Sunday, February 2, 2014

Week 20: Insurance Saga, Part 2

In my last post, I wrote about my insurance history and our most recent decision to move to "cost-sharing" through Christian Healthcare Ministries. My routine diabetes expenditures will not be covered, but all the unexpected things will be. This is OK, because after calculating it, my routine diabetes expenditures + the monthly cost of the program = about the same or a little less than what I was paying on insurance.

But then, I'm also pregnant. And unfortunately, CHM won't cover costs for this pregnancy, even though it does cover pregnancy costs under some conditions. So it's back to the Office of Family Services I go, to try to explain our complicated insurance situation, hope they'll agree that I'm poor enough to cover with Medicaid, and probably have to make several phone calls to see if I can get in touch with someone who can understand what's going on with us and won't just tell me to wait 10 more days, or 30 days, or until I get a letter in the mail.

Well, I applied for Medicaid on October 30. As of January 21, I had no word back. I had accrued about $700 worth of medical bills, and I was not sure whether they'd be covered. I had an ultrasound scheduled, which would be another several hundred dollars, and I didn't know whether it would be covered. I called two times, and they said they would get back to me. One woman called and said they were still processing applications from July, and that since I had primary insurance, I would have to submit more paperwork and wait longer. I don't think she realized that a) I was pregnant, and b) my primary insurance didn't cover maternity expenses, and c) I had actually dropped the insurance plan because it was absurdly expensive and not covering the maternity I needed it to cover anyway. I tried to explain, but she refused to give me her name and just said, "I'm just helping out. We are very short-staffed."

I was anxious. I didn't how long to wait before calling again. Each call was approximately 45 minutes-worth of hold time before speaking to someone. This someone often can't tell you anything concrete or definite. We are definitely willing to pay out of our own pocket to have this baby, but knowing that we are financially responsible would completely change the way that I agree to (or refuse) certain kinds of care and testing. I wouldn't be able to simply do every blood draw, every NST, and every ultrasound they suggested. It's a fight to get Medicaid, and a different kind of fight to insist to my doctors that I don't have the money to pay for, nor do I really need, a lot of testing. In short, I was feeling poor, pinched, without many good choices, and a lot stressed about it.

This experience taught me a lot about what it is like to be on the margins of society. What great pity we should have for the poor! I am only poor temporarily, while my husband is in school. We also live with my parents, who are so generous to us. But chronic poverty? Chronic uncertainty? Chronic dependence upon a system whose response is uncertain and you cannot always rely upon? Chronic admonishments from your doctor about the necessity of testing and treatment your health, coupled with a true inability to pay for the recommended care? I don't know how government assistance can be made more effective for the poor, and I'm not certain that a constantly-changing set of government mandates under the Affordable Care Act really makes for the best healthcare situation for the most people. But I can now at least say, with certainty, that the poor are to be pitied by each and every one of us, and we ought to be willing to stretch ourselves out with compassion for them!  I don't only say this for my poor self, but especially for those who constantly live on the edge of poverty all their lives.

The end result of all of this is that I was, in fact, accepted for Medicaid coverage. This is a great relief. In fact, it's an answer to a prayer I forgot to make. I spent so much time worrying about who I should call, whether I should cancel my doctor's appointments, how and whether we would pay for various kinds of treatments and tests, and so on and so on, that I forgot to rest in the confidence of God's love and serenity. In His kindness, He gave it anyway!

No comments:

Post a Comment