Having a baby and dealing with insurance

[ejpoeta]

Well, a couple of months ago I had a healthy baby girl. I thought I had to wait until I got her birth certificate and social security number to get her on insurance. I guess I was wrong, because now we are going to be stuck paying for the HOSPITAL BILL for her as well as her check ups at the doctor. So the hospital bill is at least $2500 just for abbey... not to mention my part of the bill for me. Then there are at least two visits to the doctor at $80 a pop. Ooh, i am so mad!! Sure, I have two kids besides Abbey. Emily was addeed to my insurance and Ashley had medicaid because I had medicaid while I was pregnant with her. So I guess I was supposed to go straight from the hospital to sign ashley up for child health plus??

I want to cry!! It's bad enough that our insurance is going to be even worse than it was this year. It's bad enough that will not be able to keep going to my counselor and probably won't be going to the doctor for any reason next year. I had wanted to get tested to make sure that my inability to lose weight isn't due to a thyroid condition because I want to try to lose weight again now that I have had Abbey. But unless I try to rush to get these things done before the end of the year, which isn't going to happen because I still ahve to pay 20% even after my deductible has been met. I swear I don't know if I can handle this!!

We just had a baby and are broke. I feel like sending the damned bill to those people who don't want me to have a choice in the matter. But even though I had not anticipated another child, I did choose to have her. I just don't know how the hell we are supposed to be able to pay a hospital bill and buy diapers and everything else. I mean, i breastfeed.... and we are better off than a lot of other people... but I am becoming increasingly more enraged over this whole health insurance bullshit. THe GOP saying how we need to slow down and wait.... and the 'dems' who are trying to neuter any sort of public option or anything to keep people like us from drowning.

We are doing what we are supposed to, but it scares me to death to think of how any illness could bankrupt us. We have busted our asses to get where we are and here we are struggling with a hospital bill and doctor bills... And this is just for a baby.... imagine if it were something like cancer or kidney disease which run in my family. I just buried my dad in april less than three weeks after he was diagnosed with a very aggressive cancer that he never had a chance with. It makes you want to get tests to make sure that you are ok.... but even if I needed to I wouldn't be able to afford it. It makes a person want to just max out on life insurance and that way when you can't get treated and inevitably die because your insurance is crap then at least the person left behind will be able to afford to take care of themselves.

I apologize. I don't bring this up with my husband because he's stressed out enough without having to worry about me going off the deep end. I want those assholes that like to pretend they represent us to have to live with my 'insurance'.... I want them to have to try to scrape by and pray to god that even though they have something calling itself insurance they don't get sick because they can't afford it.

[Hepburn]

1. Oh, geeeeeeez....

...I am so sorry. :hug:

[Ms. Toad]

2. Insurance you are usually automatically covered

as long as you were covered while pregnant. Medicaid can generally be made retroactive - and the administration generally doesn't know their own rules, so find someone who does.

Whichever it is, you need to appeal.

[Warpy]

4. Agreed, if you have family coverage

then pregnancy and childbirth are automatically covered.

Whoever you talked to is a bozo. Demand to talk to the supervisor and get nasty if you have to, threatening to find a lawyer.

[ejpoeta]

18. rhat's what my husband is good at. he said he's going to get this figured out.

[Cerridwen]

3. I can kick this and I can recommend this, but I can't say anything

to it as there are just no words.

I'm so sorry you're going through this.

:hug:

[sharp_stick]

5. Hang on a second, are you insured?

IIRC your baby should be covered by your insurance automatically for 30 days after being born isn't she? I'd be surprised if your insurance plan doesn't cover hospital time for the baby after being born. Not sure what State you're in but if you have no insurance... before giving up make sure you look into SCHIP options and State Health Plans for Infants. There is no way a bill for a just born infant shouldn't be covered somewhere.

Congratulations on having a healthy baby girl. Don't give up trying to get insurance to pay for the bill, either yours or the States.

Don't just take the hospital's word for the bill make damned sure they actually really tried to get insurance to cover it. Hospital billing departments are overworked to the breaking point in a lot of places and they screw up often.

Best of luck and please let us know how you do.

[Hekate]

6. I am so sorry. A couple of things: Appeal this asap.Send this account to your congressman/senator...

And yes, if you have the nerve, go ahead and broadcast it to the RW community in some fashion, whether in a LTTE or however you think you want to. The politicians and others who oppose real health care reform need to continually have their noses rubbed in the reality of what actual people have to deal with.

Stay strong: you will get through this. :hug:

Hekate

[pitohui]

12. better to send it to the state insurance commissioner

but for god's sake don't send it as written, send a polite explanation of what happened

[Ms. Toad]

15. That's premature.

Go through the appeal process - chances are the matter will be easily resolved. Screaming bloody murder before going through the internal appeal process just wastes a lot of energy that could be better spent on true medical/financial crises that there are no remaining avenues of appeal on.

I've done dozens of appeals - they are really not all that hard, and I've rarely had to go past the first level to get satisfaction. These companies reap financial benefit from people who don't bother to question or, if necessary, appeal. If everyone started challenging them they might have more financial motivation to do things right in the first place because (1) they always lose and (2) the appeals cost money. Right now the losses for the few who actually appeal are more than covered by the claims they don't have to pay because no one actually bothered to appeal.

