Moving to OR -Insurance denied

By DiabetesDiva Latest Reply 2009-11-09 20:01:31 -0600
Started 2009-10-28 14:46:32 -0500

My husband is retiring from his job in Calif and we are moving to OR. We are too young for medicare. I contacted Healthnet (our CA carrier) and was told that I was not eligible because of my diabetes and all other carriers in OR would also deny me. I'm blaming myself for my condition and what it will cost us for insurance thru the Oregon Medical Pool. Can my husband be covered by one carrier and I be covered by a different carrier?

20 replies

imsuzie2 2009-11-03 05:24:51 -0600 Report


I am 59 and worry about my job and insurance if I am fired (as are a lot of people at this company). I have an HMO and asked them about converting it to an individual plan but they said I would be denied (can you guess why?). But, they said if I had Cobra, they would convert the Cobra plan when it ran out to an individual plan. Hope this help you and the others, it made me feel better. S2

pop2 2009-11-09 20:01:31 -0600 Report

Sorry I am just responding I have been researching, but so far no good. Several calls I recieved were scams you have to watch out for And the discount plans most are 20/60 does't seem to be any good .My husband is also diabetic
he is on medicare already. Thanks for all the help and I
did know about Truman Med center . right now proberly my
best option right now. I will try to keep up my Dr visits from
the Cobra I want have to pay. And I no how to manage diabetes. So I will try to keep healthy. And continue to pray for health care reform.

pop2 2009-11-02 15:45:50 -0600 Report

I have also been denied and my husband is retired I was
layed off and Iam 58 can not get any insurance to any
company because of diabetes i never thought I would be
with out insurance. I am praying for health care reform.
I now have the tingling in my feet and some burning I think
that started with the cholestrol medication my dr but me
on because it happened the last time I took cholestrol meds.
any way I will talk to the dr about it. Is there any insurance company who will take a diabetic? Because I can not find one. They said when Cobra ran out the letter that certifies that you have been covered by an insurance company that should assure you coverage with any insurance company but I called and the still denied me.

jayabee52 2009-11-03 00:44:42 -0600 Report

hang in there pop2
How long has it been since you have been off COBRA? Do you still have that letter from your former ins co stating you have been insured for the previous 6 mos? Do you have a denial letter from the ins co to which you applied?
SAVE EVERYTHING! start a folder of documents to and from the ins co. SAVE ALL PAPERWORK YOU CAN TO DOCUMENT WHAT YOU HAVE DONE AND WHEN. DOCUMENT IN A NOTEBOOK EVERY CONTACT YOU HAVE WITH THE INS CO AND ASK THEM TO SEND YOU A LETTER CONFIRMING WHAT WAS SAID IN THE CONTACT. If you send mail to an ins co. you might want to send it registered mail, return receipt requested. That way the ins cos know you are keeping track. Of course you want to keep a copy of any correspondence you send. You might also want to keep a copy of all medical bills from the time you were denied until now in case there might be a court case and it is decided you could be paid for the bills you had to pay out of pocket because of your denial.

Did you get that denial of insurance in writing? You might need to go to your local legal aid society, or whatever it is called in your county, and find out what you might do legally. Is there a comission of insurance for your state [or whatever the office is called in MO] that handles health insurance? You might want to talk with them to find out what they can do for you.

Don't let that ins co. run over you. They should not be able to deny you coverage if you have that letter from COBRA insurer.

after I posted the above I emailed a friend who was a social worker in MO and worked for a religious chairitable organization, [he's been in CA for several years now] and put your plight to him. Here is what he wrote in reply: [he had gotten your gender confused, so please bear with the mistaken pronouns]

"I would support your idea that this person should contact the Missouri department of Insurance and see what their options are. Here are a few of the questions I would ask:

1. Can the COBRA. policy be converted to an onging policy? Many policies have conversion rights even if they are expensive.

2. Missouri had a high risk pool of insurance and it can be expensive but they are required to take you. Does this still exist?

3. Was the insurance policy he had at work a insured policy covered by state insurance law or a self insured policy (generally used by larger employers) and covered by federal regulation thru ERISA. The rules for each are different.

4. If he can get reemployment he should sign up for a federally qualified HMO. They cannot exclude preexisting conditions. Another option is for the spouse to get reemployed and to become a dependant on their policy.

5. If their income is low enough, they may qualify for State Medicaid and of course preexisting conditions do not apply their.

6. Overall he is in a tough spot. He may want to consider going to a federally qualified health center and they would see him based on a sliding scale. There are no preexisting condition issues there. There are a number of these in the KC area.

7. He could also seek outpatient care at the Truman medical center which is the public hospital in the KC area.

These are a few ideas. I hope they help this person get started."

I pray this is helpful to you.

kdroberts 2009-11-03 07:39:15 -0600 Report

The letter you got when COBRA ran out might have been misleading. If you switched to a qualifying insurance plan (most personal one are not, most group ones via a job are) within 63 days then you would have all pre-existing conditions covered and no exclusion period. After that 63 days you are out of luck and even if you got coverage through a job you would likely need to wait 12 months before diabetes would be covered.

