Great news arrived in our mailbox on Thursday.
If you've been following the blog, or my Facebook, since last March.. you know that our insurance company had denied the hospital stay I had early on with the twins (for hyperstimulation). I had been admitted for 8 days, and would have died without treatment. However, they claimed it was a complication of fertility meds, so it would not be covered. Note: a lot of this post is numbers and bitching, so feel free to skip to the ** to bypass ;)
The bill for that stay was $29k. Insurance, however, was only billed $12k for the same services, but since it was denied, we were first billed the sticker price. After dealing with a plethora of inept employees at St. Vincent's, one told me I would only be billed the $12k. Then a bill arrived for the full amount. Next rep told me I would have been better off without having insurance since I could have had an uninsured discount, but I didn't qualify because we technically did have insurance. Her boss disagreed and gave us the discount.. bringing it down to about $18k ($6k more than insurance was even billed, if you recall.)
So next, I apply for the financial assistance. The hospital fails to go by its own publicly released policy/chart, and decided we should get a 40% discount. New bill arrives. I call to complain it doesn't line up with their own policy based on income and family size, and am informed that it's just a "general guideline" used for people with "really large bills and stuff." Um. First, 29k isn't a large bill? Two, why post a clear-cut financial chart as public policy if it's really a vague case-by-case "large bill" decision? But at this point, getting a lawyer would have cost more than the 2-3k difference in discount. I was also informed, "The financial aide discount should have been applied to the original amount (29k), but she accidentally took it off your uninsured total. So, since that was our mistake, we'll honor it." Why thank you. Basically telling me that our total "should have been" around $14k, but they were generously going to let us slip by with 'just' $9k.
Btw, it's worth noting, that during this same time period, I applied for financial assistance with IU Health for a plethora of other bills, and they determined -- based on the same income/bank statements/etc, that my husband and I should cap out at $1500 out of pocket. But St. Vincent, a non-profit and 'charitable' hospital, decided that $9k was cutting us a huge break.. o.O
** At any rate, we had to start making payments ASAP, or it would be sent to collections. So our only option was to agree to a payment plan that would last 7 years. Basically like adding a car payment to our already tight budget -- with me barely working at all.
All I could think as I agreed to this plan was that I was going to be making monthly payments up until the twins would have been in 2nd grade. Nevermind the huge financial burden -- the monthly reminder for seven years was going to be pure torture.
So we appealed. Got records, letters from our doctor, had husband's HR people contact the insurance company -- and it was denied. So we appealed again. It was denied again. Finally, after 9 months of appealing, I had given up all hope. We had already made several payments under the "agreement" and I had accepted that I was doomed to feel that punch in the gut every single month.
But I went ahead and sent the letter requesting the final, external review. They asked if I had any new "evidence" to include. And I didn't. We'd said, and tried to prove, everything we possible could. We'd rebutted every argument. It got us nowhere, and I felt this would be no different.
Then, last Thursday, my husband brought in the mail while I was watching television. He walks from the kitchen with a packet of papers in his hands -- with an inquisitive look on his face. His brow was furrowed. I was beyond curious what kind of mail deserved this much attention.
"That's not a good look. Something wrong?" I asked.
He looked up at me, still somewhat puzzled. "It's good news.. I think."
He handed me the paper, as if he couldn't believe it until I read and confirmed it.
I scanned the page quickly, recognizing it was from the external appeal. "The previous decision has been overturned... Benefits shall be paid. This decision is binding."
I probably read it three times before the same confused look melted away from my face.
I looked up at my husband with tears in my eyes, now standing over me, and smiled. A smile that was both meek and joyous at the same time. I put my arms up and said "Yay!" -- but with the volume and breath of a sigh.
He went down to his knees, and we hugged. Stating back and forth, "I'm so happy." and "I can't believe it."
Soon, he had to leave for work, and by then we were both starting to accept the news as reality. He kissed me good-bye, but didn't let go. He was just staring at my face.. as he held it in his hands -- gently tucking my hair behind my ears. He looked at me as though I was the most puzzling and beautiful thing. Something he was seeing for the first time.
I simply asked, "What?"
And he responded, "It's just so nice to see you smile again."
It wasn't until after he walked out the door that his statement really settled in. It had been a long time since he'd seen a genuine, full-hearted, and unguarded smile come across my face. Until this, I probably hadn't had that much joy and relief since we lost the twins.
And his statement made me feel both sad -- that it had taken this long for my husband to see me truly smile, and hopeful -- that I could feel true joy and relief again.
I was burdened with the emotional aspect of getting the reminder of the twins each month. I was worried about my husband -- already working two jobs -- stressing about the financial strain. And I could let it go, all at once. I could breathe again.
And just a couple days later, was our first shower for "Garby."
My mother hosted, but did it in our home.. since her place is 'out of the way' for most, she wasn't super comfortable making vegan food for a party, and it kept us from having to drag items between places afterwards.
I decided to do a robin's egg theme -- in reference to our bird tattoos, and the nursery colors. It really was quite lovely.
And though I always stress before a gathering, I kept reminding myself to just relax and enjoy it. This isn't about the perfect food or decorations. This is about celebrating my child.
It was, of course, bittersweet, as we put up decorations on the mantle where Jasper and Bodhi's ashes reside. But in my heart, I was celebrating them too. I didn't feel like a first-time mother, after all. I held my babies already. This was just me -- loving one more.
And perhaps as a surprise to some, my husband decided he wanted to be there. I'm not sure he would have with the twins. But with everything that happened, I think he didn't want to "miss" anything that celebrated our child this time. And it honestly felt "right" having him there.
I was, and still am, so grateful we have people in our lives that have been so supportive through our loss, and this pregnancy. So, thank you again, to everyone who attended -- or even wanted to. It means the world to me.
So, to summarize, it's been a great week.
After the guests left the shower, I gave my husband a hug. We both got a little emotional. While still in his arms, I whispered, "Things are finally starting to feel 'right' again." And I felt him hold me a little tighter. <3
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