Can We Actually Talk About Insurance?

When I was a kid, insurance was just a word in a math problem. And the word problem was always something ridiculously unrealistic: 

If Suzy breaks her arm and the doctor charges her $75, and her insurance only covers 80%, how much should Suzy send to the doctor’s office from her checking account? Show your work.

Sorry, Suzy, but if you are getting out of this with a $15 charge, you are most likely a time traveler or sleeping with the doctor. The actual medical doctor, because that other Doctor is too busy with wibbly-wobbly timey-wimey business. Please don’t show your work…

As a grownup, insurance is part of my daily life. And sometimes a curse word. Because I have a disabled child. 

A common misconception is that all children with special needs are on disability or Medicaid or both. We get lots of people making assumptions about our family and our financial choices. 

Adelaide happens to be on neither. That’s our choice. I honestly am not concerned with the choices other families make. Each child and situation are unique. But it is absurd to think that a wheelchair = fill-in-the-blank services.

For several years, Adelaide was on private insurance. Some stuff was covered, most wasn’t. That’s what happens when premiums need to stay in a certain place for all the members. 

But this year, things are different. 

Dave took a new job. We love it! It’s an awesome company. The owners are wonderful. Dave uses all his skills everyday. He has a fantastic team. It’s a small company. But the insurance premiums are higher. So we had to get creative. 

We looked at all our options. We even checked out the “marketplace” and it was half our take-home pay for the year. After I laughed, peed my pants, and laughed some more, we looked into a medical sharing group. 

We were able to get a plan that fit our budget. We chose our ratio of premiums to out-of-pocket costs. Everything was looking great. Then, we got pregnant completely unexpectedly. We learned that the pregnancy and birth wouldn’t be covered, due to an issue with the start date. It was back to the Excel spreadsheet to figure out how we were going to insure our now growing family. 

Then we lost Laurence and Flannery. We were forced to sell our souls to the devil to afford COBRA. It was a nightmare. But since I was back to being unpregnant, we went back to the medical sharing group. 

It’s not perfect. Adelaide’s pre-existing conditions aren’t covered until March 2019. Three years from the start date. Eeek. It’s the price we pay to afford our premiums. But under the private insurance, she didn’t qualify for therapy or gear anyway. We were already paying out-of-pocket for all gear and using public school therapy services at our local preschool. 
So what will we be doing for all her other appointments and procedures? Haggling. Adelaide has two appointments at our Children’s Hospital next month. So I need to put my game face on. Aside from a brief season as the worst player in my homeschool soccer league, Athletic Lyndse has never existed. So I need to actually acquire a game face. But that unibrow was on point!

  
Why share all of this? Because I’m tired of folks assuming things about our kiddos. We don’t assume that every single mom is on food stamps or every pregnant woman is on WIC or that every military veteran goes to the VA. Why do we assume that every kid with a label and a slew of specialists is drawing benefits? Sometimes our kids are on private insurance. Sometimes our kids are in a medical sharing group. And we all choose what fits our families’ needs and philosophies. 

I had to leave a disability support group on Facebook after being bullied for not having Adelaide on disability or Medicaid. A new mom asked a question and I answered it truthfully. This mom, brand new to our world of disability, asked if it was possible to raise a disabled child on one income without seeking benefits. I answered yes.  I started receiving messages from moms and admin saying I was too prideful and making other moms feel bad. Just because I spoke about our experience and mentioned that we didn’t utilize those services. And I was told that all children with a diagnosis should be receiving government benefits or the parents were neglectful and abusive. We obviously differed in our definitions of neglect and abuse and I left the group. But it’s always stayed with me that an honest conversation couldn’t take place that day. 

So we’ll just do it here. That’s the fun part about blogging. I can write what I want and can’t be censored. Even when I use the worst curse word around: insurance.

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3 thoughts on “Can We Actually Talk About Insurance?

  1. learningalterations says:

    Yikes. It’s bad enough you have to navigate the waters of insurance coverage. Daily? What a part time job that is! Too bad you have to navigate some social shark waters as well. Hang in there. Many of us sympathize silently :)

    Like

  2. Allison says:

    While my personal experiences differ from yours, I do hate the insurance struggle. We’ve done it all. Private, medi-share program, state benefits. Nothing makes me sweat blood more than knowing it’s a) time to renew, b) time to apply for something different, or c) Your coverage has lapsed. Wish they would send a happy greeting card every now and then. Haha

    Like

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