March 17th, 2014
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money signInsurance has been a pain for a lot of people this year. The new healthcare regulations have affected a lot of people, including my family. I am not going to get into Obama Care, but I do want to share a glimpse of what we have been dealing with for the past year and a half.
When we adopted our son five years ago we had a different insurance company than we do now. My husband was with the same company though. During that time our adoption agency had advised us that most likely the insurance with not cover our son until finalization day. With most insurance companies though, they will back track the claims and pay for any remaining balance after the child is added to insurance. This is exactly what happened with our son. His doctor was amazing and gave us a discount for self pay until he was covered. Each visit cost anywhere between $75-125. It was a lot at the time, but we knew we were going to get paid back.

So when we adopted our daughter a year and half ago we assumed it would be the same for her.  At first it was. The first couple of visits our insurance paid the balance. Our agency gave us a formal letter to give to the doctor and insurance company stating that we are her legal guardians.  I was so happy that the insurance was paying for all costs, but our copay. For the next couple of months we continued to pay only copay for sick visits and nothing for well checks. Then one day when my daughter was about three months, we received a bill from our insurance company along with a “refusal of coverage” letter. In this letter it stated that we needed to provide the adequate documentation that our daughter was in our care and we were her legal guardians. We called the agency and they produced the letter within a couple of days. I was not really worried about it because we were going to court in the next couple of months for finalization. Little did I know this was only the beginning to our battle.
The insurance company told us that the letter stating legal guardian ship was not enough documentation. We need to provide more. Our social worker from the agency provided all the paperwork that stated our daughter was in our care; hospital records, adoption agreement, and even proof of adoption fees.  All of these documents were not “good enough” for the insurance company.  Our adoption agency mentioned that in all of their 20 years of placing children for adoption, they are never had an insurance company decline a child.  The agency even tried to talk to the insurance company to explain the child is in our care permanently and gave them the court date.  Still nothing!

For the next 6 months the doctor’s office kept submitting the claims hoping they would pay.  Last week when I took my daughter in for her 15 month well visit, the dreaded financial lady approached me.  I knew this was not good news.  She informed me that our insurance agency is simply not going to pay for the first 6 months of her life, because she was not “legally ours.”  Therefore she was not covered under our insurance. So what now?  Who was going to cover her?  Now there is a hefty bill that needs to be paid.  My husband and I feel so bad about this situation, because the doctor and staff have been so kind and patient with us.  I am just so thankful that our daughter was not sick often and did not need a lot of medical treatment when she was first born.  She did have acid reflux and we paid about $200 a month for medicine, but that was the extent of care she needed at that time.

We are so blessed that my husband works for an amazing company that is in disbelief about this how situation and is going to pay the bill.  Please don’t get me wrong, we would have paid the bill.  We just wanted to exhaust all options before paying.  I am not writing this to complain(well a little), I am sharing this with you so you can be informed.  I hope this does not happen to you.  Maybe I am just naïve and this happens all the time, but to me it is ridiculous.  Please be informed about your insurance company and ask your agency about the coverage of an adopted child before finalization.  Has anyone else experienced this?

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3 Responses to “Insurance Woes”

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