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  1. #16
    Registered User doublegwammy's Avatar
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    Quote Originally Posted by berichard View Post
    This is really frustrating to read, simply because I just don't understand how PCOS became synonymous with infertility issues. I am 24, single, and living on my own and have no interest in becoming pregnant any time soon. I was diagnosed when I was in high school because of the serious depression I was suffering from. To be honest, even on these message boards I become extremely frustrated with all the talk of pregnancy. I would love to be able to go to a doctor that understands that having PCOS IS a big deal to me NOW, not just in the future if I ever want to conceive. Isn't there anyone else who is in this boat with me!?!?!
    I can understand your frustration. Luckily for me, I don't have a ton of symptoms associated with PCOS, mainly the excess hair (which I maintain lol) and weight issues (which I fight), but even though I was diagnosed with PCOS over a decade ago, my dr has never even tried to do anything to help me. Only now that I'm trying to conceive is it even an issue in his eyes. I wonder why that is??? PCOS is a very real disease and has very real, sometimes embarassing, symptoms and side effects. You would think doctors would understand that and want to help, regardless of whether a woman is interested in having kids, now or ever. I'm sorry these boards seem to be fertility driven. I've actually kinda thought they are too (which is of interest to me, but I can understand your frustration). I have seen posts of women who aren't trying to get pregnant, so I know you aren't alone! Keep looking around. Start a thread of your own too and see what other "cysters" you have that in common with so you can keep up with each other and give advice.
    Last edited by doublegwammy; 03-27-2012 at 03:34 AM.

  2. #17
    Registered User mystique1772's Avatar
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    united health care.I got lucky in the fact that i wasn't diagnosed wit pcos til i was referred to an re while on uhc.And my first dr b 4 uhc also took uhc so they hav all my records with all the symptoms and problems but never the diagnosis. so it wasn't a pre existing condition..

  3. #18
    Registered User Overstressedmom's Avatar
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    Not sure if this is the place to ask but my daughter was just dx'ed with PCOS and I am wondering when she going out into the world will this prevent her from getting future medical ins.? Should I have her Dr. 'hide' the dx?

  4. #19
    Follistim Lover PetiteFlower's Avatar
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    That's not legal and not really necessary anyway. Even the way things are now, you can always get insurance through your job if it's offered, even if you have a pre-existing condition and the policy excludes pre-existing conditions (not all do), the longest they can exclude treatment is a year. But come 2014, ALL insurance companies, even non-employer sponsored plans, will no longer be allowed to exclude coverage for pre-existing conditions, and everyone will be able to get coverage somewhere (that's the theory anyway). By the time she's grown, if we are lucky, we will all have universal health care and won't have to worry about any of this crap!
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  5. #20
    Registered User Overstressedmom's Avatar
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    I didn't know that, Thank you for the info...

  6. #21
    Registered User JulieofDenial's Avatar
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    I my endo is a pro. She diagnosed me with PCOS, hyperprolactinemia, and hyperandrogenism. :-D

  7. #22
    Registered User SLM322's Avatar
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    Thank you for this. Its helpful as insurance is giving me issues from ttc for only 10 months, but I have symptoms of PCOS NOW.

  8. #23
    Registered User cysterless's Avatar
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    I am on medi-cal and I can't get any coverage for fertility testing. I used to have some help with acne medication but it was not fully covered, and now my plan has changed. Hopefully it still helps cover that. I'm pretty sure any treatments that directly attack hair loss will not be covered. I wonder if I point out the linkage with my diagnosis of PCOS if somehow this will help my coverage.

    Also, quick question--I'm thinking about speaking to my dermatologist about hair loss either way. Is that the right person to see for this issue?

  9. #24
    Registered User rcbaker200's Avatar
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    I guess this is a simple problem considering what's brought up on this blog. Referred to nutritionist/dietician by adolescent medicine doctor for PCOS, blue shield says that they don't cover cost of nutritionist (she was a registered dietician). Dx code was 256.4. They do cover if a patient simply has diabetes. Was it billed wrong? Anyone have experience with this. Thanks..

  10. #25
    Follistim Lover PetiteFlower's Avatar
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    If they don't cover a dietician for that diagnosis, then they don't cover it. It actually doesn't surprise me that it wouldn't be covered for PCOS, since it's not generally accepted to be a condition that is related to diet. If you have diabetes, of course they would cover it. Even prediabetes or insulin resistance they might cover it for. Some plans will cover it for obesity, some won't. But with only a diagnosis of PCOS, that would probably be considered experimental or flat out not medically necessary.
    Last edited by PetiteFlower; 05-28-2013 at 04:00 PM.
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  11. #26
    still a baseball fan... SandiaSunset's Avatar
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    Most insurance plans have an exclusion for nutritional counseling unless there is a diagnosis of diabetes or gestational diabetes. It really just depends on the policy but most of the policies I work with don't cover it for any other reason. ICD-9 diagnosis code 256.4 is polycystic ovaries so that's why it's not being covered. Sounds like it was billed correctly but based on the policy you have it's simply not a covered benefit for your diagnosis.
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  12. #27
    Registered User beeejet's Avatar
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    This is GREAT info! Thanks!!
    While I am currently dealing with the infertility side of PCOS, I think it is wrong that is all insurance sees.
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  13. #28
    Registered User cawsings's Avatar
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    Quote Originally Posted by doublegwammy View Post
    I can understand your frustration. Luckily for me, I don't have a ton of symptoms associated with PCOS, mainly the excess hair (which I maintain lol) and weight issues (which I fight), but even though I was diagnosed with PCOS over a decade ago, my dr has never even tried to do anything to help me. Only now that I'm trying to conceive is it even an issue in his eyes. I wonder why that is??? PCOS is a very real disease and has very real, sometimes embarassing, symptoms and side effects. You would think doctors would understand that and want to help, regardless of whether a woman is interested in having kids, now or ever. I'm sorry these boards seem to be fertility driven. I've actually kinda thought they are too (which is of interest to me, but I can understand your frustration). I have seen posts of women who aren't trying to get pregnant, so I know you aren't alone! Keep looking around. Start a thread of your own too and see what other "cysters" you have that in common with so you can keep up with each other and give advice.

    Sounds like my story. I was diagnosed probably 15-16 years ago and all that was ever done was to be put on BCP and told to keep taking them until you want to become pregnant. Now we're getting ready to start TTC and I am wondering if I should see about getting re-diagnosed (not really sure there is such a thing). I know my insurance won't cover infertility and I'm pretty sure it won't even cover tests to determine infertility...so I'm hoping there's a work around.

  14. #29
    Registered User Mrs.C629's Avatar
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    I just went to a new obgyn today. First time I've had insurance in my life. I have GHI. My mess are covered through my union-UFT. The dr put me on metformin and UFT wouldn't cover it. GHI did, even though they usually don't do meds. I. Assuming they are going to take it as an infertility problem since GHI does cover it 75%? I'm curious to get my bill now.

  15. #30
    I like candy. MilaHurricanes's Avatar
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    The doctors I go to just fuddle around with codes and just put it under heavy menses and irregular menses and are done with it... though medicare and the supporter don't seem to care if you go for PCOS.

    I have no interest in children. Ever. In my life. Never.

    Then They have the nerve to not allow me to have a D&C or an Ablation to slow/stop bleeding.. BECAUSE I HAVE NO CHILDREN AND IT"S PRACTICALLY IMPOSSIBLE... I guess... I'm on birthcontrol now.. I do not want children, I lothe children...

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