by mrsbigdog » Oct 03, 2007 6:11 pm
First point...you might want to check into this. If your husband is self-employed is it possible to add you as an employee? You could lower his pay in order to show paying yourself at least minimum wage. Aetna, United and Blue Cross all offer small business health plans that cover companies with as few as two employees I believe. When I checked into them the price wasn't cheap but it was better than paying out of pocket. Maybe that could be an option for you to check.
In 2005 I went through three different group insurance policies while pregnant.
Blue Cross/Blue Shield of Maryland PPO plan. We had a $1,500 deductible and then we were responsible for 20% of the home health bills. They did cover everything on the home health bills after our portion and the 20%. This was through my employer.
When my job was terminated we added the family to the policy at my dh's employer, Aetna PPO. This plan had a $1,500 deductible and again the 20% but picked up on the day BCBS stopped. They covered all of the home health bills after our deductible and 20%. Once I was weaned off my PICC they covered my Zofran (28 pills at a time). I had to pay a $20 copay for the Zofran every two weeks but that was it.
Near the end of my pregnancy dh's employer's policy year rolled over. We were given the choice to stay with Aetna PPO or change to Aetna HMO. Staying with the PPO would have meant paying another $1,500 deductible for the some of the extra ultrasounds and hospital costs. I spent about four hours on the phone with the HMO people verifying that they would continue to pay for my Zofran ODT and was assured that they would since it was on the approved list. I called several times and spoke with several people. As a result we switched to the HMO so we would only have to pay the $500 co-pay for the hospital bill at delivery. The first time I went to get my Zofran refilled would only give me 14 pills and said that was the absolute total they would cover, the rest would be out of pocket. My dr and I both argued with them about it but they refused to budge unless we woud retry all of the possible meds they listed in a letter. We had already tried several with no luck and knew I didn't react well to others on the list. I was only a few weeks from delivery so we cut my dosage and induced early.
Dh's newest employer has Aetna PPO which covers home health at 100% with no co-pay or deductible.
Every policy that is written is different whether it is for an individual or company so there is no way of knowing if something will be covered by a certain company because even policies from the same company will have different coverage. The best is to read all of the fine print in any policy you are offered in order to determine if it has the coverage you need.
Good luck...Donna
3x HG survivor: Theresa - 11/88, Katie - 1/95, Emily - 1/06
(one HG baby in each of the last three decades! - yes, just call me crazy)