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July 2012 Moms
I just didn't know! *vent*
So this is my story (sorry if I keep repeating myself on this board). My husband and I arrived in The States about 2 and a half months ago. We moved here from the UK because of his job.
I became pregnant about 2 weeks after arriving here and immediately panicked because we weren't yet covered with medical insurance. My husband gets medical insurance through his job but we had only just filled in the forms and didn't have a policy number or anything yet. (we actually still don't have our policy number!)
So we waited a few weeks hoping the policy number would come through but as the weeks passed I told my husband I just couldn't wait anymore, I thought I ought to see a doctor. We decided to just pay out of pocket for the appointment, so I booked an appointment with a Primary Care Physician, this is where I made my mistake.
First let me explain how it works in the UK. If you think you're pregnant to book an appointment with your GP. They run a bunch of tests on you, take blood samples and do a pregnancy test and confirm you're pregnant, then they tell you that a midwife will contact you within a few weeks to take it from there. And of course it's all free.
My mistake was assuming the system might be similar here, but no, the doctor I saw today couldn't do anything pregnancy related with me. All she could do was a general checkup on me, to see if I was healthy, but I already know I'm healthy!!
They said I have to go to an OB GYN. (What is this? I assume it stands for obstetrician gynecologist? sorry for my ignorance, everything is so different here!). So now I have to make a different appointment with a different doctor. I'm just so frustrated, especially because we didn't wait for the insurance policy number to come through and now I've just wasted $150 on an appointment I didn't even need! Grrrr!
This discussion has been closed.
Re: I just didn't know! *vent*
A few weeks seems like a very long time to wait for a policy number. I know this is new to you, so I don't blame you for your mistakes at all. It is a complicated (and bullshits) system.
First, I would recommend that your husband get firm answers from his HR department about his health insurance. You need to know what your plan is, what your policy number is, and most importantly, when you can expect coverage to start. It is possible that even though you don't have the paperwork, that coverage began on his day of employment or something, so you may be able to submit the $150 retroactively for payment.
OBGYNs are the standard for obstetrical and gynecological care in the US, although a growing number of women are choosing midwives. Assuming the OB you choose will accept your insurance provider, you are free to choose the doctor of your own preference. You will be under the care of that same OB through delivery.
Our medical system is tough to figure out. You were right on the definition of OBGYN. However, you do also have the option of going to a certified nurse midwife or midwife. Some family practitioners will also do prenatal care and delivery. You have to decide which level of care you want and go from there.
If you have any questions, feel free to ask. I'm happy to answer what questions I can, and I'm sure others would be happy to do the same.
This. Definitely keep all of your paperwork, you may be able to get reimbursed. Have your hubby get in touch with HR as soon as possible. There are a lot of little rules and regulations to sort through (unfortunately). You will also need to double-check to make sure the OBGYN's office you select is covered by your particular insurance.
Don't feel bad about not knowing the U.S. health care system. With all the insurance changes, rules, loopholes, etc., a lot of life-long Americans get confused as well.
If you should have been covered through your husband at that time, you will probably be able to get reimbursed for the money you spent on the appointment. I would contact the HR department to find out what is taking so long to receive your policy numbers and they should be able to direct you to the forms you can fill out to get the reimbursement (if you're eligible for it) as well.
I'm sorry you had to go through that!
Ladies, help me out here, but is it possible for OP to visit a Women's Crisis Center or place like Planned Parenthood for the first round of blood tests and etc., to make sure everything's ok? I know PP wants insurance if you've got it, but maybe some places will help you out until your insurance kicks in.
Good luck, dear. I'm sorry to say that it's not an easy process here, but we're here to help when you need it. And feel free to vent--we all hate how complicated our healthcare system is.
Fantastic idea. I would recommend Planned Parenthood, honestly. They provide excellent care specifically focused on women's health. Another option would be a low cost or free care clinic, but those can be hit or miss. PP is an excellent provider and will work on a sliding scale for cost, and also recommend a permanent care provider.
Thank you so much ladies.
Honestly I don't know what I'd do without this forum and all your help, advice and support.
I'm 9 weeks today.
I will get my husband to speak to HR about the insurance policy, hopefully get the policy number soon and then book an appointment with an OB.
Thank you
Yes I'm in the DC area. Thank you SOOOOO much!
Happy to help!
I'm so sorry you're going through all this! I've been dealing with my own insurance issues, and I've been with my insurance for years.
1. If your insurance policy has been processed now, call and find out whether or not you will need a referral to see a specialist (OB/GYNs are specialists). If so, have the PCP you saw write a referral note. If your insurance does not require a referral, the simply make an appointment with the OB/GYN of your choice, and let them know how far along you are and that you have not yet been receiving care, as this will generally get you the soonest possible appointment.
2. If you continue having problems getting insurance coverage, you may be able to apply for Medicaid's MomCare program, depending upon your citizenship/resident alien status. The program will cover your prenatal care, as well as the pediatric care of your child for two years after it is born. If you don't already have a doctor confirmed pregnancy test, you'll need to go to your local Public Health Department for a pregnancy test, and they will give you the application and further directions. I highly recommend going first thing in the morning, as the clinics tend to get very busy later in the day.
3. If all else fails, talk to your doctor up front about your lack of insurance and begin negotiating a payment plan. Most doctors and hospitals are very flexible with their fees, and will create a payment plan that will work for you. Some even offer rates on a sliding scale based on your income.
Good luck, and sorry our healthcare system is so crazy! Please feel free to PM me if you need any other help or have any other questions.