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-   -   Ok I need to vent about insurance **UPDATED 10/21** (http://www.justmommies.com/forums/f133-pregnancy-and-motherhood-after-loss/2433720-ok-i-need-to-vent-about-insurance-updated-10-21-a.html)

LindseyE117 October 18th, 2011 12:02 PM

Ok I need to vent about insurance **UPDATED 10/21**
 
So literally right before we found out that I was pregnant we lost our insurance due to unforseen circumstances. I have been frantically trying to get on the CHIP program here for prenatal care. We literally did not qualify by $10 over. $10!!! I did not realize though that they deduct child care expenses and that would help us qualify, so I applied with the help of one of their workers.

Today I get a rejection letter just for me, not for my kids but for me. I had to write out a long appeal letter to hopefully get me approved, otherwise there is no way in h*ll I can afford any of this. I am freaking out. After all this time I finally get my pregnancy, only not to be able to find prenatal care.

I am so afraid that I will lose another pregnancy and it will be my fault for not getting the proper care. I broke down in tears. I even called my OB and asked how much it would be out of pocket, and it is $500 just for the first visit. I couldn't even find a free clinic anywhere near here either.

After everything, that stupid RE broke us. All my money that I had saved up for our pregnancy and baby is gone. I don't qualify for Medicaid either. I have no idea what to do right now. I guess just wait even longer to find out if I get rejected again. :cry:

**UPDATE**

The lady at one of the clinics had a medicaid worker review my case (there is a Medicaid worker on site), and they think I will qualify for the CHIP. She actually called me back! They went ahead and scheduled my appointment for next week on Thursday 10/27 at 8:30 am! It is also based on a sliding fee schedule so I won't have to pay so much up front. I will be 6 weeks and 2 days then, so hopefully I can get an u/s. I am still scared half to death because this is how far along I was with my first loss, so I have been having a really bad day. I have cried all day long for nothing. Stupid hormones. :p

missy123 October 18th, 2011 12:13 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Deep, Deep breaths Lindsey. I went through the same thing.

It is going to take a lot of work on your part but you will get there. I ended up not being able to go to the doctor from 8 weeks - 15 weeks but all was ok.

First - are you taking a prenatal vitamin? If not, they sell generic ones at Walmart for $4.00 a bottle. This is what I take.

Second - Appeal the medicaid. It takes time but you can plead your case. Were your children approved or denied or no response yet?

Third - You can call a planned parenthood office in your area and they can help you find resources for a free clinic. It may take you 1-3 months to get in but you will get the care you need.

If you are rejected for medicaid totally the free clinics will work on a sliding scale for your prenatal care. It will happen and this will get resolved it is just extremely stressful right now.

Keep a notebook of all the steps you are taking. It will be ok in the end. (((HUGS)))

LindseyE117 October 18th, 2011 12:23 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Missy, my kid's case is still pending because they asked for more information. I just submitted my appeal letter today too. There are no free clinics even remotely near here either. They are over an hour away, and I cannot make the drive with my anxiety and Houston traffic.

I am taking a prenatal vitamin. I have the Target generic ones from the whole RE thing. I also have one more month of progesterone. I think I may have a refill still through my pharmacy, but I will have to check and pay out of pocket. I am just so frusterated and I am afraid that the stress will hurt me. I started balling over the phone with James. Ugh....

melissalaw October 18th, 2011 12:54 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Lindsey I am so sorry that you are having to deal with this. Pregnancy after loss is stressful enough without having to deal with insurance problems. I am praying that everything works out for you. Sounds like Missy has some good advice.

StaceygirlPa October 18th, 2011 01:25 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Try to take a deep breath. I would keep listening to Missy. She has been through it. She can help you. You might have to have James drive you to a clinic. I think Missy has to drive over an hour way to her doctor.

missy123 October 18th, 2011 01:35 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
yeah, my clinic is 45+ minutes away but worth it!

All of this is super stressful honey. I cried and stressed and worried and freaked out as I went through the process.

If your anxiety is too much for you to drive then your husband is going to have to take you. Many of the clinics have night time hours 1 or 2 days a week.

This is what I suggest: Call up as many of the clinics as you can - schedule an appointment with one of them. Tell them you are appealing the medicaid (and by the way did you put down that you have anxiety issues? Having a documented medical condition on top of being pregnant puts you in a different category as well). Tell them you want to set up a sliding scale fee schedule. Then when you are approved for the medicaid or chip they will go back and pay all the bills.

If you can't find a clinic start calling the Labor and Delivery departments at the hospitals closest to you. They will know where you should go :)

It is ok to cry and be stressed right now. This will all work out in the end.

lindsey2000k October 18th, 2011 02:02 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Im so sorry. I wish I had good suggestions for you.
With insurance this pregnancy is still going to cost me $9000.00 out of pocket UGH.

