Are you kidding me? I am so mad right now! I took a job with a company that didnt offer insurance. I had to apply on my own. So I applied for BCBS insurance. The sent me back a letter stating:
On the basis of medical information known to us, we are unable to issue the contract you have requested. This decision is based upon your history of unoperated polycystic ovarian disease.
What the? I cant even begin to fathom what that means? First off, I do not have PCODisease, I have PCOSydrome, which are two completely different things. Second, PCOS is not an operable disease, so how can they say that?
Has anyone else had this problem? Any ideas on how to fight this?
It's very difficult getting insurance when you have a preexisting condition. Insurance companies view it as more money they'll have to shell out, which they don't want to do. PCOS and PCOD are used interchangeably.
To my knowledge, there is no way to fight it. I tried to get insurance independently after I was booted off my mom's policy. No one would cover me with PCOS. It was only until I got a job with group coverage that I was covered. All I can suggest is to find another company. Hope you get it worked out.
I just bought a new individual policy (my only option since I'm self-employed). I was diagnosed a month into the new coverage. I received a letter from Humana last week stating that they feel that there were conditions that I did not disclose on my application...and now they want access to the medical records of every doctor I've seen in the last 5 years.
I'm guessing they'll find a way to either exclude my polycystic ovaries or rescind my policy entirely.
I'd try another company other than BCBS or Humana for an individual policy. If that doesn't work, is a different job with a group policy a possibility?
__________________ "Outside of a dog, a book is man's best friend...
Inside of a dog it's too dark to read." —Groucho Marx
Look around for a group you can participate in. Whatever your occupation is does it have a professional society? You'll have to pay dues, but the society may offer group insurance. Based on posts on this board, BCBS denies individual insurance because of PCOS all the time. See if you can find an insurance agent who deals with lots of companies. He/She will know which ones are more likely to deny because of pre-existing conditions. Perhaps you could get a catastrophic policy that will only pay if you have to have surgery or a long hospital stay. Insurance companies know if you have a pre-existing condition that requires prescription meds, doctor visits and frequent bloodwork, that they will lose money on you. If you know you can pay for those things out of your pocket, maybe you can find a policy.
I can get a no questions asked policy from my work, but the copay is like 400$ a month. I cant afford that.
I dont understand the way things work anymore. If I was pregnant, the state would automatically give me coverage. I really wish we had universal healthcare available here.
We just got insurance lsat year with Goldenrule, which is part of United Healthcare. I had PCOS and had to see a RE to get pregnant... all of that happening before we applied. They just wanted to see my records from all the doctors, but we have pretty reasonable coverage. We pay $ 300.00 a month for a family of 4. They were good to work with!!
I can get a no questions asked policy from my work, but the copay is like 400$ a month. I cant afford that.
do you mean the premium?
BTW, I have independent BCBS, and my premium is in that range...
The decision on coverage also has to do with how much medical care you've had in the past, as a result of your 'pre-existing condition'...and the current state of your health.
re: the operable part...they were probably referencing ovarian drilling.
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Sorry about the misprint. The premium is 400 a month. The deductible is really high, so basically I would be paying 400 a month for nothing unless I had a catastrophic claim. I just applied with Goldenrule, so I am glad to hear that they let you in for a good price.
I also had good luck with Golden Rule after being denied coverage with BCBS. BCBS actually told DH that they wouldn't add me to his policy since we did the whole fertility drug thing, they didn't want to have to cover a "multiples" high risk pg and birth. Funny though, due to state law they would have to cover any of his children regardless.
We have a high deductable policy that we combine with a health-savings account. Our policy does not cover pregnancy so we are wondering what we will do when we want to try for baby #2...
I know what you mean about the universal coverage, sometimes I feel like we are being punished for being a traditional family. If DH was a total deadbeat we would be covered under medicaid in an instant. It's not like every self-employed person is wealthy. We are your average middle-class family (probably on the lower end of that category).
Good luck with the insurance, I know how frustrating it can be.
__________________ Me: 33 DH: 34 Married 9-1998
Dx PCOS 1997 (Self-Diagnosed years earlier)
Our miracle Keagen born 10/21/05 after a 4 year long journey. He is the joy of our lives.
I suddenly feel very lucky to be living in Canada. Sure, you get screwed for dental and eye care, and anything they deem cosmetic, and you wait a *hell* of a long time for many things... but you're never ever refused treatment for anything if you really need it.
Honestly, "universal" healthcare isn't all it's cracked up to be. The new universal healthcare policy in MA really sucks. They don't ensure coverage for everyone, they just demand that everyone gets healthcare from somewhere, or they penalize you for it with fines (which is a funny concept considering that a lot of people still can't afford healthcare under the new law, I wouldn't imagine they'd be paying any fines either).
I have BCBS on my mother's policy and it's not very good anyway. They claim they'll cover all sorts of luxurious things like gym memberships, and I can barely get them to cover my prescriptions. Plus my co-pay just went up. Definitely try something else.
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Well I'm in Massachusetts and I get it through the state because I am self employed and a single Mom so qualify based on low income. Thank Goddess too because I take a number of meds and have frequent therapy/psych/md visits. I don't know how anyone can do without it - I'd be dead - probably quite literally.
Also - I quite agree the system in Mass stinks for the most part. Previous Gov Romney pushed it through to make himself look good for a presidential run - knowing the rest of the country wouldn't understand what a mess it is. They will impose the "fines" by reducing or eliminating your personal deductions on your tax return - and if you do require a hospital visit you will be charged a surcharge. I think it's great everyone CAN get it if they want but to force people to get it is absurd.
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Here is another MA cycter and I am changing jobs. I am worried I won't be covered, or I will have to take the the MA insurance. Health care does waste money on health club rebate.
I hope that I don't get denied... I wish there was a way to get it through the head of INS companies that PCOS is very common
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I was just denied, too. My mom was shocked - she works in healthcare and said I'd have no problem getting insurance - after all, all the testing and everything is over with. Now I just see my endo twice a year and take my prescriptions. Thankfully my company has health insurance - I don' tknow what I would have done without that.
The really bizarre thing was, when I was on the phone with the insurance people, going through my whole medical history, the lady said that I would *definitely* get insurance, despite my PCOS. She said it was no big deal. She even gave me a policy number to hold on to until my real card came. Then she switched the call over to an "underwriter," who said after about 10 seconds, "well, your PCOS disqualifies you. Sorry." How in the world did I get that policy number, then???
__________________ Previously on Met, currently on Ortho Tri-Cyclen, Spiro, and cinnamon
Denied Health Insurance due to PCOS. 
