Insurance Just Screwed Me

[Anonymous]

Anonymous wrote:Go give birth in England
Or Mexico?
Canada is also a good option

I lived in England for years. Everyone with any sort of middle class income went private for maternity care and used private hospitals etc.

[Anonymous]

OP, midwives in this area charge $3000-$4000 global fee for a home birth, from prenatal to birth to postpartum. I know you said you are too scared, but perhaps consider some more research?

Tepeyac Family Center in Fairfax is a wonderful, warm non-profit group with a lot of uninsured patients. They have a cash fee that is comparable to midwives' fees.

The problem is the hospital charges. Even a simple, no intervention vaginal birth can run $10K or more-- I know, because I had my own insurance issue with my son's birth, and had to set up a payment plan over 4 years.

So seriously, consider a birth center, at least. There is a new one in Chantilly, called Birth by Design, and the midwives are FABULOUS.

[Anonymous]

OP, if you have a benefits office at your employer (or DH's employer), see if they can help.

[Anonymous]

You should contact an insurance attorney..STAT! It will be cheaper than paying out of pocket for a hospital birth. You shouldn't have to birth at home because your insurance company is screwing you around. That's nuts!

[Anonymous]

I third the mid wife option. Much more personal, less invasive, and cheaper. A good friend delivered in her home, and the midwife gave her copies of all her notes (a small binder full), which she was very happy to have, since she couldn't exactly note when things were happening herself!

Insurance companies are the bane of most people's existence (just watch the movie Sicko). One person even through out Michael Moore's name to his insurance company (he said that Moore was filming a new movie about our healthcare system and he was going to contact him) and overnight he was magically approved.

While you are battling your insurance you need to have contingency plans. First talk to your doctor. As a PP mentioned they will most likely work with you (most hate insurance companies as much as we do). Second meet with a midwife. It can't hurt to have a cheaper alternative backup. As far as the insurance company goes whenever you talk to them have a notebook, pen, calendar, and your insurance book in front of you. Take crazy good notes, even highlight parts of your book that you know you can reference. I would get other people involved (one person mentioned the mayor) - if you let them know you are more than willing to take this public you're more likely to get things to turn in your favor. Crazy yes, but sadly this is where we are with our healthcare system currently.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Go give birth in England
Or Mexico?
Canada is also a good option

I lived in England for years. Everyone with any sort of middle class income went private for maternity care and used private hospitals etc.

A good friend of mine did not.
So she got a monetary refund from her insurance.
She had a water birth with midwives and was very happy with the experience

[Anonymous]

I did give birth at a hospital, no complications and I only stayed one night and the cost was only about $4800 including an epidural so it can be cost effective at a hospital as well.

[Anonymous]

Anonymous wrote:OP they did the very same thing to me. I sent letters to the Mayors office who put me intouch with the Department of health. I am happy to giVe you the email address of the lady who helped me of you provide an email address. They have all yr callS recorded. They told me to provide the exact dates that I called so they can look up my conversations. I told them I didnt know the dates so they said they could help me. The next day I called back asking a new person for the dates and times I called and she gave me the entire lost so I spoke with a lawyer friend who told me to write to the President of the company as well as the Mayors office. It worked the paid.

Um, why would you contact a mayor's office? They have absolutely no jurisdiction over anything to do with insurance. They just look up the right people to contact, which is something you can do yourself in about two minutes in the phone book or online.

[Anonymous]

OP. The Center for Life at Providence Hospital in Brookland provides prenatal care, labor and delivery services for uninsured women on an income based fee schedule. I know a couple of people who have had their babies under the program and they have rave reviews about the care they received. I think it's worth it to give them a call. Good luck.

[Anonymous]

File a complaint with the DC's Departmenet of Insurance, Secuirities, and Banking (DISB). DISB is the regulator for insurance policies issued in DC, including your plan. Here is a link to DISB's Consumer Alert on filing a complaint: http://disb.dc.gov/disr/frames.asp?doc=/disr/lib/disr/pdf/Final_Health_Services_DOC_4.pdf.

Do NOT delay. Once you are denied benefits or a claim, you can file a complaint with DISB.

I'm not familiar with your specific plan, so I don't know if maternity benefits are included in your policy. They are not required by law to be a covered benefit. DISB will tell you whether they are or not.

After 2014, when federal health care reform changes kick-in, maternity and newborn care will be required coverage under ALL health plans.

Good luck.

[Anonymous]

OP, another person chiming in for a birth center.

I didn't give birth in a birth center, but I DID have an unmedicated birth. Even though it was a painful and exhausting 30-hour process, I would 100% recommend unmedicated birth birth costing $4000 over a $10,000 hospital bill! The pain is manageable and even though it's bad, the first 3 weeks of parenting a newborn are SO much harder

[Anonymous]

Just to chime in.

I went with a birth center. I wound up having a C-section at the advice of the midwife a and the doc and all the nurses. It wasn't a high-alert "emergency" per se, but things weren't progressing and I was getting sick and tired and the heartbeat was dropping and so on. I would hate not to be able to comfortably agree to surgery (and the 3 day hospital stay) for fear of out of pocket costs being tooo high.

What I'm saying is: don't count on an inexpensive delivery. Definitely fight, fight, fight to get your insurance to cover.

[Anonymous]

any chance you'd qualify for Medicaid? if you live in the district the income cut-off is relatively high. otherwise, can you have your doctor's office call - it's possible you do have the coverage but the people you are talking to are wrong.

[Anonymous]

OP here. My income has been super low because I have been concentrating on this getting pregnant / IVF stuff for so long. My husband's is decent but then, he's supporting both of us on it. So I need to look into it.

I have yet to hear back from the idiots at Care First. I did look through this form to see that even 3 years ago someone posted "you call 3 times, you get 3 answers." that is still true.

My husband is taking on the duty of fighting with these morons tooth and nail. I am so beyond stressed from this I seriously had to just cry for an hour. I hate to pull this pity crap but we've been through so much to have a pregnancy actually take and now to find this out was just enough to make me consider popping some valium. (I didn't.)

I tried to call Providence hosp in Brookland but got the run around and finally disconnected. I called back and it went to voicemail so I left a message.

Sigh. I was just not equipped for this fight.

[Anonymous]

Hugs OP. You have to keep fighting. If you raise a big enough stink, they just may cave. And even if they don't, you'll be okay...you'll figure it out.