Ohio Maternity Coverage - Kaiser Permanente Denied

[Klein123]

Hi -

We live in ohio and are currently with Golden Rule United Health insurance.

Last year, with her existing insurance, went to the doctor for regular checkups - flu, cold and cough (minor illnesses). She mentioned that in her Kaiser Permanente application a week ago (as they are the only ones who do not have a waiting period).

We received a letter stating that our application was denied and the reason being that she has existing illnesses (how ridiculous!!) and that she can repeal (it would take 30 days for their decision).

My question is - is there anyone out there in Ohio or anywhere facing a similar situation ? If so, can you please respond how tackled it and if you were able to receive Kaiser Permanente's maternity coverage.

Any help would be greatly appreciated. Thank you!!

 

[saved1986]

Had the kaiser permanent option when I lived in cleveland 94-99. Did take it,paid extra for the PPO choice. KM is known to be lousy.

 

[mommysunshine]

This isn't what you're expecting because you're wanting help to find maternity coverage BUT I would consider this a blessing in disguise. Can you find a doula, midwife or birthing coach in your local area? You'll pay for it out of pocket but the experience and education you'll receive from that person will be the spring board in raising a healthy child today. IT WILL BE PRICELESS!!! If I had the opportunity to have my pregnancy over I would choose a doula, midwife, or birthing coach over traditional medicine any day!!!

 

[Mad Scientest]

There was an article in local newspaper the other day about how the number of woman choosing home birth has increased sharply. Cost was obviously a concern but give birth in a friendlier atmosphere was also stated plus some resented being pressured into a “C” section just to speed up the event.
Certainly don’t want the doctor to have to reschedule his golf date.:roll:

 

[Arrowwind09]

Being pregnant and then going on to insurance is considered a pre-existing condition... so you are likely stuck if this is what has happened. Call a medical and or financial counselor at your local hospital and inquire if there are any local options for people in your position. Often counselors are very aware of other community resources. If you can not find help there look for indigent clinics or free women's clinics, etc. to inquire within.

Yes, I highly recommend a midwife. I trained in midwifery and practiced for a short time.

Home birthing can be great but it is not for everyone and there are many considerations to take into account before making such a decision, to be made between partners, between the woman and the midwife and or the woman and a doctor. Although it is way less expensive you are still left wide open for financial devastation if all things do not go well and sometimes all things do not go well. A good midwife will seek out problems before the birth and address. Some of my clients did end up in the hospital becasue I determined they were not safe for home birth for one reason or another. You can't always see the reasons right off the bat, as they can develop sometimes during the course of pregnancy.

If you decide to do home birth come back and discuss it. I may be able to help you through some of the questions that wil come up

 

[Klein123]

Thank you all for your responses.

My wife is not pregnant yet. I spoke to the KP rep and they asked us to appeal with doctor's reports stating her normal health condition. I will give that a shot.

So I can call any local hospital or clinic and ask them about my options? I mean what should I be asking for? About insurance, cost?

 

[Arrowwind09]

Some hospitals have very good counselors, or social workers who know the options available in the community. Social workers often keep lists of community services and agencies, clinics, etc. especially to assist uninsured or indigent patients.

Ask to speak to a social worker first.


I think you will win your appeal. Probably an oversight of some lame brain office worker. You do not get denied access to insurance for a cold or flu that happened in the past.