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Old 02-02-2009, 01:03 PM   #31 (permalink)
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I was just taken off my insurance plan (Medicaid), ive been laid off work for 11 months now and have only one source of income but we are not able to cover for health insurance. I was diagnose with PCOS 3 months ago and now have no coverage to pay for my medication. Can someone tell me what possibly I could do or research???
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Old 03-18-2009, 03:17 AM   #32 (permalink)
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hi i am sitting here in aww because of this stuff thats only from my knowledge here in the us and somewhere in the uk i beilieve they have free insurance and free schooling i think thats so unfair
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Old 03-18-2009, 05:53 AM   #33 (permalink)
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does blue cross anthem cover pcos? Anyone know what questions they ask?
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Old 03-19-2009, 02:07 AM   #34 (permalink)
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hi i am sitting here in aww because of this stuff thats only from my knowledge here in the us and somewhere in the uk i beilieve they have free insurance and free schooling i think thats so unfair
The UK doesn't have free insurance. The do pay into the health care system with taxes and it is failing. The usa has free school: see public schools K-12. They do have a discounted higher education system but then again so do we, it is called state schools.
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Old 03-19-2009, 09:33 AM   #35 (permalink)
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does blue cross anthem cover pcos? Anyone know what questions they ask?
Idk hun .. I do know that I have blue cross blue shield and my docs told me that they had to lie to get my stuff covered. Put in my files that I'm a diabetic instead of polycystic or else it wouldnt be covered.
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Old 03-19-2009, 09:40 AM   #36 (permalink)
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I was just taken off my insurance plan (Medicaid), ive been laid off work for 11 months now and have only one source of income but we are not able to cover for health insurance. I was diagnose with PCOS 3 months ago and now have no coverage to pay for my medication. Can someone tell me what possibly I could do or research???

Umm being you had medicaid before I would suggest getting back on it especially since you lost your job. Otherwise you can ask a doc for a prescription for met * only cost 4.00 a month without insurance* and try that. You could also go to the health department and see if you qualify for their help with family planning "ie... Birth control". Only kicker there is that they dont cover every kind of bc. Other then that if you cant do any of those just try and watch your diet and see if that helps.
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Old 03-19-2009, 11:37 AM   #37 (permalink)
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Originally Posted by darkestsplendor View Post
Umm being you had medicaid before I would suggest getting back on it especially since you lost your job. Otherwise you can ask a doc for a prescription for met * only cost 4.00 a month without insurance* and try that. You could also go to the health department and see if you qualify for their help with family planning "ie... Birth control". Only kicker there is that they dont cover every kind of bc. Other then that if you cant do any of those just try and watch your diet and see if that helps.

Hey thank you so much for this, I will check that out. Appreciate it!
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Old 03-27-2009, 02:16 AM   #38 (permalink)
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This is awful... I wasn't aware of any of this until i read all of this.... And im just disgusted by the situation. ITs not fair.
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Old 06-18-2009, 12:29 AM   #39 (permalink)
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Default Not getting insurance sucks!

It's so true! I have been denied insurance due to the simple diagnosis of PCOS. I was told that it was because PCOS carries with it an added risk of cancer, diabetes, etc - which they don't want to be liable for. It's frustrating, but the best thing to do is make sure you have insurance BEFORE the diagnosis and then never let it lapse. I wasn't so lucky so I am left to get it through work, a high-risk state/federal program, or a simple discount plan. In FL, Blue Cross Blue Shield now has a program called GO Blue which I have, and it's decent. Soon, my hubby will have ins through work and that's good!
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Old 06-18-2009, 04:00 AM   #40 (permalink)
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Hey thanks soo much for the info. I have a really huge job interview tomorrow with the state, so we'll see how that goes, wayyyy better insurance coverage!
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Old 06-18-2009, 04:10 AM   #41 (permalink)
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Hey thanks soo much for the info. I have a really huge job interview tomorrow with the state, so we'll see how that goes, wayyyy better insurance coverage!
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Old 07-02-2009, 03:55 PM   #42 (permalink)
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I was diagnosed in ~2001 when I was trying to conceive. I had insurance (PPO)from my employer so I received great fertility treatment. Since then I've switched jobs a few times and it never came up. I've never been asked. I also have asthma. It's never been an issue. I'm shocked by the threads. I now have coverage through Kaiser via my husband's insurance coverage and again, I was never asked if I have PCOS. I was diagnosed via another insurance company. Can Kaiser find out? How do you find out if pre-existing conditions can cause you to lose insurance or be denied? I was about to go to a Kaiser doctor for treatment of PCOS - now I obesity problems related to PCOS but now I may not because of these threads. I already have 2 daughters.
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Old 07-02-2009, 11:56 PM   #43 (permalink)
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Default Anyone heard of portability/HIPPA coverage

One thing some of you might want to look into is portability coverage. Most insurance companies including BCBS, Aetna, and Cigna offer it. Portability coverage is a type of health insurance that is given without a review of the applicant's medical records. Because of this it can be somewhat difficult to get, as it has a number of conditions that must be met before it is issued. It's also not offered in every state, so you might not be able to get it depending on where you live.

Here's how it works --- under HIPPA health insurance companies can offer what is called portability coverage (also called HIPPA coverage). It is health insurance for people who have already had insurance under a group plan (such as through an employer, the military, etc) NOT individual coverage. If you have had group health insurance and have somehow lost it, for example you lost or quit your job, moved, etc, and have exhausted your COBRA coverage (yes you must use COBRA first or TCC in the case of military/government members), you might be eligible for portability coverage.

