Hello moms! I recently decided not to return to work after maternity leave and my health insurance expires at the end of this month. I applied for an individual plan through ODS and was denied coverage due to the fact that I had gestational diabetes while pregnant. Cobra is ridiculously expensive as is OMIP. Has anyone else has experienced this and if so, do you have any words of advice? I am wondering if all insurance companies go by the same underwriting guidelines or if it is something I can shop around for. Has anyone had any luck getting this decision reversed through an insurance company? I appreciate any recommendations as I am running out of time. Thanks in advance!
With so many layoffs in the State. I have heard and been recommended Lifewise 1-800-592-6804. Good luck to you.
A. Jo
Hi K.,
Since I live in Washington I'm not familiar with all the ins and outs of insurance stuff in Oregon, but I do have have one thought for you.
You may need to get your doctor on board. Seeing that gestational diabetes is conditional, it's possible you might be able to appeal the rejection if you had a letter from your doctor documenting that your health is good, and that the diabetes has gone away since you gave birth. Often, denial of coverage can be over-turned with the suppport of a doctor.
Good luck, I hope you can get coverage...you need it right now! :)
I would shop around. Try PacificSource and others. Seems to me that they cannot deny you if you have had no lapse in coverage.
It's very important NOT to have a lapse in coverage, you may never get coverage again.
It's stupid but, that's the way it is, currently.
Kystin--- Call your state's insurance commissioner and ask what the guidelines are for transferring from one insurance company to another, if you have no break in coverage, seamless. In some states, you can get coverage and be covered for 'pre-existing' conditions, such as your gestational diabetes, as long as you were covered by insurance to begin with. Gestational diabetes often 'goes away' at the conclusion of the pregnancy with appropriate diet and exercise. But give your insurance commissioner a call. Their office may also be able to give you a list of providers to meet your needs. This is just another example of why we need healthcare reform in our country.
I had g-diabetes when I was pregnant also. I ended up going through Regence Blue Cross Blue Shield. They're rates are a little high right now, but insurance is insurance. If you are relatively healthy you can go with a high deductible rate. I have had Regence for 3 yrs now and have really like them. I am moving my insurance to save a little money, as I have to pay for my insurance for the entire family. LifeWise can be a little picky too. I used to work there for a few years until I became a stay at home mom. I have never had any trouble with their insurance as an employee, but I know that they will not insure somebody of their weight. My friend got declined for that reason. I am trying to go with Providence Health Plans, but have heard when filling out the application you need to make sure your Is are dotted and Ts are crossed. So hear is my best advice. Go through a Health Insurance Broker. You don't pay them anything. They get paid by the insurance companies for bringing them customers. I just talked with my insurance broker and he sent me applications and information in the mail yesterday. He is a great guy based out of Tualatin, Or. If you want his number you can email me. I would also look online at the different health insurance company's websites just so you have some sort of idea what your broker may be talking about. My broker is great. He explains things in terms you can understand. Our friends use him as well. Also, if you haven't already done so, I would get a check-up with your doctor and get a clean bill of health. I had to do that too, for two reasons, one for my diabetes and I also had high blood pressure before I got pregnant and I had to show that my high blood pressure went away during pregnacy and I no longer needed medication. Its a process. Good luck!
Try Kaiser, I've had great experiences with them.
My daughter applied for insurance with Providence for her, at the time 7 yo daughter. She was turned down because she has asthma and eczema.
The system is terrible. I don't know if all companies use the same criteria. Perhaps you could go thru an insurance broker. They sell insurance from several companies. I don't think that there is a charge. He is a salesman for insurance companies.
I've been told about an insurance you can purchse thru the state if you're ineligible for private insurance. Perhaps that's what OMIP stands for?
I would apeal there decision. You have nothing to lose. I'd emphasize that gestational diabetes is a short term condition.
I personally would contact the State Insurance Commissioner and make sure they know that once the baby is born that the diabetes goes away (I had it with my last two pregnancies).
Good Luck!!
T.
Everett
