Well this sucks... need to vent.

RobinettMomma · September 2014

My husband has insurance through his work and he added me when we got married and the insurance i had got moved to being my secondary. Well i got a letter in the mail today and my secondary insurance will no longer cover me because of my husbands insurance. I called to see what the problem was and they couldnt explain it so i asked if they had any benefits for pregnancy and they told me no that the only benefit to our insurance plan is a 5000 out of network deductible that we have to pay before they will even help us. So pretty much i have no coverage for this pregnancy anymore and i am stressed beyond the limit. Im having to take progesterone shots which are not cheap, plus prenatal vitamins, and the over all office visits because im high risk i go in more often.... we by no means have money. We struggle pay check to pay check, he is the only one that works im a stay at home mom. Im not sure what were going to do now... i hate seeing my husband stress and i feel so bad that im putting him through this.... sorry for such a long post. Thanks for listening to me vent....

drpayne · September 2014

Confused. You should still have your primary.

That said, our births are always out of pocket. It sucks. But they work with you and far as payments go.

RobinettMomma · September 2014

Hes going to talk to them and see if he can drop me from his insurance that way i can get mine back because my insurance covered the whole pregnancy i didnt have to pay for anything...

bowlwoman · September 2014

Can you drop off your husband's policy and go back on your old one? Sorry this is happening, it majorly sucks.

RobinettMomma · September 2014

@Ainslie325‌ we got married the 1st of march and our insurance kicked in in April.

RobinettMomma · September 2014

With my first pregnancy i had the same insurance that i did have and i never had to pay a cent they covered everything

[Deleted User] · September 2014

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Cheekers2010 · September 2014

What a bummer.

BdblZ · September 2014

I am confused too....shouldn't you be covered for the pregnancy/birth under your husbands policy?

beachy6 · September 2014

You aren't covered under your husband's insurance anymore? As the primary insurance, right? Do they not have maternity coverage?

My primary insurance (only insurance) has a oop deductible of $6000, so I hear ya on that part at least. Insurance is pretty much a joke anymore! (And, I have a decent teaching job. Just crappy insurance offered.)

DoctorWorm222 · September 2014

Insurance is such a confusing, mess, PITA!

My husband just switched jobs, so we're in the middle of an insurance mess too. We're "supposedly" covered since August, but the company hasn't sent us our insurance cards yet. I ran out of meds last week (zofran for nausea, progesterone gel for irritable uterus, inhaler for asthma, etc.) Since our old policy was cancelled and we don't have the new cards, WAG was going to charge us something stupid (like $250) for the generic zofran and didn't order my progesterone when I called for the refill b/c they "want to make sure you really want it if your insurance won't pay." We had to pass on the zofran due to cost and we're scrambling to see if they'll get my progesterone before I'm totally out. Also, we've tried to call the damn insurance company about a thousand times. First, they require you to schedule a call with their representative and expect about 24h advance notice. Second, when we finally got a representative on the phone, they refused to talk to us -- they only wanted to talk to the finance guy from DH's company. TURDS!

Anyway, that was too long and too grumpy. I just want you to know you're not the only one in a bad spot with no coverage. Here's to hoping it all gets sorted out soon!

JRod13 · September 2014

See if you can get medicaid. If you guys are struggling it's worth a shot.

Grateful&Thankful · September 2014

I don't understand. Because of our infertility issues, I exhausted my infertility coverage and my DH added me onto his policy. I never dropped my policy. So everything goes through my insurance coverage from my job first ( my primary) & whatever is left over goes through the secondary (DH's policy). So even when I continued my fertility treatments, my primary would cover some of the u/s's but then rejected the actual IVF retrieval & transfer but my secondary policy picked it up. It sounds like you never dropped your primary insurance from your job so one of those policies have to cover you. I hope it all gets worked out. This is such a frustrating problem to have held over your head ((((hugs)))).

LilnNimoy · September 2014

Prenal visits are covered under the AFA and so are postnatal... If they aren't covering they aren't compliant.

ambernjj · September 2014

First of all if you work and had/have coverage through them that will always be your primary..I can't think of any reason your own employers insurance wouldnt be primary...secondly maternity coverage not being covered????? I don't get that either all insurances have to cover maternity/child birth.....maybe I just misunderstood the post... I hope everything gets straightened out for you

rshamos · September 2014

That sucks! Check with your OB for samples of the progesterone and prenatals until everything is sorted out. You can sometimes pay them cost for whatever they pay for the meds. It will be much cheaper than OOP at a pharmacy.

Tarene · September 2014

How can anyone have two insurance companies cover their benefits medically? as in one is all full so the second one picks up the slack. What?

Pros521 · September 2014

It sounds like you have insurance that covers maternity through your husband, you just have a 5000$ deductible. That of course sucks and I fully understand, bc our family deductible is also 5000$ through my H. His company offsets it by giving employees a flexible spending account that they put money into.

Grateful&Thankful · September 2014

I definitely have a primary and secondary insurance. My job is the primary & my husband's job is the secondary. It's especially helpful when it comes to medication. If one insurance covers it for a cheaper amount, I can fill it under them. If one insurance doesn't cover the meds, I can check to see if the other does. I've been doing it like this for almost 2 years. We have BCBS & Aetna.

