Insurance Woes and Pregnancy Hormones

Alright, here's my first vent session on this blog. You all wanted to keep up with what's going on in our lives, right? Well, right now what is going on is insurance... or rather the lack thereof. Here's the story.

We had coverage while at CMU that lasted for an entire year, even after we graduated. So when Sam started his new job, he deferred enrolling in his employer's insurance until the school insurance had run out to avoid paying a double premium. Brilliant plan... except that we had the termination date for our school insurance wrong. We thought that our school insurance terminated on August 31st, but it actually terminated on August 1st. For those of you unfamiliar with the wonderful world of insurance, you only have 31 days after a life-changing event (i.e. losing previous coverage) to enroll in your new insurance. Since we thought we were covered until the end of August, we didn't even look into the matter until the first week of September. By then the 31 days had passed, and we were informed that "sorry, it is too late... Best of luck!"

Actually, the HR people at Sam's work were as helpful as they could be. The told us that we could appeal to headquarters to get insured through Sam's work. So, we hurried and wrote an excellent appeals letter and sent it by certified mail. In the meantime, we tried to be proactive. We assumed that we would be able to sign up for COBRA (extended coverage under your previous plan). Well, it turns out that CMU does not offer COBRA. So then we turned to private insurance. I applied with two different carriers, just to be on the safe side, because you only have 62/63 days (don't remember which) to get new insurance after your old insurance lapses otherwise pregnancy is considered a "pre-existing condition" and they do not have to cover it.

So, it all come to a head today. We received a response from our appeals letter basically saying, "Nice try, but too bad. We still aren't going to allow you to enroll. But feel free to sign-up during open enrollment. You'll be covered starting January 1st." Hmmm... that's going to be a little too late for this baby. Then we also got a response from the applications for private insurance saying I had done my applications wrong. This is true, but only because the instructions are VERY misleading. Anyway, private insurance is out the door now because the 62/63 days has already passed, so they won't cover maternity anyway. Enter pregnancy hormones. At this point, I just begin bawling. I get a grip, compose myself, and then look up maternity options for people without insurance. Then I find a good option and feel tons better. It is called Maternity Card (offered through Afforable Healthcare Options or AHCO) and basically what it does is negotiate with providers to get you a lower fee and audit your hospital bills so you aren't charged outrageous rates or for things you didn't get/use. All this for $99 a month. Sounds like a dream, huh?

I felt so much better and much less stressed. I called up Sam and told him that I had signed up for this doable option. Well, when he comes home from lunch an hour or so later, Sam tells me that he Googled AHCO and found out all this horrible things about the company (pretty much, they rip you off). I didn't really want to believe it, so I decided to check them out with the Better Business Bureau. Well, according to the website, they are rated "unsatifactory". Basically, I got duped. Good news, though. I was able to call back and cancelled, so I shouldn't be charged anything. A little ray of sunshine in this whole mess.

So now we are working on going to our providers directly and seeing what they can do for us as cash patients. Luckily, we've had a little bit of good news. My doctor gives a 30% discount for cash patients and will allow me to make monthly payments (of my choosing) without interest. We also called the local hospitals. The one I was hoping to deliver at, Kadlec, only offers a 20% dicount and that is if you pay in full within 30 days. The same goes for Kennewick General Hospital. Lourdes offers a 45% discount if you pay in advance. Lourdes as a hospital in general doesn't have the greatest reputation, but I've actually heard some good things about their maternity ward. We'll probably end up going that route. I also talked to my doctor's office, and they are going to give us a 30% discount. So, this baby is still going to end up costing a bundle, but atleast we are getting some sort of break.

Now imagine going through all this with pregnancy hormones in full force. Anytime I tried to talk to someone on the phone, I had to fight back tears. I was so embarressed! Luckily, Sam was home and did a lot of the calling. He has also done a lot of comforting and sympathizing. He's a really good husband... boy, did I luck out!