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Forum: June 2013 Playroom

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  • 1 Post By Kyla0709
  • 1 Post By beatlechicksteph

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  #1  
November 29th, 2012, 12:52 PM
Mega Super Mommy
Join Date: Apr 2012
Posts: 1,580
...you realize you can't afford your doctor. So I went to the financial adviser yesterday and ended up sobbing in her office when she told me how they handle things. Things I wasn't aware of, since this is #1 for me: you have to pre-pay all of your services. I've heard this is typical? And I have to have the entire thing paid off by April. So apparently my insurance is terrible, and it only cover a teeny tiny little bit of the grand total, so I have to come up with $2300 by April. To me that didn't sound bad. Until she told me I have to pay them $470 a MONTH! We don't have almost $500 lying around to give them when I go to my appointment next week!! When I told her this, she set me up an appointment with Medicaid, to see if they'll be my secondary insurance...however, if I qualify, they don't accept Medicaid. Which is fine, I don't care. I asked her if I don't qualify, what do I do? I can't afford to pay them money next week. And she said, "Too bad, if you can't pay us, we'll send it to a collection agency." Is this typical??? Should I be looking around for other doctors? Shouldn't a doctor be willing to work with someone who can't afford it??? I've been crying for 2 days now, and I almost want to say "Screw this, we just won't see a doctor the rest of pregnancy, and just show up at the hospital when I go into labor." Which is not smart, I know, but seriously, I thought they were supposed to be "caring and willing to work with you in your special time" like all their literature says. UGH this sucks, and I need you all to cross your fingers Medicaid takes pity on me and we qualify.
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  #2  
November 29th, 2012, 12:59 PM
Mega Super Mommy
Join Date: Nov 2012
Location: Near Washington DC
Posts: 1,174
I didn't qualify for Medicare but I did however qualify for CHIP. Most states are willing to bend over backwards to help a pregnant women qualify for state health insurance. You might be MORE eligible if you drop the crap insurance you have now.

Paying for this pregnancy was my biggest concern when I got pregnant. I had no insurance. I went down to the local DHHR (welfare office) and asked if there was anything they could do to help and they said "We really do EVERYTHING we can do to cover all pregnancies and children."

Call your local office, ask about the chip program in your state. I have to pay 15.00 copay a visit and it covers everything else.
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  #3  
November 29th, 2012, 01:03 PM
navywifey2003's Avatar Home Birth Mama
Join Date: Dec 2007
Location: Clovis, CA
Posts: 37,247
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What kind of insurance do you have? I've only had military insurance with our children and did pay out of pocket for our homebirth will again with this one. What does that amount cover? Just your prenatal visits? What about delivery? Epidural if you want one? Ect. Tons of unanswered questions here! Huge hugs I hope medical goes through!
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  #4  
November 29th, 2012, 01:13 PM
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Join Date: Apr 2012
Posts: 1,580
I have Blue Cross Blue Shield, with a maternity rider, and apparently it doesn't cover anything until I hit my $1500 deductible for the maternity rider, and then they pay 50% until I hit my $2500 out of pocket maximum. If I didn't have the maternity rider, they would pay NOTHING, so I guess I should feel fortunate? But I feel like I've been paying almost $200/mo for nothing! Since just through my OB, they'll only be paying $850 of prenatal/delivery (the grand total is $3200).

I guess I'm just angry that the doctor isn't willing to work with us. We're basically on a single income and most of our money goes to rent. And she basically said, they can't work with us. We have to come up with magic money.

