Thursday, June 9, 2011

HMO vs PPO and Infertility

As long as I can remember I've had an HMO. I had a PPO as a kid, but I don't really know much about it. Once we started TTC we looked into our pregnancy/baby benefits with Aetna HMO. We thought it sounded great, it was only going to cost 250.00 for the whole pregnancy/delivery. I was very content even though Claim Jumper had just bumped up our insurance cost 300.00 dollars a month.

Then last month we were told that the Landry's Company (the owners of the Restaurant where J works) were switching us all to United Health Care PPO (only). I was worried that we were going to have to spend so much more money, I always thought PPO's were for rich people, and we are far from rich. I love my HMO doctor, so I had no interest in a PPO "so I could pick any doctor" The HMO of course wouldn't pay for any infertility testing or procedures but neither will my new PPO. I seriously couldn't find one good thing about this new insurance. It is costing us 100.00 more per month, we have a huge out of pocket yearly max, and a deductible that isn't cheap! After looking into our new benefits I freaked out! It is going to cost us 3,000 dollars to have a baby! and even more if we need a c-section.

Once I got over the fact that this is what we have, and we're just going to have to take it. I also tried to be grateful that we have insurance at all. I know so many people that just go without it. I talked to friends about it and got some good information. My Boss and some others even convinced me that a PPO will be good for us because I can go to any hospital, and in emergency situations you get much better care. Sad but true.

Anyway there is a good point to my long story. I work at a whole health medical clinic. Kinda like in the show Private Practice. We have a GP, an OB/GYN, and an RD,  we even are starting a preventative weight loss program.  It is a great working environment, and I am constantly learning. After work last week my Boss and I were discussing my new insurance predicament. She told me that I can see our OB/GYN if I wanted to. I felt a little awkward at first but he is so awesome that you just immediately feel comfortable with him. He told me that if I wanted to he would be more than happy to help Jand I get pregnant. I could be his patient and he wouldn't charge me, he would just bill to the insurance. If we choose to have him deliver our baby we get to deliver at Huntington Hospital in Pasadena, which I hear is very nice :) How amazing is this!? This would never even be a possibilty if I still had the HMO. It's funny how God works in this way sometimes. You think you want one thing but he tells you that you need the other thing. I realize we may not get pregnant right away but after trying for 11 months I needed some new motivation. This good news is exactly what I needed. When you have your husband poking at your ovaries and asking them to start working and you lose your chance at carrying a baby to term your spirit gets crushed, you need some new found sprirt. I found some recently and I am so grateful.

So here's hoping for a spring baby!
Ok So maybe that wasn't the best title it should be more like Daniella ramblings about insurance etc, but I was trying to be catchy.

1 comment:

  1. That's awesome news! As a person that also got married in 08' and have been trying to conceive since 08', I understand how this good news can get you motivated once again. Best of luck to you!