When I got married and had kids and decided to stay at home with them, I pictured cooking and crafts. Here’s what it actually is: an ongoing battle with health insurance companies and healthcare providers. Sometimes a bill is just a mistake, and you might get off easy with a few phone calls and letters. Or, as in the article, a hospital provider you’ve never met will send a horrifying bill, because they’re out of network at the hospital where you were treated. (You have no recollection of this person, but good luck arguing that.) Sometimes the hospital sends your bloodwork to an out-of-network lab and you have to write letters negotiating the in-network payment. After an emergency visit while I was pregnant, the hospital billed me for a maternity visit (out of network), rather than an ER visit (in network), even though I entered and was treated in the ER.
I’ve written to health insurance companies and doctors; I’ve escalated to the presidents of hospitals and the attorney generals of several states. I’ve jiggled the baby in the bouncy seat while screaming at my insurance company about a bill I got for a breast pump—which three weeks prior they’d said was covered, in a conversation that, luckily for me, they recorded. (Attorney General verdict: Covered.) Also: Don’t fuck with a postpartum woman.
A few years ago, my husband had a debilitating back problem. He could barely function: He couldn’t shave, he couldn’t drive, he couldn’t even really sit. He took a six-month medical leave from his job, as the pain made teaching impossible. We began a yearlong odyssey of orthopedists, physiatrists, neurologists and neurosurgeons, looking for someone who could locate the source of the pain (there were three potential culprits on the MRI) and tell us what to do about it. The only local physical therapist who took our insurance would put patients in the hands of gum-popping teenage assistants, who were not at all equipped to supervise seriously injured people. Neurologists shrugged their shoulders in our allotted eight minutes and said, “It looks like you have a pain syndrome” and tried to sell us on Botox injections in the scalp. In desperation, we went out of network for a doctor we had heard was good, at a New York hospital that is well known for treating back problems. We were willing to pay the out-of-pocket fee in the hopes of getting someone, anyone, to offer a treatment plan that might work. Ahead of time, we confirmed—verbally—what the visit and the tests were going to cost. The doctor was not able to offer any new diagnosis or treatment plan, so we paid the bill and moved on.
We muddled along for another year, cobbling together a treatment plan of our own devising—gentle exercises, walking, rest, non-narcotic painkillers. He spent most of a winter and spring in bed. He gradually improved and went back to work; today he’s fine, with a strenuous exercise routine and only occasional dips into Tylenol for pain management. As I write this, he’s spooning Nutella into his mouth and chortling over the Braves’ management shakeup.
A year after our visit with the out-of-network doctor we got a $1,500 bill from a “diagnostic” company in New Jersey. It turns out that what we had agreed to pay—the visit with the doctor and the tests—didn’t include the technician administering the tests, who billed $1,500 for her time. We called the doctor, who said, yes, that’s correct, you owe the company $1,500. Our verbal agreement on what we would owe didn’t include the diagnostic company; we didn’t even know there would be another provider involved. For another year I wrote letters and made angry phone calls. I finally paid when the bill went to collections.
Our insurance company said our only defense going forward was to get—in writing, in advance—exactly what we were going to pay for, for any given procedure. You tell me: How would this even be possible for someone going in for an emergency surgery, or for someone who was in pain or distress—you know, for someone in ill health?
At that point I was pregnant with our second child and resolved, at the delivery, to ask literally everyone who walked by if they took our insurance, and if they didn’t to send them on their merry way. As it turns out, we didn’t receive any bills for the delivery aside from the co-pay and deductible—perhaps because I had already tussled with this hospital several times over their billing practices and had a long paper trail. After reading the story in the New York Times, if I had another surgery scheduled I would seriously consider pinning a note to my gown that read, “If you don’t take my insurance, please keep walking.”
Now, this is certainly not specifically a parenting problem—everyone is battling these deceptive practices. But for me it felt linked to my new role as a wife and mother. In an alarmingly short period of time, I went from being a single person with no health problems to being a pregnant woman caring full time for a toddler and a bedridden husband. It was a terrifying year; I wept on the phone to my sister-in-law while standing barge-like at a freezing playground; I researched Social Security disability and made anxious calculations about my earning power and daycare fees. The bills kept coming and I kept making phone calls. Why wasn’t my son’s two-and-a-half-year visit covered by insurance? Couldn’t you have told me that before we came in? Why was my CVS workup sent to an out-of-network lab when I was specifically assured that it wouldn’t be?
These letters and phone calls ate up the precious little time I had free from caring for my husband and son. (I measured it in naps—I could generally argue one bill per naptime.) It also ate through our savings: In the worst year of our health troubles, nearly 10 percent of our take-home pay went to medical bills, many of them “surprise.” Every parent I know has a story like this—an out-of-network anesthesiologist or pathologist, or a separate bill for the newborn, who wasn’t technically on the insurance plan yet. The only parents I know who are handling this okay are lawyers, presumably because they know how to scream in a particularly litigious way.
Now I think twice before I go to the doctor or take my kids to the pediatrician, because I dread the onslaught of deceptive bills and rejected insurance claims and the feeling that if I relax for even one second, these fuckers will take every dime we have. This is how I care for my family.
Cover photo: flickr/kozumel