I just applied for a credit card that's 0% interest for a year, so worse case scenario, that's what we use...
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  #5  
November 29th, 2012, 01:21 PM
navywifey2003's Avatar Home Birth Mama
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Location: Clovis, CA
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I am laying less than that for my homebirth which is ridiculous that with insurance you are paying the same amount. What is their price for cash patients? Usually the bill more for insurance patients.
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  #6  
November 29th, 2012, 01:39 PM
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Join Date: Mar 2008
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I would also ask if they have cash discount pricing. I know one of the hospitals I delivered at even gave me a huge discount on my portion of the copay.
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  #7  
November 29th, 2012, 02:16 PM
MrsLat's Avatar Mega Super Mommy
Join Date: Oct 2012
Posts: 3,998
Get your application in to Medicaid. They really do try as hard as they can to help pregnant women. I know it would stink to change doctors, but it is better than nearly bankrupting yourself if you can avoid it! I know what it is like to have only one income... that is how me and Alex are right now. I hope you can get everything worked out.
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  #8  
November 29th, 2012, 02:17 PM
Mom2LillieAidan's Avatar Mega Super Mommy
Join Date: Jan 2009
Location: Alabama
Posts: 2,684
I would definitely see about dropping your ins and applying for Medicaid.. I hate that you're going through this when, yes, they are supposed to provide care and support during your "special time"
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  #9  
November 29th, 2012, 03:07 PM
edgeofelise's Avatar Mega Super Mommy
Join Date: May 2008
Location: Seattle, WA
Posts: 4,451
Yeah, in WA it's pretty easy to get pregnancy medical assistance. Food and cash assistance is a lot tougher because people abuse that, but Medicaid coverage is much easier because it's finite and easy to prove you actually need it. And yes, your doctor should be willing to work with you; my midwife does payment plans and even a sliding scale. I'd drop the crappy insurance, get your Medicaid app in, and in the meantime find a more considerate care provider.
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  #10  
November 29th, 2012, 04:42 PM
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Join Date: Sep 2012
Location: St. Paul MN
Posts: 773
I would definitely drop your doctor. Sounds to me like they just won't work with you. Lots of places do sliding fees now. There was this place where we were going while we didn't have insurance and all we had to pay was a $25 copay. I don't know how much a delivery charge would be however. You may even qualify for Medicaid completely if you drop your insurance. Depending on where you live, they cover you even if you make more than the qualifying income when you're pregnant. There's lots more options out there than you think, you really gotta scour for them though. I hope you figure out a solution soon!
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  #11  
November 29th, 2012, 04:47 PM
TeresaV's Avatar Mega Super Mommy
Join Date: May 2012
Location: NY State
Posts: 1,741
I have a $2600 deductible on my insurance, which will reset back to zero on January 1st, and I get to start over. I am beyond frustrated too. I had to apply for a forbearance on my student loans, because I cannot pay my student loans and medical bills. I totally feel your pain.
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  #12  
November 29th, 2012, 05:26 PM
MamaSkunk's Avatar Mega Super Mommy
Join Date: Oct 2012
Location: Minneapolis
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I would definately get a new dr too hun. Its messed up they wont work with you.
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  #13  
November 29th, 2012, 06:10 PM
8miraclez's Avatar Formerly Halfbaked
Join Date: Jul 2007
Posts: 7,472
I have a 4k deductible, which we've met for this year but get to start again next year. Then they pay 75% until we hit 10k which we could easily do if this one decides to cause problems.
Apply for medicaid. I applied back when I found out and the income guidelines are totally different when pregnant. We don't have to drop our insurance either, that way in June, when the medicaid expires, we'll still have our regular insurance.
Find a different doctor. Find a hospital around you that is non-profit, then find out which doctors deliver there. If you don't qualify for medicaid, you can apply for financial assistance through the hospital and your doctor. I'm still on a payment plan for medical expenses from 2010, but I'm only paying $50 a month.
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  #14  
November 29th, 2012, 08:50 PM
TeresaMomTo2Boys's Avatar Mega Super Mommy
Join Date: Oct 2007
Location: Lewisville Texas
Posts: 3,710
I have blue cross blue shield as well and work for Walmart....not in the stores...I work as a phone rep for our mail order pharmacy. Anyways, they (insurance) pays 80% of my sonos and about 50-70% of my other Dr visits and labor/delivery as long as I get in and out of hospital within 48hrs of birth and add baby within 30days. I have $1500 deductible and only have to pay $500 and change total so I'm only paying $105 each visit or each month. Really not bad but still considering medicaid for secondary.
I would try to file for CHIP like stated and maybe find a Dr willing to work with you. My last OB neoprene bills when I,couldn't pay and I'd just mail a check or pay on next visit.
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  #15  
November 30th, 2012, 03:53 AM
eshute's Avatar Mega Super Mommy
Join Date: Oct 2012
Location: Pittsburgh, PA
Posts: 1,719
Just a quick note, as everyone has said everything else, make sure medicaid where you are doesn't require you to take your employer's insurance. I HAD to take my employer's insurance before medicaid would take a look at me. Turns out I make just a little too much to qualify. Which really, really sucks. I hope you have better luck than me. Good luck! ((hugs))
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  #16  
November 30th, 2012, 08:00 AM
Nattie84
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Quote:
Originally Posted by beatlechicksteph View Post
...you realize you can't afford your doctor. So I went to the financial adviser yesterday and ended up sobbing in her office when she told me how they handle things. Things I wasn't aware of, since this is #1 for me: you have to pre-pay all of your services. I've heard this is typical? And I have to have the entire thing paid off by April. So apparently my insurance is terrible, and it only cover a teeny tiny little bit of the grand total, so I have to come up with $2300 by April. To me that didn't sound bad. Until she told me I have to pay them $470 a MONTH! We don't have almost $500 lying around to give them when I go to my appointment next week!! When I told her this, she set me up an appointment with Medicaid, to see if they'll be my secondary insurance...however, if I qualify, they don't accept Medicaid. Which is fine, I don't care. I asked her if I don't qualify, what do I do? I can't afford to pay them money next week. And she said, "Too bad, if you can't pay us, we'll send it to a collection agency." Is this typical??? Should I be looking around for other doctors? Shouldn't a doctor be willing to work with someone who can't afford it??? I've been crying for 2 days now, and I almost want to say "Screw this, we just won't see a doctor the rest of pregnancy, and just show up at the hospital when I go into labor." Which is not smart, I know, but seriously, I thought they were supposed to be "caring and willing to work with you in your special time" like all their literature says. UGH this sucks, and I need you all to cross your fingers Medicaid takes pity on me and we qualify.
What happend with your situation? I work in the medical billing field and may be able to give some more pointers. Medicaid of course should take you but they will want to know if there is another insurance, is there is they will not be prime. it would be best that you get dropped from your private coverage and go medicaid prime only. They have programs even if you make a decent amount of money you can get coverage due to the fact you are expecting. Also most hosptials have charity care programs for inpatient stays (they w/o the stay balance) and you have clinics that will offer you free care of accept your medicaid. let me know If I can answer any questions for you.
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  #17  
November 30th, 2012, 01:14 PM
Mega Super Mommy
Join Date: Apr 2012
Posts: 1,580
I'm meeting with the Medicaid person at the State Health Department on Monday. I've decided that I won't worry about anything until I after I meet and talk to her.