To be eligible for portability coverage you must-- (some of the dates might be slightly different in some states, but the gist is there)
1) have had group health insurance for at least 18 months prior to applying for portability coverage
2) not have had a break in coverage during the last 18 months that lasted longer than 63 days
3) not be eligible for any group health insurance, including Medicare, Medicaid, or AHCCCS for example
4) not be covered by any other health insurance
AND
5) have exhausted your COBRA benefits (which might be different/last longer if you recently lost your job due to recent Acts of Congress)

How to get it --
It can be hard to get portability coverage, insurance companies don't want to offer it because it can cost them a LOT more than regular group plans. This is because there is NO preexisting conditions provision. Also, these plans operate as a PPO, which is also more costly to the insurance company than an HMO. The good news with that is though that you can choose your doctor and you don't have to see your PCP everytime you need to go to your endocrinologist or another specialist. So, in order to get portability coverage you MUST be persistant. Sales representatives for insurance companies will try to steer you toward another plan or as what happened with me, they'll tell you they don't offer it when they do. Make sure you're clear about you're asking for --- portability or HIPPA coverage. Before the insurance company tells you that they don't offer it, they must ask what state you live in (because it's not offered everywhere), so if they don't ask what state you're in and say they don't offer it, ask to speak to someone else. Also, even if you do get an insurance company to talk to you about portability coverage, you'll find that they'll offer probably two plans to you, which may not be that great. Unfortunately, that's sorta the price of doing business here. Since the insurance companies don't make a lot of money off of these plans, they don't offer many options with them.

One more important thing--
Portability coverage is expensive. I mean ridiculously expensive. So if you have another option it might be worth it to take it. For example, portability coverage for me (a 25 year old female) in Arizona runs at the cheapest $600 per month and easily goes to $1500 per month. This is of course on top of a $1500-$2500 deductible and the insurance only pays 75-80% of the bills and I still have copays. If I was able to get health insurance after a medical records review (I can't currently because I had brain surgery 3 months ago), my premiums would be a fraction of the price. What I'm trying to do (which you might think about too) is to have portability coverage long enough to get past the preexisting conditions waiting period for other plans my insurer offers and then switch plans. That works as long as you don't have treatment for the preexisting condition for 6-12 months before applying for a new plan. With PCOS, that can be hard because treatment can be ongoing, but if you go say 3-6 months between endocrinologist visits, you might be able to apply for a new plan, pay for one visit out of pocket and then have insurance that covers the preexisiting condition. Or in the meantime, find a doctor who can "change" your diagnosis to something that would be covered as others where talking about.

I do hope this helps some of you. I had to do a TON of research to find out about portability coverage even though the insurance companies I talked to knew there was no way they would cover me right after brain surgery. Not a single person I talked to suggested it. I consider myself lucky that there was enough information out there on the internet for me to be able to find out about it. If you have any questions about it or decide that you want to apply for it and need some help, please feel free to ask, PM me, whatever. I'd be glad to help.
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Old 07-03-2009, 12:19 AM   #44 (permalink)
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How do you find out if pre-existing conditions can cause you to lose insurance or be denied?
One more quick comment I want to make -- you don't usually lose insurance for a preexisting condition. Preexisting conditions is the term insurance companies use as a justification for denying coverage in one of two ways. Insurance companies will deny any coverage for a person with a preexisting condition, meaning they have no health insurance -- usually you're talking about people with serious conditions like a heart condition. The justification for this is that the condition is so grave and can cause so many other problems that it's not worth it to the insurance company to cover them. PCOS might be seen this way.

The second way that preexisting conditions come into play, is that an insurance company will deny coverage to an applicant for the condition itself or any related treatment. What that means is if for example I apply for health insurance while I have a broken leg (which was broken before I applied) the insurance won't cover dr's visits, Rx's, or any treatment for my broken leg. Anything else they'll cover. What makes this complicated is that not everything heals like a broken leg. PCOS for example, is a lifelong thing. In this case what usually happens is that the insurance company will deny coverage for the preexisting condition for a particular length of time, say 6-12 months (it varies), meaning you have to pay for any treatment during that length of time out of pocket. But after that time period is done, the condition is covered.

So, if you have changed insurance after you were diagnosed you probably were considered to have a preexisting condition. However, if you haven't sought treatment for that condition for a couple years, then your insurance company will most likely cover treatment. The best way to find out is to call your insurance company. Honestly, it's so much better to stay in touch with your insurance company and know what they cover and what they don't, then to not seek treatment. In my experience I get a lot better treatment by the insurance company and my doctors' offices the better I know how my insurance works. It's a bit like knowing enough about cars to know when I'm getting taken by my mechanic.
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Feel free to ask me about hyperprolactinemia though, just had my prolactinoma removed through brain surgery. Happier and healthier already...
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Old 07-07-2009, 10:56 AM   #45 (permalink)
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I have Tri-Care. I don't know if you have to be military to get it but they cover just about everything. They tell you a plethera of doctors you can go to and they cover some portion of WLS too. You have to do a lot of paperwork and phone calls to find what you're looking for but it's worth when you do. I'm going to the doctor on the 28th and hopefully we start some tests to see whats going on with me. Hopefully they can figure it out.
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