The Internet Rocks
And then there was a ray of hope.
Before I get to the ray itself, I want to thank everyone for your support and creative suggestions. Many people had great ideas but Talia Devane, in particular, gets credit for the possibility which may ultimately give us more options. She suggested that we might be able to request an exception from our insurance company exactly BECAUSE midwifery care is no longer available in our area. Cait spent a long time and a lot of patience on the phone this afternoon trying to do just that (being disconnected and reconnected and repeating the same thing again and again) and was ultimately able to file the appeal. We should have an answer within a few weeks.
So a HUGE thanks to Talia Devane!!! (If this works out we owe you big time!!!)
AND the billing guy from BirthCare just called to tell us to try the exception strategy (and that they have someone with our coverage who GOT an exception, so there really is hope) but I got to tell him that we'd already done it, thanks to our friends in the computer. You rock!
Interesting thing we learned in this process: yet ANOTHER birth center in the DC area has gone out of business in the past year or two. For those keeping track: once upon a time there were four. Now there are two and the third is down to one lonely midwife. And nearly, if not all of the independent midwives are out of business.
Oh, and...
... we've got flickers! :) The full moon apparently got Harpo excited and I have definitely felt some flutters and tickles. And Cait, glued to my abdomen. I feel that a lot now. :) Yay!
Before I get to the ray itself, I want to thank everyone for your support and creative suggestions. Many people had great ideas but Talia Devane, in particular, gets credit for the possibility which may ultimately give us more options. She suggested that we might be able to request an exception from our insurance company exactly BECAUSE midwifery care is no longer available in our area. Cait spent a long time and a lot of patience on the phone this afternoon trying to do just that (being disconnected and reconnected and repeating the same thing again and again) and was ultimately able to file the appeal. We should have an answer within a few weeks.
So a HUGE thanks to Talia Devane!!! (If this works out we owe you big time!!!)
AND the billing guy from BirthCare just called to tell us to try the exception strategy (and that they have someone with our coverage who GOT an exception, so there really is hope) but I got to tell him that we'd already done it, thanks to our friends in the computer. You rock!
Interesting thing we learned in this process: yet ANOTHER birth center in the DC area has gone out of business in the past year or two. For those keeping track: once upon a time there were four. Now there are two and the third is down to one lonely midwife. And nearly, if not all of the independent midwives are out of business.
Oh, and...
... we've got flickers! :) The full moon apparently got Harpo excited and I have definitely felt some flutters and tickles. And Cait, glued to my abdomen. I feel that a lot now. :) Yay!
posted by Jen at
8:07 PM
11 Comments:
Excellent news.
Yes, insurance companies generally make an exception when there is only one provider in the area. It'll probably be covered as an out of network expense, which is normally subject to a completely separate deductible and has higher coninsurance, but should be covered.
We were paying out of pocket completely for Charlie's birth because her insurance doesn't cover 'standard' maternity care. From conception to birth, the whole thing (prenatal included) would have cost us $3600. However, her insurance, for some reason, does cover any emergency care. So when he became an emergency birth, everything was covered.
Hopefully things will work out in your favor!
By
Estelle, at 2:06 AM
I'm glad I was able to help. Congratulations on the flickers, they only get stronger from here, judt don't get too concerned if you don't feel any for days at a time right at the start. My baby did that, I felt him really early, but he was still small enough to hide. Now, he moves all the time. Beware the cervix punches.
By
Anonymous, at 4:41 AM
yea flickers!
I can totaly see Cait glued to your abdomen! :)
By
Shelli, at 8:55 AM
yay to flutters & flickers!!!
By
Calliope, at 10:03 AM
OMG how terribly exciting. I can't believe how far along you are. And good news on the insurance front.
Looking forward to seeing you guys tonight.
By
Anonymous, at 10:40 AM
Awww...I remember when you guys got inseminated with Harpo, and now s/he's moving! Yaaaay! And I second what Thalia said--you may suddenly not feel anything for a couple of days, but don't worry. Happened to me with all three. Congrats, and good luck with the insurance co. (I'm fighting with mine right now about my little guy in the hospital and it's about to get reeeeeeal ugly).
By
Anonymous, at 1:07 PM
It's actually already covered as out of network, but we can't afford that. We're trying to get an exception on the basis that there AREN'T any midwives in network. If they grant the exception, our care would be treated as if it were in-network.
And before anyone gets the wrong idea, I know we are lucky to have the coverage we do. Stories like Estelle's terrify me. How on earth could an insurance company justify not covering maternity care?!?!?
By
Jen, at 1:57 PM
Lovely, lovely flickers. I hear they're among life's most magical. =)
By
deanna, at 12:06 PM
Exciting on both fronts! Yay!
By
hd, at 6:44 PM
Woo hoo for movement!!! Go Harpo! I hope you win your petition!
(Oh, and count me as another with zero maternity coverage. Only emergencies/"complications of pregnancy." Yee ha.)
By
Elowyn, at 9:45 PM
As an attorney - my advice, for whatever it's worth, is to follow up your appeal by telephone in writing.
Perhaps I'm a bit paranoid, but it never hurts to document it in writing.
And the flutters? That's the closest thing to magic that I can imagine.
By
April, at 7:00 PM
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