more in premium to pay a similar cost in copay/coinsurance. A lot of the plans do not have mental health treatments at a copay, typically they are subject to deductible and limitations.
My advice- get thee to a broker. Allow him/her to do a broker of record change on your current plan and let them guide you to the best solution. If you stay with your current plan, at least you have someone that you can get advice from as you need it.
Good luck!