Friday, July 9, 2010

My healthcare nightmare...

My husband, Mason, and I were living in Atlanta and both working full-time with full-benefits when we decided to go on a baby-making-vacation to Key West. It was an amazing Christmas week filled with conch fritters, draft beer, bicycles and lots of baby-making. And the plan worked! Not only did I get knocked-up with our first child, we made a nearly equally pivotal decision to purchase the Wing Zone restaurant in Daytona Beach, FL.

A few months later, all the details of the business purchase had been negotiated. It was time to tell our respective employers the exciting news of becoming small business owners and parents! We were both working for amazing, self-made individuals who supported our decisions whole-heartedly. It seemed, in their eyes, that it was only a matter of time before Mason and I ventured out on our own. Entrepreneurship is undeniably in our blood.

My boss had some bad news for me, though. Because we were a small company with only 9 employees, they were not required to offer me COBRA benefits! Not only were they not required, they weren't going to do it. Having a pregnant woman on the rolls was going to do them no good for their young, healthy staff benefits, even when I was paying for it. Honestly, I can't remember if I had thought about my pregnancy coverage before that moment. But from then on, it was a foremost concern with our impending move to Florida.

I had full benefits through Aetna, a provider that also serviced Florida. Logic would presume that I could call Aetna and have them transfer my coverage to the State of Florida. After all, I was already a customer! I didn't get knocked-up and then decide I needed coverage, I was already covered. They were the first company I called and NOPE, I could absolutely not transfer coverage or start a new policy because I had... du du du daaaaa... a pre-existing condition.

No insurance company in the State of Florida would cover me due to my pre-existing condition of pregnancy. Comes to find out that this was not a self-imposed regulation by the insurance conglomerate. No, it was actually imposed through our Federal interstate guidelines. I would completely understand if I had no coverage before getting pregnant. I was, however, completely covered before inception and absolutely willing to pay for continued coverage. Our Federal Government decided that I wasn't allowed to carry coverage over from state to state!

So it came down to two choices:
  1. Pay out of pocket for pregnancy expenses, birth and any possibility of complications or
  2. Apply for Florida Medicaid
I applied for Florida Medicaid and was approved. Amazingly enough, pregnancy coverage comes in a one-size-fits-all package. Even though I was willing and able to pay for my benefits, I was given a 100%, full-coverage policy. And, on top of it, our son Jake was automatically put in the system upon birth for his first year of life. Again, everything covered without co-pays or premiums.

And we wonder what's wrong with our current medical system? We are limited by our Federal Government and nearly forced into government assistance, whether we want or need it.

Why didn't the proponents of Obamacare request to open state lines? Answer: government dependency.

I'm now on my second pregnancy. We've had private health insurance through Blue Cross at the price of $700/month (covering Jake & me). A maternity rider had to be added to my policy at least 3 months prior to inception at the additional cost of $120/month in order to cover the pregnancy - with a $3,000 deductible and 50/50 coverage after that. With a payment plan in effect at the OB/GYN, my family is paying over $1,000 per month for health insurance coverage. That Florida Medicaid sure sounds sweet right now!


No comments:

Post a Comment