health insurance
I am a dependent on Steve’s health insurance, which he pays for as an individual because he is self-employed. When we first started IVF, we called Aetna, our provider, to see if they covered it. They replied that they did not, which didn’t surprise us because it’s a voluntary procedure. They ended up covering over half of each procedure — they paid $6,000 each time. We won’t ever question that.
When the procedure worked, I called to see if it would be possible to get a midwife for prenatal care and delivery. They informed me that, though they had paid for me to get pregnant, they did not cover maternity care at all. I called the doctor’s office to schedule an appointment anyway; they told me they had never heard of a health insurance policy that doesn’t cover pregnancy. They called Aetna for me just to check, and Aetna told them that yes! maternity was covered! Whew. So I had three ultrasounds and one prenatal checkup and then got the bills, $400 per ultrasound. Aetna did not cover a penny. At this point another person at the doctor’s office called Aetna and they told them that no, they wouldn’t cover maternity. I went online and logged into my Aetna account, found my name and clicked on the “plan guide” under my name. It was a pdf with information about what was covered, and it showed pictures of pregnant women and women looking at ultrasound images. I called Aetna to tell them that my plan guide says that maternity is covered. They said that wasn’t true. I asked where in my Aetna online dashboard could I read that it wasn’t covered. They said nowhere. It wasn’t written online anywhere. They said I had to call to find out.
At this point, pregnancy is a pre-existing condition and I can find health insurance through almost no one. The only one who will accept me is Blue Cross Blue Shield group health insurance — the individual plans have a six-month waiting period for pre-existing conditions. I would not be accepted for Medicaid or WIC or any other low-income insurance. And the bill for my appointments and delivery uninsured, if all goes well and I accept no epidural and stay at the hospital no longer than one day, is $16,000.
We are lucky that through Steve’s business we will most likely be accepted for group health insurance with the only company that won’t deny my pre-existing condition — though the plan, because we’re desperate, is not cheap. If not, I don’t know what we would have done, and it infuriates me that the health care system in this country would permit me, who has gone to college and owns a home and pays my taxes and has health insurance that costs us $700 a month already and does not abuse the system, to suffer. And as I suffer, the baby suffers, the future of the country suffers through me and my child and everyone similar to me. Currently 13% of women in the U.S. who become pregnant are uninsured and therefore have to accept poor prenatal care. I have never been a victim of our health care system until now, and now I see how awful it is. When I was in E.R. and in pain I could not sufficiently breathe through, I considered saying no to pain medication because I didn’t know if my insurance would cover it. I considered requesting only the MRI and not the CAT scans because I knew they would cost us a lot of money. When I found myself pregnant and learned the cost of delivery, I considered having my baby at home, and I understood that at the very least under no circumstance would I permit myself any medication to temper the pain. We are lucky that we found a loophole that we wouldn’t have without Steve’s business, but it doesn’t ease my frustration: to have a body in the United States is a liability.
