A Penny For My Healthcare? -- My Pregnant Life

11

Igoe letter
A penny's worth of panic
I spent a huge chunk of the past week arguing with my health insurance provider. It scared the bejesus out of me, which my mom insists could have made me miscarry. I have not heard "had bejesus scared out of her" listed as a cause of miscarriage, but I certainly wasn't in the stress-free state my doctor recommends.


I still get health care through COBRA from my old job, subsidized by the stimulus plan. Thank goodness, because I'm not sure what we'd do otherwise. In fact, it runs out a month after my baby comes, so everything had better be all right ... Can't think about that now, though.

Here's what happened: I got a letter saying my policy had been cancelled for nonpayment.

I called right away, because I'd paid through online banking; they said they had not received that check, and I couldn't re-send it, because they didn't accept late payments. I got on the phone with my bank, who confirmed they'd sent it on time and even conference-called the insurance company. Didn't matter; they'd already cancelled me and I would remain cancelled till the check showed up. There was nothing to do but call back each day to see if it showed up.

During that time, I researched new health plans. Remember, I have an extremely high-risk pregnancy; I delivered early last time, and Penelope's isolette alone cost $2,500 a day. The cheapest plan I could find was an HMO that contained none of the team of doctors working hard to keep this pregnancy afloat, and there was no guarantee – in fact, a very slim chance – that I would be taken with my "pre-existing condition."

When I called back, I got different information: Oh, they had the check all right, but the company had changed systems; the old system rounded down a penny, the new system rounded up a penny, so it looked like I had paid a penny less than required, which gave them cause to cancel me. The rep on the phone assured me she'd "try really hard" to get me reinstated, but couldn't make any promises, and the process would take 3-5 days.

While I lost my shit and scared the crap out of my toddler, my husband got on the phone to our Congresswoman, who is – guess who? Nancy Pelosi. If you're not familiar, she also acts as Speaker of the House and has been instrumental in pushing the health-care bill through, earning her jeers (and worse) from the right (too liberal!) and the left (not liberal enough!).

Whatever your opinions on the big picture may be, for my individual situation, she was amazing. Her office told me exactly what the insurance company was allowed to do (they could not cancel me like that; if the error was theirs, they had to give me a written warning with 30 days to make up the ONE PENNY difference). I was given two different offices to call, the Department of Labor (and talk to a Benefits Advisor) and the Calfiornia Department of Insurance Consumer Hotline. The first office had even more helpful information, collected mine, and called the insurance company on my behalf.

Within an hour I had a call back from the insurance company, assuring me that I and all the hundreds of other people affected by their software glitch would receive a letter on Monday confirming that we were resinstated. She acted all friendly with me, as if we were old chums who'd been through some sort of ordeal together. "I'm your advocate," she kept telling me. Yeah. My advocate. Tell that to my blood pressure.

This story is NOTHING. It has a happy ending, and there are many, many moms dealing with much worse insurance and heathcare woes. But you know, I'm the sort of person the anti-health-plan people praise: I pay through the nose for a family plan, and I'm responsible with my payments even though they take up a huge chunk of my income (almost half my monthly CafeMom paycheck goes straight to COBRA).

Yet I still almost got hosed because of a computer error; if I lost health care halfway through this pregnancy, I would be bankrupted, and I'd be one more "irresponsible consumer" dismissed by the health plan's foes. I'm still waking up in a panic over this, even though I know I'm okay for now.

This has been horrible for my pregnancy. This is stress, worry and fear when I need to feel healthy and positive. This is wasted time and energy when I could have been pitching more stories to editors, working on more articles, making more money. Or just enjoying my family on a beautiful weekend. I'm sorry, I don't usually get political on my blog – and you'll have the usual Amy back on Thursday. I just had to get this off my bloated, colostrum-producing chest.

Are you having your own health-insurance woes? Have they affected your pregnancy or your kids? Tell us in the comments!

2nd trimester, doctor visits, emotions, pregnancy health, recession guide, the pregnant life, weekly pregnancy calendar

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CafeSona CafeSona

This is so sad -- and not at all unusual. I'm paying for individual healthcare, too, and it's crazy what the insurance companies will try to get away with. And usually can. I hope this health care reform thing actually changes things for the better. I know I -- along with millions of other Americans -- am waiting with bated breath to see if it really makes a difference.

lovin... lovinangels

i'm sorry you had to go through this, and while I am no Pelosi fan, I'm glad her office did a good job for you.

as for the health care plan, I hate it. it doesn't do nearly enough to address issues, but I do like some bits. You should put your feet up a bit and have some nice hot decaf tea.

nonmember avatar Colleen C

WOW! It's stories like this that make me so glad to be in Canada. We have a plan that has everyone covered. This just wouldn't happen here. Do we have long lines at hospitals at times? Yes. But every system has issues. At least my health care choices aren't dictated to me by an HMO. If my Doctor orders extra tests or decides to operate, or whatever it is, I am covered.

