Oct 8, 2009  •  In Personal, Pregnancy

Having the Worst Day…

After weeks of filing out forms and waiting…and waiting…I finally got approved for health insurance and received my insurance card in the mail.

Ecstatic, I began to call doctors right away. I could go on and on about how difficult it is to find a good OB in my area who accepts my new insurance, is currently accepting new patients, and does not have a months-long waiting list. But I won’t get into that now. There are more pressing issues at hand.

J and I just returned from an OB that had a last-minute cancellation and was able to fit us in the same day. I was especially anxious because we have not had a checkup in a month, and was worried at how my terrible cold had affected Tater Tot.

The doctor discovered that I had been bleeding. Not enough for me to notice, but definitely enough to have formed clots.

Luckily, we were able to hear the baby’s heartbeat, and my cervix is still closed.

The doctor has ordered a full bedrest for the next week.

At 12 weeks, my chance of miscarriage is less than 2%. This is the time that many parents decide to announce their pregnancy, with the most risky weeks behind them. It seems oddly ironic that we are at a very high risk of miscarriage during the last week of my first trimester.

Sadly, the story does not end here.

As we said goodbye to the doctor and proceeded to the front desk, the receptionist gave us an apologetic smile and told us that my insurance provider is refusing to pay for my visit.

“Did you just start coverage with them? They’re saying that your pregnancy is a pre-existing condition that is not covered under your policy.”

WTF.

When applying for insurance, I had specifically told them that I am pregnant. In fact, I had mentioned it twice in my application – the first under health history and the second under additional comments: “I am currently seeking insurance coverage for my pregnancy.”

Obviously, I can’t call to complain, because their customer support is not open on Thursdays. However, there is a very good chance that I will end up canceling the policy (I will try my best to get my first month’s premium refunded) because either they will require me to pay a sky-high fee to get prenatal coverage, or they will just flat out refuse to cover me.

Thanks a bunch, Horizon Blue Cross Blue Shield. You are yet another reason why the U.S. healthcare system sucks.

Please pray for us in this difficult situation, everyone…

10 Responses to “Having the Worst Day…”

  1. I know here in Michigan if you are pregnant you don’t have insurance you qualify for Medicade, I don’t know if it’s the same where you are, but it’s worth a shot,. J would be out of luck, but you and Tater Tot would be covered.

    Best wishes!

  2. girlonthepark:

    I am so mad on your behalf, I want to go down to Blue Cross and yell at them. I can’t believe there are people who still think the current American Health Care System is working. Nobody should ever have to worry about being able to see a doctor when they are in need and I don’t care if that makes me a “dirty socialist” for saying so. :P
    I am so sorry to hear that you are going through this right now and am sending big internet hugs your way.

  3. Awful. Just awful. :(

    I’m so sorry you’re having a hard time. Best of luck to you on trying to get different coverage, and I would definitely try to get your first month refunded.

  4. Geek in Heels:

    Thanks everyone for your support.

    Emily and Wendy – unfortunately, we do not qualify for any assistance programs because our current income level is JUST above the maximum. Thanks for the suggestions!

  5. Mary:

    I don’t have any advice to offer, but definitely sending good vibe your way.

    Oh another note, how did your doctor find out about your bleeding? Through ultrasound?

  6. I’m guessing you’ve checked into WIC already? We (and my that I mean I) freaked out a few weeks ago thinking I was pregnant and looked into WIC, which we would have just barely qualify for. The threshold for public assistance is really whack.

    What about going to Planned Parenthood or your county women’s clinic? They usually have a sliding scale for payments based on income.

  7. That is just really unfortunate. I’ll definitely be sending up some prayers for you and the fam.

  8. I think it’s absolutely ridiculous the pregnancy can be a pre-existing condition. UGH. I hope you can get the premium refunding and find an insurance that works for you.

  9. anonymous:

    hi, my sister shared your story with me (i previously worked in insurance). did you have insurance coverage under your husband’s employer before he was laid off? if so, upon his lay off, the insurance company at the time, should have sent you a Certificate of Creditable Coverage document, which is essentially proof that the two of you had insurance coverage prior to the layoff. I believe that if you show this document to Horizon, they are required by law (Health Insurance Portability & Accountability Act) to cover your pregnancy. for this to apply, you may have had to continue your prior coverage through COBRA (no break in coverage). sorry i can’t be certain of the information i’m sharing with you, but just trying to give you ideas you can look into further.

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