I just want to cry (stupid medical insurance rant)

[writermama]

(but that would upset the kids, so I'm putting it off until DH gets home)

I love my DDs' pediatrician. I tried 2 others before I found her. She's 5 minutes away from our house. She's great with my 3 year old and the baby. She's not just pro BFing, she actually knows about it (and extended BFed her own kids). She is supportive of my choices as a parent and offers information and alternatives without making me feel guilted or bullied into doing things her way.

Just to show how great she is, her office was CLOSED today, but after I called concerned about DD's nagging cough that has gone over two weeks and is starting to sound junky, SHE OPENED HER OFFICE THIS AFTERNOON JUST FOR US!

Why is this a bitch? Because as of 2 days ago, she doesn't take my insurance anymore. It was so sudden, she hasn't even had a chance to send out letters to her patients' families.

And it's all so stupid. My (moderately crappy) insurance company got bought by another (incredibly crappy) company. She wanted to keep accepting my plan, but they told her she couldn't. We just signed up for another year in October, so we can't change until then. We have huge deductibles on both kids (which wasn't a problem when our doctor was in the network). So now we either have to pretty much pay all of both kids medical costs out of pocket for the year or find a new doctor.

I don't want a new doctor, dammit! And I don't want to go broke between the 30% annual increases and the out-of-pocket expenses. $%&^%$##@! insurance companies!

[candybomiller]

Crappy. I don't have any advice, but I know how devastated I'd be in your position. ((HUGS))

[dules]

I'm so sorry! Can you get insurance to pay a %? Then you can maybe negotiate your part with the doctor's office.

That totally stinks. Our pediatrician does take our current insurance but it's got ZERO out of network benefits. For $1300/month. Ugh.


Mary

[Momof3Labs]

>We just signed up for another year in October, so
>we can't change until then.

OK, maybe I'm just ignorant of the individual health insurance market (I shouldn't be - I don't work too far from it), but there isn't a single other insurance product that I can think of that can't be cancelled at any time, and you get a refund of any unused premium.

I know that shopping for new insurance stinks, too, but I truly think that is a third option for you.

We haven't found an amazing ped since we moved, so I can certainly relate to your desire to not leave this dr!!!

[KrisM]

For our insurance anyway, we get to sign up every November. It's through DH's work. Only a "life changing event" during the year allows us to change it. Having DD this year allowed us to change it. I would guess we could cancel, but then would be having to find health insurance from somewhere else. Going through his work is way cheaper than on our own. I'm guessing her's is like this.

I don't know what I'd do. Probably figure a way to pay, if possible. I know that a well-baby for us costs about $60 and a vaccination is about $100. If the kids are healthy, it wouldn't be bad.

[Momof3Labs]

Ah, yes, if it is group insurance, then you cannot change mid-year. In reading the post, it sounded more like individual insurance to me, but I'm probably wrong.

[val01]

Sorry you are going through this!

Please do not sit quietly and steam about this. You need to let everyone know who will listen that you are unhappy about this. I would write a letter to your husbands benefit administrator, as well as the insurance company. In the meanwhile, I would try to get a negotitated self- pay rate with your pediatrician.

(I am the HR Manager (and benefits administrator) for my company. I pass these letters along to my broker and the insurance account executives. I have been known to get a few things changed this way.)

HTH,

Valerie

[maestramommy]

Aaack!! Hugs, I lost my beloved OB/GYN this way, and didn't find out til I called to schedule my annual. I live in fear that I'll lose my current OB or ped this way.

[squimp]

Oh that sucks! DD's pediatrician, who is my favorite medical professional ever, actually quit her practice earlier this year, and I was heartbroken.

I hope you can find a way to continue seeing her.

[writermama]

I just want to say thank you from the bottom of my heart to everyone who responded to my rant. I value your suggestions and your support.

DH and I talked about it over the holidays. We've decided to stay with our ped. After she reopens for the new year, we'll talk to her about which insurances she does accept and look into the feasibility of dumping our current company for one of them. If we can't, then we'll just pay out of pocket. Great peds don't grow on trees and we've been incredibly lucky to find one who suits us so well.

Thanks again for being a shoulder to lean on when I needed one.

[writermama]

Well, you're both right. :)

We have individual insurance but would have had to sign up with DHs insurance in October to go on his company's plan. From my previous insurance hunt, I was only thinking of those two options. I'm not sure if I can ditch my current company mid-year, but it's worth looking in to.

Thanks for the ideas.

[writermama]

Thank you for the suggestion.

When I can get some time, I'll write a detailed nastygram to the company to express my displeasure with their decline in quality of benefits even though the costs are spiraling. For example, there are at least a dozen pediatricians in practice near us who used to take our insurance, but only 2 accept our insurance now.

Thanks again.

[C99]

I would be really upset, too. Not quite the same thing, but my insurance is not accepted by the largest medical provider/hospital group in the area, in which some of the best peds groups and natural/midwife groups in the city are a part.

[o_mom]

This sounds like a great option. If you are doing things like immunizations, find out if your local heath department offers them. Ours offers them free up to age 2 and then for something really cheap like $5 after age 2. That way you aren't paying out of network prices for those. You can also ask for any lab orders and just go to the lab yourself instead of having them done at the office (not as likely with kids). I know when our beloved RE was dropped from insurance that is what we did - just went to him for the appointments and paid the out of network office visit. Everything else was done at the network lab.