Tuesday, January 1, 2013

The Big Health Insurance Drama of 2012

Hmmm, little did we know how much we were about to spend on this hospital stay....

I know that many people write about what 2012 looked like for them and what their hopes and plans are for 2013.  I was going to do that, but in all honesty, the one topic that kept coming up over and over again for Paul and I was health insurance.

Many of you have seen posts of mine on Facebook about Evie not having health insurance.  It was definitely one LONG year of praying and stressing about her health and counting down the months, weeks, days, and hours until January 1, 2013.   I have been waiting to blog about this until all was well and taken care of, so without further ado....our big Health Insurance Drama of 2012.

Evie was born November 11, 2011.  All was good.  I had an emergency c-section, but other than that, things were no big deal.  In January I brought Evie in for her 2 month check up only for them to inform me that she was not in their system.  Rather shocked, we did some calling around, and realized Paul and I completely missed enrolling her in our group plan.  By all means, feel free to call us idiots.  We know.  We could not believe that we let this slip our minds.  We figured we would get it all worked out and it would be no big deal.  HA!

You dummies!
Over the next couple of weeks it was made very clear to us that since we missed our 30 day enrollment period to add her, we could not add her until the next enrollment period that wouldn't become effective until January 1st, 2013.  The only way we could make a change is if Paul was fired and rehired, we had another child (HA!), or we divorced and remarried.  Not going to lie--we actually entertained the idea of getting divorced and remarried in order to add her.

During this time I was an anxious mess. I felt like an awful mother.  I felt so guilty.  Thankfully, Paul and I never went after each other during this time with the blame game.  Neither of us pointed fingers, but instead we took it one step at a time and worked together to figure out a solution.  We finally accepted that Evie was not going to be able to be added onto our group plan, so the next step was figuring out how to find her insurance elsewhere.

We first looked into getting her on her own individual plan, but it turns out that if you are under the age of 18 you cannot do this.  Therefore, I was going to leave our group plan to get onto my own insurance and add Evie under me.  Easy, right?  Nope.  I was denied by one insurance company because they said they could only offer insurance to me if they were a last resort, and since I would be voluntarily leaving my group plan they could not be considered a last resort.  We tried to explain that they were our last resort for getting insurance for our infant, but that did not change their decision.

I was denied from two other insurance companies due to my health history.  The items they listed were the facts that I had a c-section, I suffered from migraines, and I had a history of bladder infections (this issue only arises after I give birth).  In general, I am a very healthy person, so I was shocked that I was denied health insurance because of these items.  Paul and I began to wonder how anyone gets insurance without a group plan!

I should add that I did call the state of Michigan to look into MiChild.  Unfortunately, and fortunately really, we did not qualify for this based off of our income.  I asked them if they had any other suggestions and they could not give us much.  They gave me information about another company I could look at that offered insurance for people with pre-existing conditions.  I looked into it, but my "conditions" weren't severe enough, AND I have to be without 6 months before I can even began to be insured through them.

So, here we sat.  Evie could not be added to our group plan, but could not be on her own individual plan.  I could not get insurance outside of the group plan in order to add her to mine, and MiChild wasn't going to work either.  All in all, we were willing to pay out of pocket to make sure our daughter had health insurance and we still hit dead ends.

We began to call our congressmen and send emails and letters.  We called the Insurance Commissioner of Michigan.  We tried to advocate for SOMETHING for ANYTHING.  We did find that they tried to help us, but even they were running into dead ends and road blocks.

During this time we had to start figuring out how and where we would be getting her well-child visits and immunizations.  For one, we had a hefty hospital bill to pay off for her.  In case you were wondering---those basinets that are in the rooms are $1000 a day.  Just saying.

We are part of Grand Valley Health Plan and they worked great with us on trying to figure out how to get Evie some coverage.  They have something called PrimeCare, which allows us to pay for 4 visits at a time at a discounted rate.  We had to do this twice during the year, but it was well worth it, and gave me a huge sense of peace.  We went through all 8 of our visits between well-child appointments and basic appointments for when Evie became sick.  As far as immunizations, I went to the Health Department, and because we had zero insurance for her I only had to pay the minimum amount for each injection.  Nonetheless, this was still very expensive.

Thankfully, Evie never had anything serious happen to her.  I definitely thought twice before putting her into any nursery, and once she started moving I felt like a helicopter parent because I was so scared of her falling and needing stitches or getting a concussion.  Anyone that knows me knows that I don't tend to get overly worried about these things, but this year was an entirely different perspective.  My mind also went to the awful thought of her having cancer or some other terrible disease.  Not likely, but still was something I thought about.  The fear of Evie getting sick or hurt and not being able to give her proper health care was petrifying to me.  Thankfully, my MAJOR anxiety was in those first few months, and then I was able to relax a bit and focused on praying nothing awful would happen to her.

I know this was our fault and we were so stupid to miss enrolling Evie, however, I am still really disappointed that we weren't left with any options for her.  This was definitely a costly mistake for us, but I fear how much more costly it could have been if Evie needed a hospitalization or major testing.  Money should not be an issue when it comes to health care for your child, but I learned this year that it definitely is thought about when you don't have insurance.

So, all in all, the biggest lesson we learned and want others to learn from us is NOT TO MISS THE 30 DAY ENROLLMENT period.  Paul and I have made it very clear that when we have our next child we are going to be trying to fill out the enrollment form in the hospital!

This year we were happy to ring in the new year with great friends, but even more so, when that ball dropped Paul and I gave each other a kiss and we both breathed a HUGE sigh of relief.  This was one new year that we had been anticipating for a very long time.  We had made it.

Happy New Year from the Thompson family, especially this little healthy cutie!!

(Kate Krueger Photography)

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