If you're new here, or you don't know me well, or even if you do, I'll start from the beginning so you're not left in the dark.
In the beginning....(just kidding, we wont go back that far.) After David & I were married and he decided that he wanted to start CrossFit FMS in Midland, TX we decided to seek out our options for insurance for our family. At the time I was working in real estate in a job that did not offer benefits, with him being self-employed he obviously didn't have benefits either so we began the search to see how we would attain health insurance being self-employed. This was in 2011 before the ACA act was in place. We found the policies we were able to qualify for and checked rates. They were expensive, but we expected that. What I didn't expect was the fact that we COULD NOT, no possible way, under no circumstances, be covered for Maternity coverage under an individual policy. They told me that the reason for this was that they were preparing their policies to be compliant for the ACA and therefore there were no riders for maternity on NON-GROUP policies. Since we were business owners we decided that we would attempt to create a group policy for our business. This would allow us to get maternity coverage but we were looking at around $3,500 a month in insurance for only my (young, fit, healthy) husband & I. So, that wasn't an option with us being such a small business. BUT, since we did not have children we decided it was best I leave my job (that I enjoyed and that I was pretty good at ifidosaysomyself) in order to take a job that would allow benefits. Knowing that I had some potential issues with conception (endometriosis, PCOS and some other more complicated medical stuff) I was hoping we would be able to start to try to conceive ASAP. Think of my uterus as a ticking time bomb. Just waiting to make me barren and sad. Okay, maybe that's dramatic. But, I put my real estate career on the back burner and took a job at a local bank in order to get insurance. I waited the three month period to be eligible for benefits and for the first time I had REAL LIFE HEALTH INSURANCE. Whoooop. So, we started to try and we were blessed with a beautiful, healthy, lovely baby girl in January of 2013. You can see her birth story here, if you want. At this point I was on COBRA coverage and I was paying about $900 a month JUST for me. So, thinking the worst was behind us (yanno, pregnancy and delivery) we switched to an individual policy with Humana on Febuary 1st, 2013. All was well, until on February 7th, 2013 (six days later) I got a DVT (blood clot) and PE (pulmonary embolism). Here I was on a brand new policy with a huge blood clot and a newborn. After they submitted my policy for review they decided I wasn't trying to screw the system (just, terribly unlucky) and I was prescribed six months of Lovenox injections.
Fast forward to today (May 2014). Harper is 17 months old and as you can see here, we are/were struggling with if we should be trying for another child. Feeling like we were ready to have another baby we decided we would be willing to start trying to conceive. Knowing the issues and the lengths I had to go to last time to have insurance that would cover my maternity care, that was forefront in my mind. I immediately called my insurance company (Humana) and asked them if my policy was able to be modified to include maternity coverage. They said no. Not, no you can pay a lot of money and we will do it, just simply no. They said that because of the new 'open enrollment' period of Obamacare that unless I meet a qualifying event (having a baby would be one, but only AFTER the baby is born.) that I can make NO changes to my individual insurance policy that I pay for myself.
Now, I consider the options that would be available to me if I decided to have a baby without maternity coverage. Because of my blood clotting issue I will need to be on blood thinners while I am trying to conceive, during my pregnancy, and 3-6 months post partum. That's at LEAST a year of blood thinners. Not just any blood thinners, either. LOVENOX, which I'm pretty sure is greek for "LIQUID GOLD OF THE GODS" or at least I assume that because of it's price point. Just for fun I call the pharmacy to see what it would cost me to pay out-of-pocket for it. He first had to ask a supervisor to even be able to find out how much medicine costs because AND I QUOTE "I've never had anybody pay for a prescription without insurance". Mr. Manager tells me I'm looking at about $3,000 a month for Lovenox. JUST for Lovenox. That's not including, doctors appointments, ultrasounds, high-risk doctors appointments, labs, delivery, etc. THAT'S JUST THE THINNERS. Well, as much as I'd like to think my money grows on trees (where I live leaves don't even grow on trees) I just cant swing that on a self-employed business single income family.
I called BCBS to see if they were able to write me a new policy and the same answer was, no. I would have to wait until open enrollment for 2015 and there was nothing they could do to change, modify, cancel, increase, etc, my insurance policy until that time.
So the government has told me when I am able to have, or not have, a child.
Because of the ACA and because my current policy is NOT compliant I cannot have maternity coverage. So, my next step was to call the Healthcare exchange themselves and ask for a special exception to see if I could qualify for the ability to change my own insurance policy.
I do not qualify for an exception. Pregnancy is not considered a life-altering event.
So, I ask the lady what my options are. Here was her answer...
"Well, maam, you can always apply for medicaid."
Right! I can always allow the tax payers to pay for my baby. So, I allow her to run my information to see if I qualify for medicaid for assistance. Here's what she says..
"I'm sorry ma'am, you are too much of a responsible, contributing member of society for us to qualify you for care you literally cannot get otherwise. AKA, you make too much money for us to help you."
Okay maybe those weren't her exact words, but you get the gist..
So, I think, hmmmm...what else could I do? Could I hire a midwife and birth at home? I call several local mid-wives, and nope, they wont take me due to my previous blood clot/health issues.
So, here I am. With my uterus clock tick-tocking and no ability other than to put serious financial strain on my family to have another baby. Every cycle that passes my endometriosis worsens, every cycle that passes my chances for endometrial cancer increases, every time that I have a cycle I am one less cycle away from being able to carry another child.
But an unplanned pregnancy from a girl that did not research her options, did not consider her fertility, did not need anything to be worked out for her to be able to be blessed with a child. This drug-addicted-high-school-drop-out who has several children and does not work qualifies for 100% of her maternity and even the first year of her child's life to be paid for by the taxpayers. But I don't. Because my Husband provides for his family well.
What's my point in all this? I guess just to let everybody know my day sucked. Haha. But really, I can't help but feel this system is inherently flawed. And that if the entire medical system was not SO dependent on the insurance system than people like myself would be able to afford to pay for medical procedures out of pocket. But until that day, I will do all I naturally can to keep my baby maker healthy and I will pray that if God does have another biological member of my family that He will provide a way for me to remain fertile until the government allows me to be pregnant again.
Here's to praying for favor, praying for hope, and praying that someday medical insurance will not be able to dictate the way people live their lives.
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