Fuming
Jeff and I have had health insurance issues since we decided to adopt. Initially, several companies said they do not insure families who were planning to adopt within the coming year. This seemed pretty unfair to us, but I guess they've lost a lot of money dealing with the severe health issues of some adopted children. So, we wound up going with a very expensive plan. After a year of paying large amounts of money left and right, we were ready to change plans. After all, we aren't planning to adopt again within the coming year, so that should no longer be an issue when applying for coverage.
After researching several plans, we applied to Health Net of California. They had pretty good premiums and our physicians accepted their plan. We answered the questionnaire as honestly as we could and submitted all the required paperwork.
Last week, we received a letter from Health Net stating that while Vika and Eamon qualified for coverage, Jeff and I were declined. The reason? My "history of infertility."
What?
I was completely confused about this. I have "undiagnosed infertility." Doctors have found all my reproductive faculties in good working order - there is no physical condition keeping me from getting pregnant. As far as fertility treatments go, I didn't do anything aggressive. I only took Clomid for a few months and then stopped. Getting pregnant was a not huge priority for me - being a mom was.
So I called Health Net today to find out why they would decline both Jeff and me because I had struggled with infertility a few years ago. I was especially confused because most health insurance plans (including the one we applied for) do not cover fertility treatments anyway.
This is the answer I received: Health Net's guidelines state that because I took Clomid to address fertility issues, they will not cover me unless I have a hysterectomy or reach menopause. These guidelines apply to anyone who has had any sort of treatment for infertility.
?????
So, basically, unless I choose to sterilize myself, neither Jeff nor I can get coverage from them. How is this even legal? I'm just fuming right now! I'm especially angry that they will not cover Jeff because he is married to me. I suppose they would reconsider him if we got a divorce. It's just crazy!
I'm not sure what to do now. I guess we stay with the high-priced insurance company until we find a more reasonable one that does not discriminate against people based on their reproductive status.
After researching several plans, we applied to Health Net of California. They had pretty good premiums and our physicians accepted their plan. We answered the questionnaire as honestly as we could and submitted all the required paperwork.
Last week, we received a letter from Health Net stating that while Vika and Eamon qualified for coverage, Jeff and I were declined. The reason? My "history of infertility."
What?
I was completely confused about this. I have "undiagnosed infertility." Doctors have found all my reproductive faculties in good working order - there is no physical condition keeping me from getting pregnant. As far as fertility treatments go, I didn't do anything aggressive. I only took Clomid for a few months and then stopped. Getting pregnant was a not huge priority for me - being a mom was.
So I called Health Net today to find out why they would decline both Jeff and me because I had struggled with infertility a few years ago. I was especially confused because most health insurance plans (including the one we applied for) do not cover fertility treatments anyway.
This is the answer I received: Health Net's guidelines state that because I took Clomid to address fertility issues, they will not cover me unless I have a hysterectomy or reach menopause. These guidelines apply to anyone who has had any sort of treatment for infertility.
?????
So, basically, unless I choose to sterilize myself, neither Jeff nor I can get coverage from them. How is this even legal? I'm just fuming right now! I'm especially angry that they will not cover Jeff because he is married to me. I suppose they would reconsider him if we got a divorce. It's just crazy!
I'm not sure what to do now. I guess we stay with the high-priced insurance company until we find a more reasonable one that does not discriminate against people based on their reproductive status.
That is terrible, really really terrible and it is discriminatory. It makes no sense when you consider that fertility treatments aren't covered anyway!!!
Your post made me for the first time think about a good thing about being here, total free health coverage which covers everything from medication to hospital stays to appt with family dr to braces!
I'm sorry that you are stuck in this, I hope that you can find a new insurance company soon!!! Can your Dr recommend any?
That's crazy!!! I took Clomid and haven't had this problem ever. Doesn't sound like you want them for an insurance company anyway!!
That's RIDICULOUS! Insurance companies are supposed to "discriminate" so that each person is charged FAIRLY according to their risk. They're NOT supposed to make random unrelated rules exclusions. If I were you, I'd contact the insurance commissioner in your state. That sounds totally bogus to me. Sorry for the rant but I work for an insurance company (property / casualty, not life / health, but the basic principles should still apply) and that really hit a nerve.
I've been through that! I was turned down because of adopting, too. And I've also been turned down because of my weight.
I ended up going with a Blue Cross Blue Shield plan because they don't turn anyone down. It's not cheap -- $180/month for me for full coverage.
Holy Cow!!!
That's enough to make me want to write the Insuance Commissioner!!!
http://www.insurance.ca.gov/
Hugs!!
Jeff & Family
Thanks guys for the support and suggestions. I think I will write to the insurance commissioner, just to see if this is legal and if I have any recourse.
Kate m - you are lucky to live in a country that provides total free health coverage. I don't know that we'll ever see a system like that in the US!
It probably stems from all those women that do get pregnant and have all 7 babies and they all end up with medical problems. The insurance companies don't want to pay anything. They even stopped insuring houses in Florida. The ones that do charge very high rates. I tell you insurance companies suck. They want your money but they don't want to pay out.
Check out this site: http://healthinsurance.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=healthinsurance&zu=http%3A%2F%2Fwww.healthinsuranceinfo.net
And definitely write the state department of insurance!