When I returned to work after maternity leave I reduced my schedule to a 17.5 hour work-week, and my status changed from full-time to “temporary, part-time, off-site, employee.” I forfeited all paid benefits for the sweet opportunity to enjoy being a mother.
Losing my health insurance stressed me out the most, especially with a pre-existing condition and my complete and utterly compulsive nature when it comes to hypochondria and access to the providers I know and love.
When I was 20 weeks pregnant with Roscoe, Andy and I decided that our first babe would be born at home. Soon after, I left a traditional group practice with physicians and midwives to hire an independent nurse-midwife who continued my prenatal care and later delivered Roscoe. As great as my insurance was at the time, it did not cover homebirth so we paid for the cost out-of-pocket. After verifying that the new policy would be accepted by all my current doctors, my secondary focus was maternity coverage.
Employer based health insurance is relatively comprehensive and straightforward for the consumer; I know very little about private insurance. In September I contacted an expert on the topic, an insurance broker, to learn more about my options. I chose a plan that consists of a base rate with added-on “riders” for extras like dental, immunizations, and maternity. The maternity rider costs an additional $71/month and—as I was told repeatedly—it must be added to the insurance policy at least 6 months before conception, or the pregnancy will not be covered.
On October 31st I said goodbye to solid group health insurance, and hello to a $700 monthly premium for a private individual insurance plan under which the three of us are now covered.
We opted not to add the rider in October when we initially purchased the insurance because we weren't planning to get pregnant until the Summer. Yesterday I called Anthem to request the addition of the maternity rider—we’re 6 months out already!!! I was surprised to learn that open enrollment periods apply to individual insurance too, and that I can only add the maternity rider when I renew the policy (next year!), change policies, or decrease my deductible.
In all the maternity related conversations I had with Anthem and the insurance broker, this fact was never brought to my attention.
Who to blame!?!?
Anthem says it was my broker’s responsibility. When I called him to share that I would be filing with Anthem a formal complaint against him (and actually, I was hoping he would take a stab at rectifying the situation), he attempted to manipulate the truth by insisting that while he did tell me the rider could only be added at certain times of the year, he also considers this information such common knowledge that he shouldn’t have had to explain it to me in the first place…he continued whining that he doesn’t have time (and shouldn't be expected) to explain every little detail written in my contract with Anthem.
American Benefits Planning is so-o customer service oriented!
As it stands, Anthem dictates when we will have our next child. According to them we cannot conceive before July 2011. Lunacy!
Oh my heart aches for you. I know how hard it was for us to wait to start TTC after my husband was made redundant and that only held us back by six months not a year. I hope it all works out for you.
ReplyDeleteI am so sorry that you are having to deal with this; I know that it can take such a toll on you....I hope that everything works out in the end!!
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