Parents in Process of Adding Baby to Insurance When She Comes Early. Now They're Paying for It — Big Time
When Amy Jay learned she was pregnant again despite a history of infertility and miscarriage, she and her husband did everything right. They even uprooted their lives to make sure they would have good health insurance.
But they still ended up with a hospital bill that nearly bankrupted them.
As the Daily Mail reports, Amy and Mac Jay wanted to make sure their family had good medical care. And after seeing the cost of the tests and medication Amy required as part of her prenatal care, they knew their health insurance was inadequate.
As Amy told PopSugar, early in her pregnancy she learned that her anti-miscarriage prescription cost $200 a month — and that wasn't the only thing her insurance wouldn't cover:
“I had two choices: rack up debt on a credit card or risk losing another baby. Obviously we chose to do whatever was necessary to keep our growing baby safe. I only thought that was the worst part of the situation until I started receiving bills in the mail for that blood work. I received a nearly $200 bill for every single lab that was done to make sure that our baby had not died.”
The problems with their existing insurance only got worse. Eventually, the family decided that Mac would have to leave his job (which he loved) for one with better health coverage.
So when Amy was 34 weeks pregnant, the family moved from North Carolina to Huntsville, Alabama. Mac's new job had fantastic insurance. The only problem was that it didn't begin until one week after Amy's due date.
Because they didn't want to go without health insurance, the family paid for COBRA coverage, which extended their (old, problematic) insurance until the new coverage began. Amy told the Daily Mail:
“Growing up in America, I've always been told to be insured; not to even let a minute go by without being covered because in that moment something will go wrong. My due date wasn't until February and we were crossing everything hoping that she wouldn't come before then.”
Meanwhile, Mac emailed his insurance representative, asking what they needed to do to make sure their new baby was covered when she was born. When he didn't hear back from the representative, he assumed the issue had been handled.
Only days after Mac sent his question about coverage for their newborn, Amy went into labor. Evelyn Jay was born via C-section at 36 weeks. The preemie's lungs were very immature, and Evelyn struggled to breathe. Amy told the Daily Mail:
“Just crying was collapsing her lungs. Her chest was moving as fast as butterfly wings and she was purple and blue.”
Evelyn needed help from specialists as well as round-the-clock care from the hospital staff. Amy told PopSugar there were times when they feared they would lose their daughter.
During this time, Amy was still recovering from her C-section. She had developed a postpartum infection that needed treatment, and the entire family was preoccupied with stress and worry over Evelyn's health. But at least they were covered by insurance for all of the expensive medical treatment ... or so they thought. Amy told PopSugar:
“We never heard anything from anyone with the insurance company or Mac's old company, and therefore we assumed that everything was covered and that we would soon be receiving a bill for our portion of the entire ordeal. We were very, very wrong.”
Instead of getting a letter from their insurance company, Amy opened a bill from the hospital. It was the first indication that they were on the hook for more than $200,000 in medical costs. She told PopSugar:
“I didn't think much of it at first, but I opened the envelope and felt like my world stopped. The bill was for $173,000. But I stopped myself from panicking. I knew something was wrong. There'd been some mistake. We had been assured that nothing like this would happen.”
Hoping to clear up the mistake, Amy and Mac contacted the insurance company and learned that their daughter had never been added to their insurance. What's more, the insurance claimed that the hospital they used was out-of-network. Therefore, none of the specialists, tests, emergency treatments, or therapy were covered.
Mac and Amy pointed to their earlier efforts to get their daughter added to the plan and were told that it was their responsibility to take care of the paperwork. When they tried to add Evelyn to the insurance plan immediately, the insurance company said they had just missed the 30-day window to do so.
Because their first child had been born while Mac was in the Army, the couple didn't know that adding a new baby to their insurance would be so difficult. Amy told PopSugar they had expected some help or warning, not an overwhelming series of medical bills:
“During the most tumultuous, terrifying, physically, and emotionally painful time of our lives, we were expected to have known to do something that no one ever told us we had to do. And because we didn't do it, we would be responsible for over $200,000 in medical bills.”
Amy told the Daily Mail that she had thought they might end up owing about $15,000 for the birth and care of her baby. Now the family is contemplating bankruptcy:
“I don't know anyone who has $20,000 lying around, much less $200,000. It's unfair that this is what happens when your baby is born sick. We have an unjust and broken system that harms the in-between folks, which is a huge chunk of Americans.”
Desperate to avoid financial ruin, Amy and Mac spent months talking to lawyers, the hospital, and the insurance company. But they got little help. Finally, a friend set up a GoFundMe page to help pay down the family's medical debts and save them from bankruptcy.
In a matter of days, the fundraising effort raised more than $20,000 toward the goal of $25,000. A grateful Amy plans one day to “pay it forward” by advocating for others who have been victims of the medical system.