Figuring out insurance (or, pulling my hair out).

With impending baby, I needed to figure out what to do about insurance.

I work for the state as a teacher, so I have a really good plan (Blue Cross Blue Shield standard PPO). The state pays for this plan which is awesome, and they will continue to pay for me until the end of February, at the end of my Family and Medical Leave. I plan on staying out at least another 5 months after that (more if finances allow), and if I wanted to continue my plan, I'd have to start paying over $400/month out of pocket. For myself only.

Um, too much. I wish I could afford it because it's a great plan, but to pay that much for myself isn't feasible with our budget. And besides, I'm a healthy person. I know insurance is just that: insurance... but we can't afford a major plan like that for one out of three people in the family.

Kevin has a HSA plan through his work, where there is a $2500 deductible and then everything is covered 100%. His work pays the monthly fee, and so basically health coverage is free for him unless something happens. Then he pays out of pocket till the deductible is covered.

Here is where it gets tricky. Did you know how difficult it is to have coverage for a newborn? "They" seriously do not make it easy for new parents to insure their new baby. After researching our options, we've chosen to get Adelaide a Blue Cross Blue Shield HSA plan for herself (at least for a while). However, unless she's born by a specific date, we can't start coverage for her.

For instance (and I know this is SOOO interesting to you guys), she had to be born by December 8th to get coverage starting December 15 through the plan we want her to have. Obviously that didn't happen. Now if she were born before December 22nd at midnight, we could have coverage for her on January 1st. Which would be fine if she turns out healthy.

But if there's some unforeseen health problems with her straight away, obviously that wouldn't work. And there's no way to sign her up and start paying for her now, because according to them she's not an actual person yet.

So we have to add her to my existing plan (you know, that expensive one) and pay for the entire month of December (even though it's nearly halfway over already) AND January. Just so she has coverage. Then we can think about moving her to the much cheaper individual HSA. And then figure out something for me, since we won't be keeping me on the state plan.

How confusing and frustrating is all this? I can only imagine how entertaining this post has been for you all, but trust me when I say, I am 100x more bored and perplexed by the whole insurance biz. Trust me when I say, don't wait until a week before your due date to try and figure it out. Not that it will change anything as far as when your baby can get covered (unless you have some magical insurance company), but the stress of figuring out the mumbo-jumbo is not needed in that last week.

But now it's done, will be paid for out of my next check (goodbye extra cash for January), and I can cross that mad sucker off my to-do list. SHEW!

Check! Found a pediatrician! Oh, and now I can legally give birth.

I just got back from meeting with a pediatrician, who I've decided is pretty great. It was a really quick meeting, where I didn't ask nearly enough questions, and it actually felt kind of rushed. So you're probably asking what makes this guy/place so great.

Well, the whole practice works with a very natural, holistic mindset. The physician, his assistants, and the nurses all share the same philosophy and beliefs about healthcare - that it's a mind and body thing, not something to be treated automatically with a prescription. As a pediatrician, this doctor I've met with basically said, before even I got a chance to ask, that he will work with us on whatever immunization schedule we want, when we want it. That's a plus for us. We haven't worked out exactly what we want, but we're pretty sure we're going to be on the "as-little-as-possible" end.

He also said that he will only prescribe medicine when really, really needed, and only after trying other routes to solve a problem. This is good for us because we rarely take medicine ourselves (why would we assume our child would?).

He is also perfectly accepting and fine of our intention to solely breastfeed, and that we are a vegetarian family.

So yay! And not only did I check off finding a pediatrician, by meeting with this physician, I was able to have him sign a form clearing me to give birth at the birth center. Legally I need that form to prove that I am low-risk, and I've got it!

Now I need to figure out insurance for this little one. I know I've waited too long, but I'm calling them today (as soon as I get done with lunch!). Hopefully it won't be a hassle and will be easy to set up.

Check! Called Colonial insurance yesterday!

Woohoo! That was easy! And I got something checked off my big to-do list! :)

Along with my regular state health insurance (Blue Cross Blue Shield), I also have a Disability plan with Colonial Life. I signed up for a pretty minimal plan with them years ago in the case that I'd get pregnant, as that's covered under disability (what?!).

I just called today and talked with a wonderful representative (awesome customer service so far!) about the process of filing a claim since I had no idea how that works. I've been really healthy and lucky so far in my life and haven't had to file any claims. The birth center is filing my BCBS claim for me, and all my dentists have filed dental claims, so this will be my first!

Under my plan, if everything goes well with the delivery, and I'm able to deliver vaginally, I will be eligible for $250/week for 5 weeks. If there are complications, surgery, hospital stays, problems healing, etc... I will be eligible for more.

The only thing I need to do is fax in a form filled out by the midwife after delivery, along with a copy of her license and a letter saying that I went to an actual OBGYN (which I did, for the ultrasound). Two weeks later I get a check.

Sweet! I feel good. :) Come on baby, stay healthy for moma!