What really sucks about this whole situation is we've only lived here, and in the state, for a year and a half. We don't really know the area yet, and we don't really know that many people. And all the people I know who have had kids recently, all went to the place I've been going, so I didn't bother to do any research. Bad one on me. I'm hoping the lady at the Health Department will be able to help me find things that I need to know, and will be able to point me in the right direction, in case we don't qualify for Medicaid.
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  #18  
November 30th, 2012, 01:55 PM
Nattie84
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Posts: n/a
Quote:
Originally Posted by beatlechicksteph View Post
I'm meeting with the Medicaid person at the State Health Department on Monday. I've decided that I won't worry about anything until I after I meet and talk to her.

What really sucks about this whole situation is we've only lived here, and in the state, for a year and a half. We don't really know the area yet, and we don't really know that many people. And all the people I know who have had kids recently, all went to the place I've been going, so I didn't bother to do any research. Bad one on me. I'm hoping the lady at the Health Department will be able to help me find things that I need to know, and will be able to point me in the right direction, in case we don't qualify for Medicaid.
Well most def dont worry, there are alot of programs out here for expecting moms and their babies. You can check online for the requirements for medicaid in your state. It will tell you how much your income can be and any fees ( if any at all). If you dont qualify for medicaid I would call a hospital that is in a blue collar area, they usually have a doctor's that are free or accept medicaid. Thats how I found my doctor with my last daughter, I had Medicaid at that time ( my kids still do).
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  #19  
November 30th, 2012, 02:08 PM
Mommy to Be
Join Date: Apr 2011
Location: New York
Posts: 199
You will most likely qualify for medicaid since you are pregnant, I have blue cross blue shield, and it covers some but not a lot on my visits. I will be applying for medicaid as a secondary insurance because I am union where I work and that's where I have blue cross blue shield from, I live in NY so I dont know how it is where you live but if you apply with a letter from your doctor stating that you are pregnant and you include the bills you currently owe they will back pay 3 months of medical bills
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  #20  
November 30th, 2012, 03:25 PM
MamaSkunk's Avatar Mega Super Mommy
Join Date: Oct 2012
Location: Minneapolis
Posts: 3,064
Man insurance companies tick me off considering how much ya pay them and often they cover so little. When i was younger I worked at a casino and I paid zero out of my monthly checks for it. To add a dependent was like 8 bucks and they were covered 80% and as an employee I was covered 100% for everything...medical/dental/vision. Then I quit that job and entered the real world. Every job since then has had insurance that was way over priced just to cover myself...let alone a dependent. And they all have been absolutely useless as far as coverage! Makes me really regret quitting a native american owned casino...cuz since it was on a reservation we got federal perks and the amazing insurance was definately a perk. I was just young enough not to fully appreciate that.
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