Baby Making update- Health Insurance & Health Care Reform

Written by Elena @The Art of Making a Baby on. Posted in Pre-CONCEPTION

Baby Making Update or lack thereof.

We haven’t even started. The maternity insurance was supposed to come any day now and then we have 30 days of a waiting period before we can even start trying. So for now, it’s all about practice if you know what I mean.

I am still trying to figure out the whole wisdom teeth business. I want to remove them prior to getting pregnant, so that I didn’t have to deal with any infections of anything, since they’re partially impacted. However, the bill for that is $2700 ( Yikes!). That’s a freaking baby’s room full of expensive furniture and toys. You know it amazes me that they want THAT much to take something out of me. It’s my freaking teeth, just pull them! Well, put to me to sleep first and then pull them.

Anyone ever had their wisdom teeth out? Share!

So for that purpose alone, I got a supplemental dental policy with a limit of $1000. So now I have two policies with a combined limit of $1750. That’s leaves me with $1000 out of pocket which is doable.
Except for when I went to schedule my surgery, my dentist told me that they no longer accept BCBS! Oops!
Back to square one of finding an oral surgeon. I call about three or four offices off of BCBS website and I get snooty receptionists with their annoying bitchy nasal voices telling me that they only accept this type of insurance, or they can only use 1 insurance policy, which sounds like bull to me. What does it matter to them? If both insurance policies coordinate benefits, why do they care?

Finally, I get a really nice receptionist named Evelyn, willing to help me out. She volunteered to call BCBS claims department and get whatever info she can regarding how this is going to work. Eventually I get a call back informing me that one policy is considering them out of network and will only pay like 400 bucks out of $1000. Not going to work. Nope.
So I go back to BCBS website and specify the particular type of a plan I have in hopes of finding a dentist who’s in network. Nada! Not a single oral surgeon is IN Network! That’s bull! What’s the point of the policy then?

I call my agent and tell him that he sold me a policy without participating dentists :) and that I need to switch to the Plus plan. Well the truth is there are plenty of dentists, just not oral surgeons on this plan. He informs me that it’s a one form change! I jump from joy! End credits.

So it looks like when I switch to the Plus plan I can go with the surgeon at that nice girl Evelyn’s office and get most of my wisdom teeth charges covered. YAY to that!

Also the agent informed me that our new health insurance policy that we’re switching to has been underwritten and they’re including an pre-existing condition exclusion writer. Say whaaaah? Those money grubbing sons of a female dog wanted to exclude this one condition on my hubby’s part that is comparable to excluding a fucking cold!
“Oops, sorry, you got a flu this year! We’ll be issuing a policy with an exclusion writer for a flu because it’s a pre-existing condition”.
I, of course, immediately went to my trusty Internets to find some kind of law ( because there’s GOTTA BE ONE AGAINST THAT) that says they can’t do that! There IS a HIPAA law that says that if you haven’t had a lapse in coverage  and are switching to a new one, they can’t exclude pre-existing conditions. Well, it turns out it only applies to group plans ( plans through your employer), not individual plans, which again seems ridiculous to me. The new Obama Health Care reform has done many good things ( including better maternity coverage) and one of the most anticipated changes for many people will go into effect in 2014, which is no exclusions or denial of coverage allowed due to pre-existing conditions. I gotta tell you, that Obama Health Care reform has done MANY great things. I cannot believe that there are people out there who want to repeal it. Our American health care is one of the worst health care systems EVER. I lived in Russia, and I can say the health care system there sucks ass, but it’s way better than in US. If you’d like to read about the GREAT changes that the Affordable Care Act  has brought and will continue bringing, as long as republicans don’t get their way, click here.
I never thought it was an issue for us, cuz we’re really healthy and young, but I also didn’t expect them to be so petty with it came to issues like that. I mean if my husband had a mole cut out out of preventative reasons, does it mean you should now exclude anything related to skin cancer ( that’s not the issue, I’m just giving an example)? I truly think that people ( not politicians) that want the Health Care Reform repealed are either VERY selfish or simply don’t understand the reform and have never dealt with insurance companies the way self-employed people (us) or people with conditions have to deal.

So we’ve decided that we don’t want to deal with exclusions and that hubby will stay on our old policy and I will get a new one, since the only reason we’re switching is to add a better maternity benefit.
So if everything gets switched over properly and on time, the new policy will go in effect March 1st, which means we can only start trying for a baby effective April 1st. 
Things keep getting postponed, which sucks. But it’s better to have everything in place and insured than to mindlessly get knocked up and then deal with the consequences.

That’s my story and I am sticking to it.

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Comments (7)

  • Ambrosia Clark

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    I had my wisdom teeth out in Oct last year, just 3 months ago. I dont ‘do’ dentists so it was a horrible experience for me. My insurance covers 80/20 so I was responsible for just under $400. I was told when i was 18 to get my wisdoms out cause my mouth didnt have the space to accommodate them. But because I dont like dentists I avoided and avoided. But then the bottom 2 came in, all 4 were impacted, the 2 that were in were decaying…it was time. I say just do it. Before baby. Just get it over with. Gosh I ate the dentist!!

    Reply

    • E

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      That’s exactly why I am doing this! I know I need them out before the baby, so that there wouldn’t be any problems while I’m pregnant.
      I wish someone told me to get them out when I was 18, I would have so done it. Though, I do hate dentists! Them and gynos are my worst nightmare :)

      Reply

  • Krissy @ MommyMisc

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    Aren’t insurance companies just the best?? I had a hard time finding a dentist that was on my policy too. I don’t know why they’re so few and far between. I’m glad you found one that was and most of your costs are covered!

    I’m following you from Fun Follow Friday! I hope you can stop by and do the same!

    Mommy Misc…

    Reply

    • E

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      Oh I hate health insurance companies! I’m still struggling with my dental plan though. Hopefully it’ll end eventually.

      Reply

  • Blues_thief

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    I got mine out 3 years ago it was alright for me, except I looked like a hamster for a couple days. My bf’s sister had a harder time though, she was really sick for two weeks ( flu like symptoms). I guess there is no way of knowing how its going to go.

    p.s. I thought the supreme court squashed the healthcare reform, or did I misunderstand something (I live in Canada so I don’t know as much about it)?

    Reply

  • Ashley

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    I totally thought you were pregnant already. I was so confused when you posted the pics of your ski trip because you obviously don’t look pregnant. Haha. I guess I’m not a very careful reader. I hope your insurance gets straightened around quickly! The doctor won’t see you until you are about 7 weeks pregnant and pregnancy is not considered a pre-existing condition so….maybe you should start now. haha. I had my wisdom teeth out and it was easy peezy. I looked fine and felt fine. I know that’s not the case for everyone but hopefully it will be for you too!

    Reply

  • Miranda

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    I HATED having my wisdom teeth removed. I had to get put out completely, but the healing afterwards! I was out for a week, and cleaning the voids left by the teeth after every meal was a pain! But its true, get ALL teeth work done before pregnancy!! Baby’s are calcium thieves! If i could do it all over again i would be regular on all my vitamins everyday! You’re teeth will suffer. Honest truth.

    Reply

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