But back to the main point - it's sort of like the boy who cried wolf. Better to make sure there really is a wolf first.

[DefenseLawyer]

7. I'll go you one better

I was a principle owner of a law firm for about 10 years. I had a group insurance plan that covered me and my family as well as my partners and employees and their families. At the end of last year we closed the office and liquidated the corporation. Because the group plan was not longer operative, I made arrangements to get an individual plan for me and my family (at no small expense) with the same company, Anthem, through the same agent. We had a "maternity rider" on the old plan, however when the agent submitted the new plan he left the rider off. I caught the mistake immediately and he said it was no problem and he contacted them the next day and it was added before the policy was written and before the new policy went into effect. Well as it turns out, we found out my wife was pregnant with our 3rd like a week later. We went through everything normally. Doctor visits, hospital etc etc. Everything went through our insurance, no one ever said there was a problem. In fact at the hospital the business office lady stopped in to tell us that our bill had been processed and we had met our deductible etc etc. This was last month. In the last week we have gotten bills from the OB and the hospital saying that we weren't covered because this was a "new" policy and there is a 9 month waiting period for the maternity rider to kick in on "new" policies. So about 12 grand staring me in the face. Now believe me, I have not yet begun to fight, but essentially it appears the insurance company is using the fact that the agent forgot to add the rider and it had to be "added" a day later and being a break from the old policy and therefore they refuse to cover during the waiting period. Never mind that I have paid a couple hundred a month extra for the maternity rider for the last 10 years. As they say, stay tuned.

[ejpoeta]

17. omg!! wtf! but our system is great!! why should we need a "rider" for anything!!

insurance companies are leeches as far as i am concerned!! eventually enough people will realize it i suppose. i hope you can get it straightened out. i know the publicity helped those babies that got denied. you pay for it then they screw you. no other businesas could get away with it!!!

[Patiod]

8. Congratulations on your baby girl!

It sounds like the folks here might have some solutions for you, or at least areas to explore.

I asked a "pro-life" Catholic priest recently if he realized how much cheaper abortion is compared to live births if you're not insured (and we didn't even talk about people like you who are are insured.) I positioned it as "I'm sure you're strongly supporting this health care bill, Father, since now abortion is SO much more affordable than a live birth with the current set-up, and we don't want that, do we?" Got a stupid reply, just as I expected: "insuring someone with a pre-existing condition is like a person whose house is on fire being allowed to buy fire insurance".

What I replied: "you wanna talk to my Dad, now?"

What I wish I'd replied: "It's a baby, not a pre-existing condition, Father. Isn't that how the saying goes?"

[ejpoeta]

19. i'm sure jesus would be all over that!! it's not a fire.... it's a person's life...

something these people CLAIM to cherish and think needs to be promoted... so fucking promote it christian person!! (not you... the supposedly pro life people)

[peabody]

9. I agree with the

other posters. Births are usually automatically covered and you just have to notify the insurance company
and give them some information about the baby. Do it right away; and just like a previous poster said don't
let some low level insurance bureaucrat stand in your way. Dig out your insurance policy or ask to speak to
someone higher up. Good luck.

[ejpoeta]

21. thank you for the help. i get depressed and this kind of stuff just makes things worse.

i have a a hard time thinking through things when i get like this. and hearing other ideas helps me so much. thanks to all.

[pitohui]

10. really? "we're doing what we're supposed to do" really?

sounds like to me you just had a THIRD child you can't afford, seems to me if you were doing what you were supposed to do to take care of your family you would have figured out what's causing that

there's a point at which if you keep making the same mistake i lose all sympathy for you, you say you "chose" to have an unplanned baby that you couldn't afford and now it's everybody else's fault?

as far as the insurance company, yeah, they're kicking everything back now with some bullshit excuse, just had it happen to me, i wrote an immediate letter of appeal and got the charges reversed but if you just wallow in misery and bitterness and post-partum depression then they're going to get away with it

it's a tough economic time and one of the first things insurance companies do is make little mistakes, if only one stupid person believes the first letter and thinks they have to pay this bill instead of the insurance company -- ch ching, that's $2,500 saved

your baby was almost certainly covered so instead of running around in circles like chicken w. head cut off, just write a polite well written note, not a screed or a rant, and send copies to your state insurance commissioner

[Name removed]

11. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Ms. Toad]

14. That's a tad harsh

But the basic point is correct - insurance companies make tons of mistakes - perhaps true mistakes; perhaps not. Whatever the source of the mistake, they reap the financial reward when no one challenges them.

[Tumbulu]

16. What terrible things to say to the OP and to us!!!!!

I guess you have never had a baby. I hope somehow in your life you become more human and humane.

[sharp_stick]

22. Classy reply, really classy

I'm really impressed that you can climb so high on that horse and preach to people that you really don't know the first thing about.

Why did you bother with a second reply in this thread? Was the first one a bit too levelheaded for you?

[seabeyond]

13. i paid more cash out insured having baby, then when i paid cash up front for

first child.

i got discount with both hospital and doctor for paying cash up front with first child

second child i was insured. with all the deductable the put on with me and the baby, i paid more cash.

[kentuck]

20. Good luck...there are horror stories even here on DU..

Don't surrender. Fight them.