My daughter has PCOS and has recently left her job. Her new company does not offer health insurance. She has been turned down by Blue Cross/Blue Shield because of the Pre existing Condition of PCOS.
No surprise, she has got to have insurance. With medication and tests running in hundreds of dollars each month, she is going to need some help. Does anyone have any adivice?
1. Insurance Co. to apply to
2. Help with Medication costs.
ANYTHING!!!
She lives in California. Right now she is so sad and depressed. She just went on Metformin and has not had any weight loss. She works out hard 90 minutes a day. She can not take anymore bad news. She is ready to give up. My heart is breaking because I can not make things better for her.
Is her diagnosis new, sometimes you have to wait a few months and then they won't consider it a pre-existing condition anymore. Here is a link for information on health insurance in the state of California.
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It's a shame she couldn't sign up for COBRA. If she works in a field that has a professional organization (i.e. nurses, contractors, engineers, etc.), she could check with those organizations to see if they offer health insurance for members. If she's not in an organization, have her search for one to join that offers health insurance to its members. This may be a bit expensive, but being without health insurance can be even more expensive.
If she had group health insurance from her previous job & she wasn't without insurance for more than 60 days she cannot be turned down for group health insurance. This is spelled out in the HIPPA law which went into effective April of 2004. The key is going from "group" health insurance to "group" health insurance without more than a 60 day gap. Hence, the "portability" portion of HIPPA. Also, if she doesn't have that gap of more than 60 days, the waiting period for pre-existing conditions must be waived according to HIPPA. However, the key here is, again, going from "group" health insurance to "group" health insurance. "Group" usually refers to employers/organizations of 20 or more employees/members.
Another thought may be to have her ask her new employer if they belong to Costco as a business membership. Costco offers health insurance plans to business members for their employees. I haven't check into this, but I know it is offered around here.
She may also look into a health insurance broker. We had to do this a few years ago before HIPPA went into effective & DH was laid off. We ended up with some coverage that wasn't great, but it was something.
Let us know what progress she makes with this.
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Oops! I made the common mistake by referencing "HIPPA" when in fact it is "HIPAA" which stands for "Health Insurance Portability and Accountability Act". Here are some links for more info:
The biggest portion of HIPAA is patient privacy which has most of the health care industry groaning with all the paperwork involved. However, this act/law gives patients recourse when their privacy is violated (i.e. HC workers talking about your care in an elevator or over dinner at a restaurant within earshot of non-involved persons). HIPAA also allows various ER & specialists patients visit to have their pertient infomation exchanged readily to seek the best care for them. And, it covers the portability portion which minimizes the gap in insurance for many.
Again, love to hear how your daughter makes out.
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Just a gardening-chef-domestic engineer-SAHM who helps out in DS's school just about everyday (I'm there for the big bucks -LOL! )
I'm not understanding how people get turned down for BCBS! I have BCBS and does my mother.
What is the difference here?
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I know CA offers a state insurance program.... I was on it briefly a few years ago between jobs but I think they go by income.
Prescriptions ~ Walmart is offering a lot of low cost prescriptions now...I know metformin is one of them that is only $4 a month.
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I recently heard of a Generic Drug Program that offers a number of prescriptions at just $4. A variety of drugs are available through this program, and perhaps your daughter could benefit from it. While insurance is a necessity, perhaps your daughter could utilize the services of free health clinics for the time being in order to obtain perscriptions and then have them filled through this program (http://www.walmart.com/catalog/catalog.gsp?cat=546834). Furthermore, programs such as planned parenthood may be able to help with BCPs at least for the time being. Hope this helps!
If your daughter is not eligible for Cobra and too much time has lapsed for the HIPPA rules to apply then there may be another option. Check out the MRMIP (Managed risk medical insurance plan). You have to have a rejection letter from any of the insurance carriers and there is a waiting list (I waited three months to get into the program) and then there is a 3 month pre-existing clause. But once you are in it is wonderful. I selected the Blue Shield PPO program.
Insurance companies will turn you down for anything! I guess I didnt realize that medical insurance considers wont pay for Pre-existing stuff. I thought that was only for life insurance.
I was in the same boat--lost job and had PCOS. I got denied by every private insurance company in 4 states. It sucks. I wasn't even on meds or overweight. I chose to pay COBRA and had to move back in with parents to afford it on unemployment. Finally DH got a sorry minimum-wage state job and we got insurance again.
I'm sorry I don't have any help though! PCOS & insurance SUCK!
Note: HIPAA only applies to GROUP health insurance (through an employer), not private insurance for the unemployed, students, etc like BCBS.
On a different note, met never worked for me but unprescription herb d-chiro-inositol was my miracle. She might try herbs rather than "drugs" but they're not always cheap either.
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Since this topic has been brought up I have a few questions too. My husband and I are moving from california to Colorado in the next couple months (2-3) and we will be changing from full-time employees to freelance/contract workers, that means our insurance goes down the drain. What are your best suggestions on?
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Health Insurance for PCOS 
