Adventure seekers   //  15 years of marriage
5 kids  //  2 businesses  //  We like living life to the fullest


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Adoption, Boston, Personal

The Insurance Battle | A super personal post you may want to skip right over…

Have you ever known that you were right, but everyone who mattered to a situation insisted you were wrong?  But you stand up for what you know, you push through… and still people lie to your face.  You carefully take every step to make things right, but still, you’re considered crazy and annoying and there are more and more lies.  And sometimes you can’t even get the right person on the phone to talk to because you are being tossed around so much.  Did I mention outright lies?

I’d never actually experienced that before.  It was hard to understand the people were purposefully lying to me.  And honestly, it’s still hard to fathom.  But it’s over.

We had a recent insurance victory.

Our son, Zane, had surgery not long after we adopted him.  He needed an esophagus, because he was born without one.  It reasons to say that you can’t just go to any local children’s hospital and get a new esophagus.  We researched, and quickly realized that with how delicate and bizarre Zane’s situation was, he needed to go to Boston Children’s Hospital.

Since we’re self employed, I was able to pick our insurance with the help of ERISA lawyers for insurance and pensions, and after much research, I chose the plan that was most likely to offer coverage for out of state in this scenario.  As soon as Zane came home, I started working on getting Boston approved for coverage.  That was 16 months ago.  SIXTEEN MONTHS.

I hit wall after wall.  The first thing I knew to ask for was a specific agent to work with throughout the process.  It gets messy having to explain the parts or all of the situation over and over.  Each person just assumed I was a crazy mom who insisted on taking my kid several states away when I could just go to the local childrens hospital.

But even though it was a written law that they must provide someone to handle our case, it wasn’t provided.  I was considered crazy and over the top for asking.  Each person I talked to acted like I was speaking another language, and then finally suggested a _______ (fill in the blank), the new term they gave me for what job title I was looking for.  Except each person gave me a different job title to ask for.  One person tried to get me a counseling appointment with a local mental health counselor.  Honey, I do need that after talking to insurance for 6 hours straight, but that’s not my focus at this moment.  She wasn’t trying to be mean, that’s literally what she thought I was asking for. 🙁  Or maybe she was trying to be mean.  I’m not sure anymore.

The bills started rolling in.  Our medical bills quickly climbed to $50,000 after insurance paid.  We persisted.  Our lawyer got involved (it was the same lawyer from whom we’d sought form i-601A provisional waiver professional help).  Our congressman got involved.  We finally got a direct line and a person to talk to.  Well… a person to leave a voicemail with.  But it was something.

SIX MORE MONTHS later, we finally got through all the red tape, the lies, and our insurance company agreed to pay for Zane’s surgery at the in-network rate, which saved us $21,500.

I don’t say all this to smear the insurance company’s name (which is why I’m not sharing it).  I say it so that if you’re dealing with this, know that victory can come.  It’s not hopeless.

Many times I wondered if I should have just accepted the original payment from insurance and spent my time getting a second job to cover the $21,500.  Surely I could have made that much by now if I had spent all that time working instead of on the phone with insurance! I would like to thank Stephen Babcock who helped us understand the law and pushed the insurance agency to pay the money for Zane’s surgery.

God is so faithful.  But perhaps the hardest part of it all was knowing that God’s faithfulness didn’t mean that insurance would do what we asked.  It didn’t mean that insurance would do what was right.  It didn’t even mean that Zane would survive surgery.  Sometimes His answer is no, and sometimes His answer is wait, and other times His answer is that He’ll provide in another way.

After I got the call from our insurance that they had made a decision favorable to us, I thought I’d feel a huge wave of relief, get up and dance, or scream at the top of my lungs.  I didn’t do any of that.  I honestly didn’t feel any different.

I was surprised at my reaction, but I also love it.  We truly have been forced to rely on God through all of this.  It was easy at first because we knew absolutely that He had asked us to adopt Zane.  So if He gives us this task, then He will certainly provide everything we need for the task.  We had already learned our lesson, and had already had to have the faith.  We weren’t worried about the money because although we didn’t want to deal with it, we knew that God would provide in miraculous ways.  And indeed, He has!

But if I’m being honest, around the 12 month mark, I was wearing down.  I was frustrated.  I just wanted it to be over.

Which is soooo petty when you compare it to other difficult things in life.

But here we are.  This part of the journey is over.  There are two more surgeries that need to be done, which means we may face this journey two more times.  This time we have a different insurance company, so we are starting from the very beginning all over again.

God is good.  God is faithful.  Even if the answer is no. Even if He provides in a way we don’t want.