Lauradi1010 · September 2014

I agree. It sounds like you do have insurance just a very high deductible. Having a deductible does not mean you don't have insurance, just that you have to hit it before a major payout is made. Our detuctible is up there too. Family medical plans have higher plans than single person coverage. If there was only one of us on a plan, I would have hit the deductible for my plan in June. Good news we are only about $300 from deductible. As an FYI, the birth is covered seperately as well. Our plan pays 80% w/ a maximum of us paying $ 5,000 out of pocket should any catastrophic medical complications arise.

sararhino · September 2014

My husband and I ran into this issue when we first found out that we were pregnant also. I'm under 26, so I was still able to be on my dad's insurance instead of joining my shitty insurance group at work... Turned out that because I was a dependent they wouldn't cover anything for pregnancy. We didn't get our situation straightened out until last month when my husband moved jobs. We're currently stuck paying a pretty high deductible that we're supposed to try to pay off before the baby gets here (NOT going to happen) but what keeps me sane is that my OB is really understanding of what we're going through. The fact of the matter is that you can't give them money that you don't have, and you just need to make sure that they understand although you'll pay them, it just may take a little bit longer than what they want. I know it sucks, but in the grand scheme of things money comes and goes and all that matters is that you stay calm for you and your LO. Trust me, I understand though! My first few months of pregnancy we're filled with stress because of financial stability, but it'll be okay! Good luck to you and your family. Keep your head up!

RobinettMomma · September 2014

Slaps said:
I thought you said you were on your husbands insurance? Does it not cover you?
What insurance do you have if you are a housewife?
Medicare?

Im on it but it doesnt cover anything for the pregnancy and yes i was on medicare.

RobinettMomma · September 2014

In oklahoma they have a state medicade that is called soonercare that covers pregnancy so when i got married my husbands private insurance through his work got bumped as my primary and soonercare was made as my secondary insurance. With soonercare there were no premiums, no out of pocket expenses period and what my husbands insurance didnt cover they picked up.

[Deleted User] · September 2014

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RobinettMomma · September 2014

sararhino said:
My husband and I ran into this issue when we first found out that we were pregnant also. I'm under 26, so I was still able to be on my dad's insurance instead of joining my shitty insurance group at work... Turned out that because I was a dependent they wouldn't cover anything for pregnancy. We didn't get our situation straightened out until last month when my husband moved jobs. We're currently stuck paying a pretty high deductible that we're supposed to try to pay off before the baby gets here (NOT going to happen) but what keeps me sane is that my OB is really understanding of what we're going through. The fact of the matter is that you can't give them money that you don't have, and you just need to make sure that they understand although you'll pay them, it just may take a little bit longer than what they want. I know it sucks, but in the grand scheme of things money comes and goes and all that matters is that you stay calm for you and your LO. Trust me, I understand though! My first few months of pregnancy we're filled with stress because of financial stability, but it'll be okay! Good luck to you and your family. Keep your head up!

That is the same thing that we are going through. My husbands insurance is through united healthcare and they said that since my ob is an out of network contract that i have to meet a 5000.00 deductible before they will pay half of anything. So till we meet that 5000.00 deductible everything is coming out of pocket. I dont understand insurance and ill be honest im pretty dumbfounded when it comes to it all so i may not be making sense but going from having one child and not paying a dime to having a child and having all these expenses all of a sudden is a little overwhelming...

[Deleted User] · September 2014

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RobinettMomma · September 2014

@Slaps im not sure what has taken them so long to contact me about all of this till now but it is very overwhelming. I havent received any bills or statements so im not sure what im going to end up having to pay but im sure it's not going to be cheap...

[Deleted User] · September 2014

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RobinettMomma · September 2014

I appreciate all of you ladies and how understanding you all are and have been. Thank you for letting me vent

sararhino · September 2014

@Ainslie325‌ Basically they wanted it all before baby arrives (I wish I could tell you exactly why- I still have a lot of questions to ask and I couldn't give you an exact answer if I tried, insurance sucks) but after talking with them about how it was almost impossible for us right now because payments would of been almost $800 a month, we got one set up to end in Feb. As for the deductible resetting and getting stuck with a second one, it's a real worry of ours! We could really get screwed in this entire process. Oh well though I guess.

Essentially what I was getting at is that they're not going to deny you prenatal care just because you need an extended payment plan, although getting the bill isn't necessarily going to be fun. Haha.

Shortstack06 · September 2014

RobinettMomma said:

My husband and I ran into this issue when we first found out that we were pregnant also. I'm under 26, so I was still able to be on my dad's insurance instead of joining my shitty insurance group at work... Turned out that because I was a dependent they wouldn't cover anything for pregnancy. We didn't get our situation straightened out until last month when my husband moved jobs. We're currently stuck paying a pretty high deductible that we're supposed to try to pay off before the baby gets here (NOT going to happen) but what keeps me sane is that my OB is really understanding of what we're going through. The fact of the matter is that you can't give them money that you don't have, and you just need to make sure that they understand although you'll pay them, it just may take a little bit longer than what they want. I know it sucks, but in the grand scheme of things money comes and goes and all that matters is that you stay calm for you and your LO. Trust me, I understand though! My first few months of pregnancy we're filled with stress because of financial stability, but it'll be okay! Good luck to you and your family. Keep your head up!
That is the same thing that we are going through. My husbands insurance is through united healthcare and they said that since my ob is an out of network contract that i have to meet a 5000.00 deductible before they will pay half of anything. So till we meet that 5000.00 deductible everything is coming out of pocket. I dont understand insurance and ill be honest im pretty dumbfounded when it comes to it all so i may not be making sense but going from having one child and not paying a dime to having a child and having all these expenses all of a sudden is a little overwhelming...

I understand switching OB's may not be ideal, but could you find one in network? The deductible should be half and they will cover more.

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Well this sucks... need to vent.

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