I Hate Insurance!

I know I'm not alone in this sentiment, but when you work for yourself and have no employer provided health plan, the sour taste in your mouth only intensifies.

For the past several years, Peter's been on an individual health plan. He never goes to the doctor, but his rates keep getting knocked up anyway. Since leaving Austin ISD, I've been covered under Cobra. It's an HMO, but everything I've needed has been covered with no deductible, so the only down-side really has been the cost. When Jaden came along, we got him his own individual plan which has worked out nicely for him except for the two price hikes we've already been subject to in a year and a half.

Last year, when my Cobra term was about to expire, I looked into getting my own individual plan, and that's when the real woes began. I discovered that maternity coverage on an individual plan is virtually non-existant. So, we decided that since we would be saving money on the monthly premium, we would simply put some money aside each month to pay for maternity costs out of pocket. The policy would still pay for any "complications of pregnancy". . .except they wouldn't, at least in my case. Because I had had some "complications" with Jaden (ie endometriosis, gestational diabetes, and a c-section), I was excluded from coverage for all three. Argh!

So, we renewed my Cobra for another six months and started to look into other options. We discovered the Texas Coalition which groups small businesses into a larger group to try to reduce premiums. We set about "officializing" Peter King Design into an LLC with me as full partner so that we would have two employees and qualify for group insurance. We filled out all the paperwork, got some decent quotes, and felt like we were finally making some progress. We were told that because we would be applying for group coverage, it would make no difference if I got pregnant again before the new policy took effect. (Individual policies will deny you outright if you're pregnant, even though they don't cover maternity costs!). So, between the time of filling out the initial paperwork and doing the actual application to the insurance company, we got pregnant, only to find out that we had been misinformed. I could not be denied coverage, but I could be charged double the monthly premium we had been initially quoted. No good.

I found out that I could renew my Cobra one last time for six more months, putting the expiration date a little over a month past my due date. This timing has been one of the fortunate aspects to this entire fiasco. I would be fully covered for all maternity expenses, including all complications whether new or repeated, with no deductible, through the entire pregnancy and delivery, giving us time to find and start small group coverage when I was no longer pregnant.

So, that's where we are now. I'm looking into coverage effective 9/1 for the entire family. After all I've learned over the past year, I feel like I understand the process and the lingo good enough to have intelligent conversations about policy options with the agents I've been working with. We have found some decent plans out there, but this is all before the underwriting can jack up the prices for pre-existing conditions. No one in our family has any chronic conditions, and aside from my maternity care and Jaden's well-baby visits, we hardly ever go to the doctor. However, some companies are still using my previous laparoscopy and c-section as excuses to skin us alive with the costs. They apparently have the right to raise rates up to 67% from the "prime rates" that are initially quoted based on medical history. Some companies are much more specific in asking questions about medical background than others, and we are forced to toe the fine line between being deceptive and simply not offering any information that is not directly required.

Please pray for us as we continue in this process. We hope to have a plan chosen based on initial quotes and preliminary health screening questions by the time baby #2 arrives. That will give us a month to officially apply when I'm not pregnant anymore and the 4th member of the family is actually born. Our initial goal was to reduce the total cost of insurance premiums we pay each month. At this point, however, we may have to be satisfied with maintaining our costs while still retaining coverage for the entire family.

I agree that insurance is a necessary evil. It's great to have when you need it, but it sure does hurt to pay sooooooo much for it when you don't.

Sorry for the long post about such a droll topic, but I really needed to vent a little!!!