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I hate insurance companies! *vent*

missgooseyfacemissgooseyface
in Preemies
I had to deliver at a hospital 90 minutes from home because the hospital closer to home only has a level 2 NICU and because of LO's gest age at birth she needed the care of a level 4. The Drs here said that often times they can transfer a baby to a hospital closer to home once the baby doesn't need the type of care offered here and the lower level NICU can handle her (the hospital closer to home is affiliated with this hospital and the same Drs rotate between them). Driving 3 hours a day with 2 different cars (hubby has to work so comes after work) is costing us a fortune in gas not to mention tolls and daily parking at the hospital for both of us...we figured it out to be over $500 a month. Not to mention the stress, traffic, etc. so moving to the closer hospital would be so much easier and we would get to spend more time with our daughter (mainly my husband...I spend all day but he only gets a couple hours after work). Well, we just found out that our insurance won't cover the transfer because it isn't "medically necessary". They only approve transfers if where she is can't care for her any longer, not for "convenience". It's not about convenience, it's about being here for her and helping her grow strong with the support of her parents. But do they care, no! It's all about money to them, not what's best for patients and their families. It makes me so mad! They said they transfer babies all the time so some insurance carriers approve it, but I guess mine just sucks! I'm so mad I could scream....or cry. I stay with family a little closer a few nights a week but miss my husband and feel like being away from him is the last thing I need right now. Thankfully, DD is doing really well which definitely makes it easier, but I just wish insurance wasn't such a money game. 
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Re: I hate insurance companies! *vent*

  • missgooseyfacemissgooseyface
    Luckily we haven't had any problems with them covering any of the medical care....yet. But the hospital she is in now is in network and our policy covers 100% in network. I just wish they were more reasonable about the transfer. I've looked it up and it ranges in cost from $400-$1000 which seems like such a small amount in the grand scheme of things. We may look into paying for the transfer ourselves to be able to spend more time with her, but then there's the question will they cover her care at the other hospital if we pay for the transfer or will they still consider it "not medically necessary" for her to be there instead of here. 
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  • SquishyMineSquishyMine member

    I'm sorry you are going through this.  We had a similar situation when one of our girls needed to be transferred for surgery.  We needed to get her back to our original hospital with her sister for our own sanity - or at least get them together. We were told that if insurance didn't cover it, we might need to consider paying for it out of pocket.  Sounds like the cost of driving offsets the cost of the transfer some, - add in the cost of your sanity, I would really consider it.

    Fortunately for us, my employer who has the health insurance is self-funded, so they made the exception to cover it, but no, normally a "non-medical transfer" is not covered by our policy either.  One would think the emotional cost would be taken into consideration, but sadly it's just not unless whoever holds the policy (an employer, for example) has it covered.  "Non-medical transfer" sounds logical enough to not be covered as not "necessary".  Keeps premiums down.

    I would also talk to the hospital about what they do if they are in need of the space.  Sometimes higher level hospitals will cover the cost of the transfer if they need the bed for more acute patients.  See if they have something like that and you can volunteer to be first in line for that. 

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  • eMiLee920eMiLee920 member
    I don't have any advice about the insurance company, but are you sure the hospital/NICU doesn't validate parking? At our hospital NICU parents only had to pay $1/day for the first 14 days. After that they gave us a pass that told the security guard in lobby to validate us for free parking. It's worth looking into. 
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  • missgooseyfacemissgooseyface
    imagerunningmommy519:

    Totally unrelated but is there a Ronald McDonald House in the area? Our NICU was 90+ minutes away from our house. We got into the Ronald McDonald House, which was about 4 blocks to the hospital. I would walk to the hospital and DH would commute to work from there. We had to make a donation (of our choice) when we got discharged but it was nice to have a place to stay and not worry about gas, hotel stays etc.

    Have you tried to talk to the social worker?  When DS was in the NICU there was a mom and dad trying to do the same thing. When we got discharged they were still trying to make it work but I think their insurance company was doing the same.

    I am sure my insurance company would have been the same. I fought for a week to RENT a frickin' hospital grade breast pump.  

     

     There is a Ronald McDonald house right across the parking lot, but there are only 12 rooms, all of which are full.  We are on a waiting list but there is no way to know how long that will take.  :(

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  • missgooseyfacemissgooseyface

    imageeMiLee920:
    I don't have any advice about the insurance company, but are you sure the hospital/NICU doesn't validate parking? At our hospital NICU parents only had to pay $1/day for the first 14 days. After that they gave us a pass that told the security guard in lobby to validate us for free parking. It's worth looking into. 

     They do not validate parking, but offer a monthly parking pass for $35 (we had to buy 2 because DH and I usually take 2 cars except on the weekends).

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