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Wednesday, June 3, 2009

Unsurance

For the past few weeks I've been comparing health plan benefits, costs, etc. for little Eddie. Since I have graduate student health insurance through UC Davis I have to buy a policy for the little guy because Davis doesn't offer dependent insurance. The school used to, but the policies were literally prohibitively expensive (given what little graduate students are paid) that the program was dropped since no one signed up for it.

My policy covers all my OB/GYN stuff related to the pregnancy--including the delivery at the birthing center. The baby, on the other hand, is only covered for delivery-related problems during the first 31 days of his life. Meaning that his first well baby check up isn't covered and if any problem arises (illness or emergency) that is not directly related to a problem encountered during delivery then he's not covered.

When I learned this several months ago I thought, "no problem, I'll just buy him a policy through Kaiser or Blue Cross or something." So I've spent countless hours comparing health plans. Deductibles, out-of-pocket expenses, co-pays...blah, blah, blah...those terms literally haunted my dreams for a while.

I finally settled on one of a few Kaiser plans--I have no personal experience with Kaiser but talked to a bunch of people here in Davis who use it and they all seem to like it. The Kaiser hospital is in Sacramento (about 15 minutes away) but the medical offices are here in Davis, which I really like since I like doing as much in-town as possible. Kaiser is WAY cheaper than Blue Cross, Health Net, or Aenta.

I tried to find out the estimated cost of a policy for our baby-to-be with the online calculator, but it wouldn't work for someone who isn't born yet. So I called to find out the mechanics of buying a policy for a newborn--do I sign him up ahead of time and just call to "activate" the policy once he's born? I was clueless.

The lady on the phone informed me that they (and most other insurance companies) don't even offer insurance policies to infants until they are 31 days old. I asked why and she said "because most babies are covered under the mother's policy for the first 31 days." Well, mine won't be. Babies are automatically covered from the day of birth if either of their parents have policies with a given insurance company. (Birth and adoption are apparently the two things that allow someone to join an employee-sponsored plan during non-open enrollment time periods.) Well, Dave's dad doesn't offer insurance to dependents since it is such a small company. And mine "employer" (the UC system) doesn't either.

So what the heck am I supposed to do to make sure my baby is covered for the first 31 days???

The lady suggested that I get a temporary policy for that time period and she transferred me to a Medi-Cal consultant. But we're one of those families whose income doesn't fall within the range for no-cost/low-cost Medi-Cal, nor do we qualify for Healthy Families or AIM (supposedly the "mid-income" health insurance options).

Of course we can (force ourselves to) afford to pay for a private policy for Eddie...but no one will sell us one! What the HECK are people in our income bracket and job situation supposed to do???? Simply postpone doctor's visits during the first month and hope for the best? There's no way I'm taking that risk with my baby!

Dave is working with his office manager to find out whether or not he can simply sign the baby up on his work insurance policy and have the full cost deducted from his paycheck. (Most companies at least partially subsidize the first few dependents on employees medical insurance, like by paying for half the cost or something. But really small companies like his dad's simply cannot afford to offer that.) Hopefully we'll be able to sign him up for this super expensive policy (~$300) for at least the first month and then switch him over to a Kaiser plan later.

My GOD our country's medical insurance is so completely screwed up. It shouldn't be this difficult for someone who can actually afford medical insurance to get medical insurance. Right?

2 comments:

Mimi mouse said...

ya things get screwy especially when it comes to tax brackets. I worked all through my pregnancy to save up for the deductible max out of pocket for Andrew. I had to work to save up. We made too much to qualify for medicaid and sometimes I thought "ugh-we both work to afford it and some people don't work and get it free"

Tina said...

Yes. Very very very messed up!!!