So here I am again, in the middle of a medical insurance debacle featuring Obamacare, Horizon, and Monmouth Medical Center. Things haven’t played out to the bitter end yet, but I’m fairly certain I know how this one is going to go. I will be more than happy to post a retraction if Horizon or Monmouth Medical comes through in the end. Please, read on for a (hopefully entertaining) real-life anecdote in today’s insurance landscape.
My family’s been covered by a Horizon plan that we purchased through the Affordable Care Act’s exchange (aka Obamacare) since March 1. I don’t really have anything bad to say about the insurance plans or the new laws, because they’ve all been very beneficial to us. But it was hard to get things in order before Jack was born. I was frantic to get coverage that would at least partially cover a home birth (not a chance), and I had months to research and get it together. Rick and I both ended up unemployed in mid-February and needed coverage to begin March 1.
I picked a plan and applied through the website, not knowing that I entered our income information incorrectly in order to qualify for a subsidy. I paid full price for the first month and never got a credit back. But when we called the exchange, they were always very helpful and our subsequent monthly premiums decreased drastically. We spent many hours on the phone over the past couple of months trying to get it sorted out. To make a terribly long story short, Horizon never received the updated information from Obamacare, or if they did, they never made the changes until a couple of weeks ago. But I had faith! Everything would be retroactive and all the insane hospital bills would evaporate when my improved insurance paid the claims!
I went into the hospital to begin my labor induction on March 25 at 7:00 p.m. The hospital dated my entire $16,000 claim March 25. Jack was born on the morning of March 26, and we left the hospital on March 27. Can you guess which date my new, improved insurance was made retroactive to? Yes, the date Jack was born – March 26.
I just hung up with Monmouth Medical Center’s billing office. They won’t change the date of the bill, even though the 5 hours I was there on March 25 are costing me thousands of dollars (that they aren’t going to get now, at least not for many months). They won’t change the date because it’s their policy to date the entire claim the date the patient is admitted. Even though it means that their claim is mostly unpaid. Unless of course Horizon pays the claim according the policy that went into effect on the 26th. ROFL! Right.
As things stand now, it would have been cheaper to have Jack at home, completely uncovered by insurance. And just three and a half years ago when Hugo was born, I paid nothing out of pocket for the exact same induction and delivery at Monmouth Medical Center.
I consider myself pretty insurance savvy and I tried really hard to make this work. Insurance today seems to be designed to confuse participants and deny services.