Friday, November 6, 2009

Insurance is Frustrating.

Seriously, insurance frustrates the hell out of me, and especially right now. Here's what's up:

-I have insurance through my work, which is paid by the company.
-Justin has insurance through his work, which used to be paid entirely by the company for him AND I, but since we started having to pay premiums, we took me off his insurance (which isn't great, but is better than nothing).

Our plan was to put both Lizard and I on a private insurance plan once I stopped working. We talked to the insurance agent through my work back in June, who said that my allergies might be a problem, but we could apply anyway come November (even though I would be pregnant) to make sure that I'm covered. Okay, cool. Only, when I called yesterday, he said that he can't write any individual insurance plan for me while I'm pregnant. We'd have to wait until I delivered, then apply, and then it would take several months before I was covered--if they even accept me. Um, we talked specifically about this like 6 months ago, and it wasn't a problem. But it is now. Whatever.

So, Justin talked to the insurance lady at his work, since I should be eligible to go on his as soon as I stop working since it's a qualifying life event (as is having a baby, coincidentally). However, she says that she doesn't think it actually qualifies, and that I need to wait until open enrollment in March. Ugh.

But wait...there's more. Back to Lizard...when I actually deliver her, I will still be covered by my insurance through work. We still planned to enroll her in a private plan since J's plan isn't good for frequent doctor visits. So, I talked to insurance rep about doing THAT. Of course, we can't apply until she's actually arrived...and then coverage wouldn't be effective for 2-3 months. And that's assuming there are no complications whatsoever, because if there are, the insurance company will elect not to cover her. I asked the representative what we were supposed to do in the meantime with well-baby checks and whatnot, and he said, "Uh, I don't know what to tell you."

I know that typically in Oregon, the baby is covered under the mother's insurance for the first 31 days of it's life. However, I was recently told (and I have no idea whether or not this is true or where to find out), that this only applies if the baby will then be enrolled on the mother's insurance plan after the 31 days. Well, she won't be, because I won't even be enrolled in that insurance plan. So is she covered, or not? None of this makes any sense...

And even more frustrating...there really doesn't seem to be anyone to ask!


  1. I know the feeling. I cannot tell you how many times I held back tears on the phone with a rude insurance rep because I didn't understand what I was supposed to do. Sometimes being an adult is not fun!
    In response to your posts below- you look fabulous for 30 weeks- you are almost there! And can I say that I am SO SO jealous of your new lens! Tell me how you like it- I'm a little hesitant to buy it (even though it's inexpensive)- I'm not sure if I would like the fact that it doesn't zoom.

  2. When in doubt, call mom and dad-just don't tell hubs! I know its frustrating...Matt just lost his insurance at his work and is going on mine. Luckily, it hasn't been too big of a hassle. Hope you get everything worked out! Sorry for the frustration!

  3. I hate insurance. I've had lots of issues with insurance and "pre-existing conditions". I hope you guys are able to figure something out!!

  4. I hate dealing with Insurance stuff. Can you shop around for any other private places on your own?

  5. The baby needs insurance for those well-visits. Put her on J's plan at work (qualifying life event) until she can be covered by a private insurance plan. It's better than nothing. And you definitely should be able to jump on his plan as well - again, qualifying life event. My SIL is going on my brother's as soon as she delivers (but couldn't before b/c her pregnancy was pre-existing condition).

    Does J's company have an HR rep that handles this or an insurance broker? You need to schedule a meeting directly with them to tell them your expectations for coverage - not to ask them what they can do.

  6. I used to cover health insurance and policy when I worked as a journalist. Unfortunately, I'm mostly only familiar with how things work in Florida (where I live and worked).

    I do know this, though:

    Worst-case scenario, every pregnant woman is allowed to claim pregnancy Medicaid (it's called something else, depending on the state you're in, but it's run under the federal Medicaid services) and that insurance will cover you and baby for 31 days, regardless of previous insurance, husbands' insurance, or income level.

    Now, it's a huge pain in the behind to file for and get, but at the very least, baby is covered, from my understanding of it all.

    Let me ask someone who may be able to give me a more specific answer. If I can find out, I'll let you know.

  7. The insurance companies are also doing especially ridiculous shit right now in anticipation of whatever half-assed legislation Congress manages to pass (if they do).

    Health care in this country is a crime against humanity.

  8. What about continuing your coverage under COBRA? Even if your workplace doesn't have 20 employees to qualify for federal coverage, your state COBRA would cover you. I would also contact your state department of insurance, their website would probably have a lot of info and you can also call them. Also check out the DOL site regarding employee benefits:
    It says (and it's what I have always understood) that pregnancy isn't a preexisting condition and that they baby is covered from day 1. Hope those sites help some! Good luck!


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