Aug 10, 2009

Oops, They Did It Again...

Ok, first, please forgive the language that is about to follow...

::takes deep breath and visualizes their medical director roasting on a spit::

Ok, now that the vent is out of the way, let me explain.

Yes, the health insurance company is at it again - determined they shall not fail in their mission of racheting the stress level of pregnant moms to Total Freak Out Level by the last few weeks of pregnancy. People who have been reading here awhile may remember that, last time, they threatened about 6 weeks before I delivered that I wouldn't be able to deliver at the hospital where my OB practices. That, being an issue that affected the state insurance pool as well as our tiny little bit of business, got resolved by the State Controller getting involved.

This time... well, a bit of background first... Evie, my 16 month old, was delivered nearly a month early as her amniotic fluid levels had dropped precipitously (>50%) from Tuesday to Thursday. This time, the OB warned us that the insurance company wasn't going to cover twice weekly fluid check ultrasounds and we've been scheduled for weekly ones with fetal non-stress tests for the next 5 1/2 weeks until delivery. Well, today, my mail brought me the news that the insurance company won't cover those either - sorry, they say, it's not medically necessary. If a baby doesn't have enough amniotic fluid, first, he or she stops growing, then, loses weight, and, if it goes on long enough, the child essentially starves to death in the womb. There is no question that ultrasounds are safe, they are not experimental, and have been shown, as I am a direct example of, to save fetal lives.

Not medically necessary, my substantial ass.

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Blogger h. said...

Make room for me in the boat! My girls were delivered at 36 weeks for my first child and at 34 weeks for my second child. Both were emergency cesarians due to low amniotic fluid levels, and both would have died without doctor care. In a world before/without ultrasounds, I would have been a woman who birthed stillborn babies for reasons that could not be explained. I am eternally thankful to both my OBGYN and to the age we live in that I have my daughters..

And to those scum sucking idiots who think that prenatal care is an "optional" item... well... I can think of many horrible fates for you, but none are as dire as not being able to get the medical care your child needs. May you bastards live in the medically retarded world you are creating.

7:33 PM  
Anonymous Anonymous said...

Oh my dear! Big hugs! They suck!! I hope something works out for both of you! This is just plain stupid!

9:11 PM  
Blogger LauraJ said...

that was me by the way

9:11 PM  
Blogger PeppyPilotGirl said...

@H - It doesn't even occur to most people, I don't think - the majority seems to think ultrasounds are simply a cool little luxury to tell the gender of the baby - how many lives are saved as a result. It's terrifying to those of us who know what the alternative can be. And, you're right, in an earlier time, we would have been in the sad majority of people who would have birthed stillborn children with no explanation. I am very sorry you had to experience that but glad the girls are happily tromping about your world now.

@LJ - Thanks!

9:45 PM  
Blogger Brightdreamer said...

Remember, the current state of health care in America is perfectly sound and doesn't need an overhaul. (Don't even get me started...) I'd think, given your history, you could appeal the decision, backed by reams of medical evidence, but I don't suppose health insurance deals in appeals.

aechra - Hole-in-the-wall insurance outfit that actually provides good health care at an affordable price, but has been run under by the big names in the industry.

1:52 PM  
Blogger JerseyTjej said...

Doesn't a pre existing problem overide the bullshit protocol they are trying to enforce?

7:43 AM  

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