Nana Jones
Nana Jones 2009-10-28 20:21:27 -0500 Report

I don't know what is going to happen with Insurance prices going out the roof. My husband & I own a small home business and can't afford insurance for our employees for the past few years. In fact with the economy the way it is we are on the verge of bankruptcy. We pay a little over $1200.00 a month for the 2 of us and come the first of the year we will be paying around $1450.00 a month. I really don't know how much more we can take of this. My heart goes out to you and your husband but hang in there. Hopefully everything will turn for the better for you and everyone else. A couple of months ago we went on different policies hoping to bring the cost down.

Hinboyz3 2009-10-28 18:40:10 -0500 Report

Yes you can have two different coverages, my hubby and I did for years. But stop worrying so and hold your head up try and fix it and move on. Don't worry yourself you will become ill, and you don't need that.

cussinwolf 2009-10-28 18:27:44 -0500 Report

Go to and use the free clinic search engine that Dr Oz has on his website. I have been without job and insurance for nearly a year now. I do not know what meds you are on but Walmart has been my best source for insulin (novolin N) syringes, meter and strips. It is their Relion brand. You have got to stop beating yourself up. Get a grip and go on. I know that feeling of panic but rise above it.

ptsparkle 2009-10-28 17:47:06 -0500 Report

Most insurances let you bridge over til you get other coverage…I think. It's called COBRA. It is costly, but not sure how it works with unions. Maybe that's what you are doing now. Good luck, and you are not to blame. Blame your hubby for moving lol.

jayabee52 2009-10-29 01:59:09 -0500 Report

howdy jim
i believe she mentioned something about $1000/mo. that sounds about right for COBRA. They really sock it to you if you have to use them.

kdroberts 2009-10-29 07:25:59 -0500 Report

COBRA isn't a plan it's being able to carry your existing insurance without an employer. The price for your insurance doesn't change, you just don't have the employer subsidizing the majority of it any more.

John Crowley
John CrowleyCA 2009-10-28 16:42:29 -0500 Report

First of all, don't blame yourself. It's the system that's so messed up--not you. You're trying to do the right things, take care of your health and get coverage.

You'll have to keep us posted on how this all works out. I myself am wondering about all the insurance nightmares as my son transitions from child to adult over the next few years. He's thinking about med school but making sure he has no gaps in coverage over that many years is just horrifying to me.

salmanda 2009-10-28 19:58:18 -0500 Report

As long as he is dependent on you, your son can remain on your health insurance plan. My daughter did while she was in college. When she was between jobs for several months a couple years after college, I was able to cover her then also because she lived with me.
Maybe your carrier is different, but worth checking into.

DiabetesDiva 2009-10-28 16:03:49 -0500 Report

Thank you all for your advice & support. Hie is employed by the county and is a union member. I thought his plan would carry us to the end of the month, like the private sector, but it ends his last day at work. It appears we may have to pay $1000 a month to stay on his current plan. I do understand the divorce joke, sad but true. I have been unemployed for the last 2 years & my benefits have ended. Need to pull a rabbit out of the hat. The guilt comes from the fact I should have eaten more properly,etc.

Harlen 2009-10-28 19:41:20 -0500 Report

You know that diabetis is not your folt you didnt do this to your self.
I ate well was allways on the go and I got it to.My mom and grand mother on her side had it too.Grandmother was 98 lbs
so its not that you did this to you
O and by the way it wasnt a joke lol
I did ask her lol

Sarguillo 2009-10-28 16:03:13 -0500 Report

If all else fails, start a home buissness. Get a group plan for small buissnesses. Hire your husband. You dont have to show a profit but it would be cheaper than paying for your medical by itself. Also, with a group plan, the risk is spread out over a larger group that an idivisual plan.
Also, if that home buisneess makes enough to pay for your benifits, thats a plus.

Good luck with the move.

Harlen 2009-10-28 15:53:37 -0500 Report

Boy do I know what your going thrue
I have asked my wife to give me a devoress so I can get ins on my own I can get the gov ins from the mill but she makes to much money for mr to do that she sed NO WAY lol
Hope things get better for you soon
If you need anything let us know we may be able to help
Best wishes

imsuzie2 2009-11-03 05:13:53 -0600 Report

Harlen, can't you get coverage thru the VA? My husband has it. I don't qualify cuz he only was in for the one tour. And, he didn't start with the VA until around 2000.

kdroberts 2009-10-28 15:48:39 -0500 Report

If he retires and you have insurance via his job you should be able to carry it over for at least a while. You shouldn't blame yourself either, it's not something you could do anything about.

alanbossman 2009-10-28 15:12:38 -0500 Report

I know insurance is high but what is your life worth. Yes you can have two diffrent carriers as long as you are paying for it

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