I know some DR's offer a Self pay option and it is deeply discounted you can always try to call OB's in your area and ask what the Self pay option would be. Your DR told you $500.00 per visit but thats what he submits to the insurance company... he probably only gets $50-$75 of that. So sometimes you can argue that and only pay that amount.
I was with out insurance and got sick years ago and my insurance co pay was $35.00 the self pay option at my DR office was $45.00 I was so pissed that it was almost as cheap to not have any insurance at all .... then they gave me samples so I did not need to pay for a prescription. So in the end it was cheaper for me not to have insurance.

My Friends family does not belive in insurance and she had a baby and it was a C section and the bill was $14,000. She argued it and kept aplling for help and in the end I think only had to pay $2000.00 of that. Again cheaper than someone who had insurance would have had to pay. I had a baby around the same time and none C section so it was cheaper and with my insurance I still had a $4,000 hospital bill.

Sorry this subject pissed me off after I had to pay $3500 for a D&C last year and I was only in the hospital 2 hours. I was told by the hospital billing staff if I did not have insurance they would have been willing to work with me but since I do I am on my own.

luvmykids623 October 18th, 2011 02:49 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
I'm so sorry you're going through this. You have every right to be upset. You've gotten really great advice! I hope it all works out soon. :hug:

AZsnowflake October 18th, 2011 03:26 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
I'm sorry :( I hope it all gets worked out for you soon!

TnPhotoMama81 October 18th, 2011 04:41 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
I agree with Missy's advice as well. I think it will all work out in the end.

I lived in Houston for several years (I am originally from Beaumont - not sure if you knew that or not) so I totally understand about Houston traffic. I lived right on Westheimer near the Galleria. I am so glad I don't live in that area anymore...it was a very stressful place to live!

SillyKitty October 18th, 2011 05:11 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
I'm so sorry you are going through this (but congrats on your pregnancy!). I think Missy has provided you with some good advice.

LindseyE117 October 18th, 2011 06:17 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Quote:

Originally Posted by TnPhotoMama81 (Post 25040622)
I agree with Missy's advice as well. I think it will all work out in the end.

I lived in Houston for several years (I am originally from Beaumont - not sure if you knew that or not) so I totally understand about Houston traffic. I lived right on Westheimer near the Galleria. I am so glad I don't live in that area anymore...it was a very stressful place to live!

I did not know that. I am originally from Lake Charles. Our mini vacations consisted of going to Beaumont for the mall and Chuck E Cheese. Lol. Lake Charles has grown a LOT since then.

We live 30 miles south of Houston. I could NEVER live downtown and drive. Ever since my accident, my anxiety has shot through the roof.

Also, thanks Missy. I am definately going to start looking into that ASAP.

missy123 October 18th, 2011 07:56 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
You just keep venting away and posting... We are here for you!! :pullhair: <--- It will feel like that often. LOL

JessP October 18th, 2011 08:04 PM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
So sorry I hope it all works out. Keep us posted.

.:Shortcake:. October 19th, 2011 05:32 AM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Lindsey I am so sorry that after all you have been through now you have to deal with this. I agree with Missy. She has been there and has all the answers for you right now. I hope that your appeal is heard and they approve you. ((HUGS))

Happy Song October 21st, 2011 04:07 AM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
I read everything and I am not sure what your exact issues are with you previous loss/losses. But thinking outside the box can you see a nurse midwife? They are usually much cheaper and are used to doing out of pocket.

Good luck!

hearts.0nfire October 21st, 2011 04:25 AM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
:dothug: . Missy gave some great advice. I really hope everything works out and you are able to get medicaid/chips soon. I was so worried about not getting it this time, and someone had suggested looking up Ameriplan which offers discounts on everything.

LindseyE117 October 21st, 2011 04:52 AM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Well ladies I found a free clinic about an hour away from here until the insurance stuff gets figured out. I am going ot make an appointment today for next week if possible. James already said he would take me.

I tried to make an appointment yesterday, but I called a little too late. I was shaking so bad while I was doing it (I keep having nightmares that I was bleed before then or have another u/s with no baby in the uterus). Plus I am at my loss point right now for my first loss and I have been freaking out more than usual. Bleh. I'll keep yall updated.

LindseyE117 October 21st, 2011 06:35 AM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
Edit that, seeing how I am in another county, they will NOT see me at all. This sucks!!!! Grrrrrrrrrr!!!!

KeepingFaith October 21st, 2011 06:59 AM

Re: Ok I need to vent about insurance, so I am sorry in advance...
 
I'm so sorry Lindsey, I hope you can figure something out. ((HUGS))


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