Health Insurance for PCOS - Page 2

Danusmom · 02-21-2007, 03:10 PM

I would arrange for COBRA via your current job(s). Yes, it is expensive but it is even more expensive being sick/hurt without insurance. While on COBRA this will give you coverage for as long as they permit (usually not more than 6 months) until you can find insurance in your new location. Check on the State's web site as well as the county you will live in for information on insurance availability. Also check into joining either one of their chambers of commerce if they have health insurance for members. Another option is to join a national group of whatever field you will be freelancing in (ex. journalism, photography, etc.). If you join a large enough group, they usually have an insurance plan for you to opt into.

You all are very lucky to have the time to plan your options. Most people, in today's economy especially, don't have this luxury.

LookingForHope16 · 02-21-2007, 07:25 PM

But how can BCBS not cover it?

Danusmom · 02-21-2007, 09:00 PM

It depends on your health care plan, doesn't matter which insurance company is the underwriter or TPA (third party administrator). Every group has a different plan, even if it is with BCBS. Each company has a different plan suited to their needs. Also, you have more 'wiggle' room if you have a plan that is "self insured" vs one that is "fully insured". If your plan is fully insured & a claim is denied, you cannot appeal. If self insured, you can appeal a denied claim.

guineapig · 02-23-2007, 02:46 AM

I think you can continue COBRA for up to 15 months. 24 monts if it is due to a death or divorce.

Your Mom · 02-25-2007, 09:32 PM

Thanks to all that have contributed.
Cobra is an option for my Daughter, however, at 340.00 per month, it is unlikely that we can keep it up for long. Since I last posted she has been denied individual coverage twice.
It is so disheartening, isn't it? It is bad enough to have PCOS, but to be treated with such disregard by insurance companies certainly compounds the issue.

LookingForHope16 · 02-26-2007, 04:19 AM

Is there not any service in town that will help her?

JosieFB · 02-26-2007, 03:20 PM

COBRA premiums are so high because the insured must pay everything that the employer was paying for them. If she finds individual insurance, it might cost that much too! The company is generally paying the going rate for insuring someone or perhaps a little better than the going rate if they are self-insured. Health insurance is a very valuable benefit that we don't appreciate until we no longer have it.

Tell her to try talking to an independent insurance agent who works with several different companies. He might have some ideas of what companies are less rigid about pre-existing conditions. It will be difficult to get individual health insurance to cover the PCOS treatments, but maybe she could find an insurance policy that will cover catostrophic medical problems or cover everything but PCOS treatments.

You say the tests and meds for PCOS run into hundreds every month. Once you get past the initial diagnosis, that's not always true. You can get Met at Wal Mart for $4 per month. If she is taking other brand name meds, she can talk to her doctor about prescribing generics. It might not be exactly the same med, but there is a generic to treat most every ailment. Labwork is is only done every six months or even annually after the initial diagnosis. Don't be afraid to discuss prices up front with the doctor. Ask them, how much do you charge for an office visit? How much will labwork cost? Some will give discounts if you don't have insurance. If she's trying to conceive, she might have to delay that while she is without insurance.