On the heels of John watching "Sicko" and me hearing about it and seeing the Oprah show with Micheal Moore on it, we found out we are going to have to pay close to $2000 out of pocket for our home birth. It's super frustrating because even though our midwife is legal, because she is billing under herself and not under a doctor, our insurance considers her "out of network" and thus we pay a bundle. Here's how it breaks down. We have to pay $1250 before our insurance will pay a cent. After we've already paid all of that, then they only pay 60%, which means, we sill will wind up paying about $600-$700 more after they start paying. Even more frustrating, it looks like they aren't even going to pay for my lab work, which is done at a hospital, because it was ordered by the midwife. John's going to call them on Monday and see if he can work something out, but if we can't, there is no way we would get an ultrasound. :( Getting an ultrasound means we'd probably have to pay at least $1000 for it. Just to get a glimpse of our baby and be told everything is ok...I'm not sure we can justify $1000. Even worse, this means I'm going to have to seriously consider any and all tests I get, Ie I probably won't get anymore tests because we can't justify the cost. I don't know the statistics, but I'm sure there's at least a 95% or higher chance our baby is perfectly normal, so how can I justify hundreds of dollars just for peace of mind? I can't.
I was thinking how ironic it was-again on the heels of "Sicko"-that I am carrying an American Citizen in my belly and am having to forgo certain medical benefits-or "rights"-simply because of money. Wherever you stand on the health care issue, our country needs a HUGE overhaul. I'm voting for socialized medicine, but however you see it, certainly you can agree something needs to be done when a middle class couple can't get all the medical tests they want to ensure the health of their baby because of money and profit hungry insurance companies.
PS. On a side note, the insurance companies should be making it more attractive to have a home birth, offer more benefits, because start to finish, this birth will only cost 3 grand. That's at least half or more of what a hospital birth would cost. You'd think that knowing how much they are saving, insurance companies would be offering perks to couples who choose it just so they can have more choose it and save more money. How backwards everything is. I can't wait for Heaven where this sort of stuff doesn't exist.
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3 comments:
That is really frustrating and completely unfair. Midwives and Nurse Practioners are certified health care providers and their services should be covered under insurance. They have to be licensed to provide health care, just like an MD has to be. For them to not cover it is completely crazy! I'm sorry you are going through all of this, it is so not fair. If your insurance won't cover an ultrasound because it was not "ordered" by an MD, you may want to get one for like $100 (albeit out-ot-pocket) at one of those store-front 3D and 4D ultrasound places. Although it's not done by the same person who is taking care of you, at least you'd be able to see the baby while you're waiting. Good luck dealing with the insurance!
also some colleges that offer an ultrasound technician degree do it for free so that the students can
"practice"...
kate
Be sure to do a little research before going and getting a 3D or 4D ultrasound. I remember reading some not cool stuff about them awhile back. Also, you could look into going to a crisis pregnancy center with an ultrasound machine. We did that for our first ultrasound cause Erik wanted to be present for it and we couldn't get any appointments at the hospital that worked for his schedule. We just made a nice donation when we left. Mutually beneficial situation. They didn't ask any questions and were very nice. Just an idea.
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