Tuesday, December 9, 2008

The Best Laid Plans

I was suppose to start home monitoring this week.  I know that occasionally insurance can be a bit of headache so I decided to start working on making sure all my ducks were in a row last week.  Since I had already verified that services I needed were covered, I thought this was more of precaution that anything else.  As it turns out, while my insurance will pay for home monitoring, the company that provides the service, Matria, does not accept my insurance (Tricare).  This is the 1st time in my life that this has ever happened to me.  I was completely stunned!!

You would because I live in large metropolitan city I could just find another provider, right???  NO.  It appears that Matria is the only company that offers the fetal monitoring I need.  

So what are my options?  Pay out of pocket and then file for reimbursement with Tricare.  I don't know what the total cost of that will be, but I can promise for what I was hoping would be 6 weeks of home monitoring will be very costly.  

Option 2, being admitted into the hospital.  This is of course a viable option and where I was going to end up eventually, but I was hoping to stay home as long as possible.  It is more comfortable, more inviting, and more relaxing, but mostly because I wanted to extend the time I have with my son and husband.

Turns out the insurance coverage is not the only issue on the table.  As it turns out, my doctor's orders, which have not deviated from our 1st conversation about home monitoring, may not be able to be met by Matria.  So it may not matter if we can work out insurance issues, they may not be able to monitor me in a way that is satisfactory to my doctor or to me.

This is a pregnancy and a high risk one at that, I know there are no guarantees, but I did not expect THIS to be an issue.  I know it is naive of me, but I never thought that I would have to make decisions on my healthcare based on cost.  I HAVE insurance!  I thought because I had insurance I could receive the best care possible.  

We are in the process of figuring out exactly what all of our options are and then will make the best decision for us.  We are now back tracking and trying to reconfigure many of the plans we had set in place.

Best laid plans.........

4 comments:

Carolyn said...

gack. I'm so sorry. You have so many better things to be thinking about ...

Kate said...

Insurance boggles the mind. Honestly. And healthcare needs a revamp, badly. I'm sorry to hear that this is happening to you, you don't need the stress on top of the pregnancy. I hope a solution comes along soon...

-Kate, from Monoamniotic.org

Unknown said...

I'm sorry you are forced to deal with this additional stress, but at least you found out about it ahead of time, sort of. Things will work out, you just have to believe that.

Amanda. said...

Best of luck! I hope this gets resolved for you and your family soon!