Health insurance

I wonder if it isn't quite appropriate to use my "Mamacita" blog to vent my feelings about social issues. Ultimately, I suppose that my views on issues are a part of being a Mama.

So, here's the thing. In Mexico, because I was employed, I had access to "public" heath care. Meaning, I could obtain care, any care, free. The clinics were a bit rundown, and I think the wait for certain testing could be long. But, it was free. Brian and I opted to use a private doctor for my prenatal care, which cost $550 MX per visit- about $40 US- including a full exam and ultrasound. That wasn't a copay. That was the cost of the appointment. My doctor was located in a new, state-of-the-art, hospital.

Our plan to return to the States for Kinnie's birth presented a lot of concern about how we would pay for it. We knew I would probably have a c-section. If we stayed in Mexico, it would have cost about $1000 US if we had it done by the private doctor- it would have been free if we used the public system. After working for pesos for almost a year, we did not have the money to pay the tens of thousands out of pocket that a c-section would cost in the States.

I researched options. I discovered that I may qualify for Medicaid, and when we got home, we applied. I was approved. It was such a relief. I knew that whatever care I needed, and any care Kinnie needed, would be covered.

I was aware of the stigma. When I would walk into the doctor's office, or to get a prescription, I felt myself wanting to discuss my insurance in a whisper. What do you think when you see someone who is using Medicaid? I never had anyone judge me openly, but am aware of the judgments often made. Ultimately, I decided to carry my head high. I had paid into the system, and was truly in need of the care offered through the government. And it covered everything. I paid nothing out of pocket for Kinnie's birth.

Now that Brian and I are gainfully employed, we have "real" health insurance. I went to the pharmacy yesterday to pick up my thyroid medication. I have had hypothyroidism for several years. It's no big deal, and has been stable since I was diagnosed with the daily use of medication.

Because of the stability of my condition, my doctor has prescribed 90 days of medication for each refill. When I was using Medicaid, this presented no problem. However, when I picked up my script yesterday, I was informed that my new insurance would only pay for 30 days at a time. The copay for the 30 days would be $8. The pharmacy had filled the 90 days, and for the sake of ease, I asked if I could just pay out of pocket for the 90 days. The cost, without using my insurance, was $26. So, If I go back every 30 days, and pay just my copay, I'll save $2 over 3 months. Hardly worth the gas.

It gets worse. We were sorting through our mail last night, and found a letter from our new insurance company. Mind you, this is a major insurance company in Colorado. The letter indicated that if we have any prescriptions for which we want a 90 day supply, we must first fill a 30 day supply 2 times through the insurance company's mail-order system, and then we can begin to obtain 90 day prescriptions through the same mail-order process. And, they'll only charge us 2 copays for the 90 day script.

What?!?! Who makes these rules??? Why in the world does it need to be so complicated? Seriously? I just can't believe it. Clearly, there needs to be a change. If my doctor believes it's okay for me to have a 90 day supply, because my condition has been stable for years, why should I have to play games with the insurance company to obtain that prescription?

I hope for an improvement to our system. It is ridiculous. To think that this is the process one has to go through in order to obtain a simple, inexpensive medication. What would it be like if we needed something for a much for significant condition? Perhaps when Kinnie is grown, we will have had the ability to simplify. I hope.