My BIL is a doctor in the US, and his mother is with an HMO. In order for her to get the care she needed, he flew her from California to his state, and had her cared for at his expense. She had cancer, was dying, and he is an Oncologist, and had other specialists call her HMO to get her the proper care, and they still denied it, and delayed it as much as possible.

It's tough in the US when you have health issues. And there are a lot of us up here that don't get how lucky we are.

I am glad this worked out for your for now. Best of luck with the baby and with the future. All the best!

Sabre... SabresMama09

I'm so sorry this happened to you- I had issues with my insurance right when I found out I was pregnant, and they still continue. My health insurance was cancelled 2 months into my pregnancy because I just graduated from college a month before and couldn't be carried on my parents' anymore, but my job didn't offer benefits. I couldn't afford to buy my own insurance or COBRA, so I ended up going to the Medicaid office to see what they could do. I was covered and so was my son- up until he's 1 year old. All was going fine until a few weeks ago when I got a letter from my insurance company that said I was cancelled because they didn't receive my information on my current income. Apparently they didn't hear that the Social Services building in my town had BURNED DOWN, so instead of contacting me to tell me that my social worker hadn't sent in my proof of income, they simply cancelled me. My son is still covered, which is all that really matters to me right now, but I'm not. I offered to send my proof of income personally to be reinstated, however it was "too late because I was already cancelled." I understand that a lot of people assume that anyone on Medicaid is lazy, milking the system, and doesn't work to help themselves, but that's simply untrue and this whole situation is extremely frustrating to me. Change is necessary.

Cafe... Cafe MicheleZ

Wow, Amy. I too am so sorry you had to go through this. Okay, this is what you must do ... deep breaths, ohmmmmm, ohmmmmmm, ohmmmmm, envision blood pressure lowering .... I would send you a cookie but that will probably just jolt you too much. Hugs from me and my Penelope.

Super... SuperMomof3kids

I usually stay out of politics, and I will honestly admit that I havent paid that much attention to the national healthcare plan, but I will say that SOMETHING needs to be done about insurance and health care in this country. I have 3 children, my older 2 are covered by the state, I am no longer able to work, so I have to count on it. My youngest is covered thru her Dad and his job, but is also covered by the state for anything that her primary insurance doesnt cover. I am giving this background to show my point. Last yr, my middle child needed her tonsils and adnoids taken out, she was seen in May by her Primary MD and the referal for ENT went in. It was August before she was seen by ENT and Sept before she has surgery. My youngest needs her tonsils out too, I took her to her primary MD, the referal went in, she was seen by ENT the following week, and the earliest she could go in for surgery (due to scheduling at the surgery center) is May 4th, but we decided to wait til the end of May so school would be out and she wouldnt miss the last 2 weeks of school for recovery. My whole point is this, why did my younger daughter get in in less than 2 weeks while my other daughter (who is covered by the state) had to wait almost 4 MONTHS!!! Why is one child treated differently than the other??? Shouldn't healthcare be provided the same regardless of who is paying for it? Apparently not. It makes absolutely NO sense at all to me.

nonmember avatar Shannon's Mommy

I want to thank you for posting this because, as you pointed out, no mother should have to count not having healthcare among her worries when she is sheltering a new life and trying to juggle hers at once. I was uninsured when I became pregnant, and since pregnancy is considered a preexisting condition, I can find no insurance company willing to cover me. This leaves my husband and I with a few thousand dollars in prenatal care bills and hospital delivery bills that I assumed we'd be able to pay a little at a time, until they were paid in full. Today, I recieved notification from my OBGYN that the payments we have been making are not enough and that if they do not recieve $1,000 within the next fourteen days they are dropping me as a patient just as I enter the beginning of my third trimester. That payment is more than our rent, car payment, and utilities combined, but really what choice do we have? I'm not completely for universal healthcare (surprisingly) but I do think it's a shame that people's personal health and wellbeing has become such an inpersonal business in America.

madfoot madfoot

amazing stories, guys. keep 'em coming. thank you.

nonmember avatar Kim Stewart

I got pregnant last year after 7 years of infertility, while my husband was unemployed, just before our COBRA ran out. I had to go on MediCal, our state welfare program - no other insurance would take me. Luckily, we qualified.
I honestly don't understand those who oppose healthcare reform. I don't know anybody who isn't paying more for less service than they were 10 years ago. I only wish we had gone to a single payer system.

nonmember avatar Rachel Galardo

wow, that's crazy! glad you got everything sorted out..

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