This Week in History was an eventful one for us back in 1992. My preterm labor started and put me on bedrest that would last the rest of my pregnancy, and my insurance tried to dump me.
This week in September twenty-four years ago, I was fourteen weeks pregnant. Most days, I laid pretty low because I hadn’t tolerated all the fertility drugs and treatments very well, plus once the morning sickness kicked in, it was pretty intense. It had let up quite a bit by eleven weeks, so during this fourteenth week, I was flying pretty high. I’d had three full weeks of being able to leave the house for an hour or so if I wanted to, and I could sometimes eat more than a bowl of cereal or toast. I was on the phone with our friend David in Atlanta and as we were talking, I noticed how hard my belly was. Though most women don’t have much of a baby bump when they’re just barely past three months pregnant, I had gone into maternity clothes by six weeks. After I remarked a few times about what I was experiencing in the course of our conversation, David said, “Don’t you think you better get off the phone and call your doctor or something?” “Oh, wow. I bet you’re right,” said I, the OB and NICU nurse. Duh. So we ended the call and I phoned in. And they said, “Go to the hospital!”
Once at the hospital, they got me all hooked up and an IV inserted into my arm and they monitored and ultrasounded me and did the whole work up. It was quite strange really to hear their perspective. Normally if a woman came in having labor at fourteen weeks, they called it a miscarriage. They’d give her an information packet on what to expect and send her home with a compassionate look and pat on the shoulder and say keep us posted and better luck next time. (Not really. Mostly. Well, actually that happened to my sister, so I know some bedside manners out there are lousy in certain places.) But they told me that since it was a “valued” pregnancy, they’d do what they could for me. Valued meaning intentional, expensive, and we’d worked hard to get that far. So instead of the pat and packet, they gave me lots of IVs, kept a close eye on the babies, and had me stay at the hospital overnight. They sent me home the next day prescribing bedrest and home monitoring. It was time to begin the intensive incubation.
Three days later, my doorbell rang. I waddled to answer it and on the other side of the screen was one of those fellows who delivers registered letters. You know, the kind you have to sign for. How exciting. I love surprises. So I waddled back to my perch and tore into my letter. Oh dear. It was from my insurance company. Like a good patient, I had called them during my first trimester to let them know I was pregnant and expecting quadruplets. The lady on the other end of the phone was just so nice and glad to talk to me and she explained that soon I would receive a call from a special agent who would manage my case.
With this letter it seemed they were trying to manage me right out of my coverage. Since my call, my insurance company had been scrambling to find a way out of being my insurance company. According to my personal telegram, my personal agent had dug around until she found a way they thought that they could drop me.
Dear Mrs. Gillard:
It has been brought to my attention that you had other insurance coverage available through — — Corporation while you were enrolled under [our] coverage.
This was code for, “It has been brought to my attention that you're about to have some hefty medical bills and we don't want anything to do with you if we can possibly do anything at all about it.” The letter went on:
[Our] guidelines state that once you're eligible for other insurance coverage, you are no longer eligible to continue under [our] coverage. Since you could have been covered through the — — Corporation effective January 1, you became ineligible for [our] coverage on that date.
This meant, “Oh yay! We think we found a loophole through which we can toss you.”
I probably don't need to say this, but I will. I freaked. At the end of the letter, the nice lady writing told me to feel free to call her with questions. And to have a nice day, or some crazy advice like that.
Well I did call her. As soon as I could catch my breath, at least. Not only did the nice lady confirm that they were canceling my coverage, but they were doing it retroactively and they intended to demand repayment of all claims paid from January 1 to date (remember, this was September, so that was nine months worth of coverage).
About eight months earlier I’d had this little episode where I’d nearly died and was in the hospital for almost two weeks. That was a $25,000 episode, much of which this particular company had covered. They wanted it all back.
I was unemployable and Jason just had his new minimum wage job. (He had been a commercial commodities broker in Chicago at Paine Webber. There wasn’t anything like that in Colorado Springs.) And my infertility doctor had all our money, plus dibs on the first kid, if he was cute enough. We certainly didn't have $25,000 just hanging around to give to the insurance company, nor the money to cover the future expenses without insurance. As it was, we were paying $200 a month to this corporation trying to stiff us to keep me eligible and in good standing. That $200, plus rent, more than used up our monthly income.
Jason's dad had been a lawyer, as was our friend, Mike, who was Best Man at our wedding, so we gave them each a frantic jingle. Their consensus: you can't squeeze blood from a turnip. This was supposed to comfort me? I wasn't even familiar with this phrase. But once I pondered it, I figured it out. I was the turnip and some huge corporation was about to squish me to a bloodless pulp. This is not a very good thing to say to a pregnant woman with more hormones raging through her system then any given man will produce in a lifetime. Of course, I could see the turnip correlation, but I certainly did not want to consider the squishing part.
So Mike and Jason’s dad, with other family and friends with lawyer connections (David in Atlanta, whose wife was a lawyer) (my sister who worked in a law firm), helped me research and draft a letter to address the whole issue. Mike did actually go a long way to calm me, once a few hours passed. A peace came over me that replaced that initial panic.
I wrote back to the nice lady, with the help of my “team” of lawyers, and clearly pointed out where their strategy was flawed. Their argument that I couldn't continue coverage after becoming eligible for another insurance was only applicable under certain conditions which didn't apply to me. Then I went on to tell them that their actions were making my already difficult pregnancy more difficult and that they were contributing to my anxiety level, which was obviously harmful to my physical and mental health, and subsequently the health of my four babies. I told them I expected the situation to be resolved satisfactorily or I would hold them responsible for any detrimental health effects attributable to their actions. Then I threw around a few names of partners in law firms (my friend’s and family’s) and finished up by cc:ing copies to everyone I could think of, including the Commissioner of Insurance for both states involved.
Oh my. It makes me shudder just to remember it all. I had no idea what they would do with all that. I could only hope. In the meantime, still the penniless, pregnant turnip, I needed to look for other possible ways with which to pay for our babies. It would have been a shame to get through the whole thing and just have to sell them to pay the cost for having them. Plus, the infertility doctor still had claim to the one, if he wanted him, leaving us with only three to make money off of.
So I made a call to Social Services. Not something I wanted to do, but we had little choice. I discovered there was a program for which we could apply to receive medical coverage, based on our paltry income, which would cover me during the pregnancy and the kids for a year. Plus, the bonus was, if we had insurance, this program would pay the premiums to keep us covered and then act as a secondary insurance, which would cost them much less in the long run. Either way, we found some help.
A week passed. I got a letter telling me my letter had been forwarded to a senior vice president at my unscrupulous insurance company. (They didn't call themselves unscrupulous. I added that.) The VP would be thoroughly researching the matter and get back to me. One day later, I receive the third letter which said:
We are pleased to inform you that your coverage will continue...
Yay! Translation: “You win.” I got it back! And because we had found secondary coverage, they would now pick up the $200 a month we had been paying to keep the primary insurance. Now we would have enough money left over after rent to buy some cereal and peanut butter. We were feeling grand! It was great to see how quickly God turned a potentially nasty problem into a much better situation. We never would have considered looking for help if it hadn't been for the nice lady trying to shove me out their loophole.
Want my stories delivered right to your inbox? I can do that! Click the button below to sign up and I'll make sure to send my post right to you each day that I blog.