I have been wanting to share my experience with our healthcare system for a long time. Frankly its a very long story so I have been putting it off…
I will probably split up my story over a couple posts each having a different focus. This post will focus on the fact that I have literally done it all….
Yes. I have been covered by parents, self pay, medicaid, sharing ministries, covered through work and attempted to get coverage through the market place (I chose to eat instead of buying through the marketplace. That’s where the self pay came in.)
When I was covered under my parents I had the Federal Employees Blue Cross Blue shield coverage. (Does anyone wonder why federal employees seem to have the best coverage in country… hmmm…) I never paid for anything. Literally everything was free (at least for me). Now obviously my Dad was paying a premium but I had no clue what it was. All I knew was I went to urgent care for free, had birth control for free and honestly never once thought about health insurance or how I would receive medical care. Then I got pregnant.
This new arrival would not be covered under my Dads insurance. So I thought no big deal! I will just put the baby on my husbands insurance… haha… no. At the time my husband had insurance through work and a minuscule amount of money was taken out of his paycheck each month to cover his premium. If I added our kid to it, he would lose 2/3 of his pay check to health insurance. I was shocked. I didn’t understand why this was the case but obviously that was not an option. So… off I went to Obamas healthcare marketplace… Where I was told I could get affordable health insurance… oh boy…
I remember scrolling and scrolling through what seemed like hundreds of plans with different companies on my computer. Nothing was affordable. NOTHING. I would be paying close to 600 dollars a month in premiums with a 10,000 dollar deductible. I did not care that well visit were free. 600 dollars was almost HALF of what my husband and I lived on a month. After months of searching I had found nothing we could afford for my son. I learned from a friend that apparently cash pay patients are a thing and so I called around to find a Dr. for my son that would accept cash. Best choice ever.
We found a Pediatrician that charged a flat rate for visits. 40 dollar well visit. 80 dollar sick visit and 10 dollars a vaccine. It was so easy and it saved us money. In the first 15 months of my oldest sons life we spent a total of 370 dollars for check ups, sick visits and vaccines. Compare that with 7,200 dollars in premiums with free well visits… no freaking thanks.
Now I realize that I got lucky as a self pay patient with my son because I never had to take him to the ER or anything like that. So as the time was drawing near to me getting kicked off my dads plan I started looking again. I started looking for our family this time because my husband lost his insurance after switching jobs. Needless to say its not like the market place had improved. We made too much money to qualify for any kind of discount on a policy and we didn’t make enough money to pay full price. Enter Sharing Ministry.
Out of desperation I stumbled upon the concept of sharing ministries. I talked to a few people at my church who used them and discovered that this would be my best option. This was also a fantastic choice. I got my Husband and son a catastrophic plan (40 bucks a month) and my self a maternity plan (150 bucks a month). The way it works is that we function as self pay patients for all medical services but the services that are covered under our plan we receive reimbursement after we have covered the amount we are responsible for (think deductable). Like for my pregnancy I was responsible for the first 500 dollars. Then I got reimbursed for all other expenses. This was working great for me with my second pregnancy. Then I moved half way through the pregnancy into Iowa. Enter Medicaid.
Every time I went to my Dr in Iowa I got a lecture on how I needed to be on medicaid under title 19. EVERY SINGLE TIME. I explained EVERY SINGLE TIME that I did not need medicaid. All I wanted was a self pay discount (yes that’s a thing even though most providers try to hide it) and the option to set up a payment plan. This all came to a screeching halt when I showed up for an ultrasound appointment at the hospital and the hospital demanded since I was self pay I had to pay up front for the services. I did not have 1,500 dollars on hand. Shocker. Through some emotional manipulation and needing the ultra sound to address a possibly serious complication for my sweet second baby I was pushed onto medicaid. The good news was the rest of the pregnancy was free (to me. Not the tax payer.) But only up until my due date. After my due date I was on my own again. Now I still had my sharing plan so that was not a huge deal but for real? What kind of policy is that?
Ok so I do have something good to say about medicaid. In the state of Iowa its standard operating procedure for every child to have medicaid the first year. I actually think this is a great thing. It relieves the urgency and worry of trying to find health insurance and it can prevent absolute bankruptcy if your little bundle ends up in NICU. Its been a relief to me because if I didn’t have it for my 2nd baby I would still be functioning as self pay which means I would be shelling out 200 dollars every 2 months for check ups (Apparently its not 40 bucks everywhere >:[ )Not to mention if something actually went wrong. 200 dollars once a year for my toddler is one thing. Every 2 months is another.
I guess to some up this long monologue I have done or tried to do it all. Self pay is by far superior if its coupled with some kind of catastrophic plan with a sharing ministry. I have decided that I would rather pay 40 dollars a month for my kids to be covered in case they end up in the hospital with pneumonia and just pay for my own well visits. I need insurance against a broken leg or meningitis. Not the flu shot or a sports physical. But that can be the topic of my next healthcare rant.