Pre-term Labor Took Our Daughter, NOW They Say We Missed Insurance Enrollment!

So sorry for your loss.

In my experience as both an employee and HR representative, insurance companies typically stipulate that additions can be done within 30 days of a qualifying event or at open enrollment. You should have 30 days to enroll your child but the bills from within the 30 days should be covered as well. Since your bills are from within those 30 days, you should be covered.

If I understand what you are saying, they are declining to cover your daughters' portion of the hospital bill for their birth and 10 day NICU stay. Is this correct? I suggest that you contact your HR department head and explain this to them and ask again for thier help. I would also call and ask BCBS if they cover the first 30 days after a child's birth before they are "added" and then go with that. Explain that your bills are from days 1-10 and your girls no longer needed to be added. Therefore, you did not have them "added" after their death since further coverage was no longer needed.

If that doesn't work, contact the insurance commissioner and the press.

Your HR Department should have called you when you missed work due to maternity leave/early delivery. I am sure your supervisor knew why you were out and they should have immediately notified your HR Department who in turn should have send you information regarding insurance (and told you if you still needed to add your girls even though you lost them).

Best of luck to you.

6 moms found this helpful

Get an employment lawyer. You need one quickly.

I'm so sorry about your loss.
D.

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I also work for our employee benefits office and like most have said, the babies should be covered under mom's insurance for the first 30 days and before the 30 days was up they had to be enrolled. I don't know how her policy reads but ours is free for the first 30 days. But under your circumstances I don't understand why there is an issue, the babies were born and unfortunately didn't survive they should still have been covered. I would definately fight someone on this. I am so very sorry for your loss, I pray God give you the healing that you need thru all of this!

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So very sorry about your losses!

Contact your state insurance department. Get help from your state rep or state senator if the dept. gives you the run-around.

If possible, document the times you tried to get the insurance info from your employer. If you can show that you attempted to do this in a timely fashion, that should help. You might, unfortunately, still need a good lawyer.

Is there an ombudsman at AAA? or at the hospital? Contact them.

This is certainly extenuating circumstances, you'd think that everyone could work together to get it sorted out!

Going forward from now, document everything--phone calls, copies of letters, emails, etc. Maybe even have a witness with you if you go in person to talk to people.

Are you in a union, and if so, can they help?

Ask the hospital if they can use Hill-Burton funds to pay some of the expenses. They should know that term.

As another mom said, just pay them a minimum amount to keep them from sending you to collection. When my husband got cheated out of insurance , we paid something every month, and eventually the hospital offered us a deal--they cut the remainder in half if we could pay it all at once. Not saying that will happen, but it might.

Hang in there, I hope things go better for you soon! Hugs to you!

K. Z.

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It's been many years since I worked in HR, but agree with Abbie in that regardless of subsequent enrollment, coverage for the first 30 days is automatic.

Call them back and ask to see the Plan's "SPD", Summary Plan Description. Call the carrier directly and ask as well (their number should be on your insurance card.)

Also, if this Company was aware the twins were born they were required to notify you by mail of your coverage rights. Call the HR department back and talk to the Director.

Don't give up...you have rights.

I'm deeply sorry for your loss. No words can even measure your hurt.

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Honey....I am so sorry. God. I wish every blessing for emotional healing for you.
As a licensed agent in California, I am thinking that this can be resolved.
If you had insurance that covered pregnancy and delivery, etc, you should be fine.
Technically, you have 30 days to ADD a child to your policy, but for the first 30 days, they should be automatically covered under the mother.....delivery charges, etc.
It's AFTER the 30 days that they become separate.
If a baby doesn't survive beyond 30 days, it should be covered.
Please privately message me if you need more help with this. I am in California, but the laws for group health coverage are the laws.
If you were covered for maternity, you should be covered for what happened within a 30 day window of the births.
You need someone who understands how to deal with insurance carriers if you can't get help from your HR department.
I hate to say it, but insurance companies will try to deny claims if they can.
If your policy says you have rights, you need someone to advocate for you.
You should not be going through this unless there is some weird provision in your policy. But anything within 30 days of birth should be automatically covered.
I wish you the best and I believe there might be a way around this depending on your coverage.

Write me privately if you want.

Again, I am so sorry for you loss.
The insurance should be the least of your worries.

2 moms found this helpful

I am so very sorry for your loss and it actually makes me want to cancel my AAA membership. HUGS
Call a lawyer there must be some out there that specialize in something like this. Blue Cross Blue Shield is horrible to deal with at least out here in MA. I would call them constantly until someone there helps you.

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I actually think that they are probably not trying to hurt you and this might just be a misunderstanding. Before you get any more hurt by all the back and forth make an in person appointment with someone at HR. Take your spouse or another support person if needed. I know each AAA is different by state, but when my husband was employed there, they were always most helpful.
Secondly get in contact with your insurer. I know laws regarding insurance vary by state, but here you child is automatically covered under mom's insurance for the first 30 days. Son due to the sad fact that she did not get to live past 10 days, you would have not even had to enroll her.
And then third, if you don't get anywhere, contact a lawyer.

I am so sorry for your loss and that you have to go through this horrible bureaucracy at this time. Good luck!

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I don't know jack about insurance, but I just wanted to say that I am so very very sorry for your losses. I cannot imagine the pain that you're enduring. I'll keep you and your family in my thoughts and prayers.

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the medical bills that piled from day 1 to day 30 are automatically covered by your insurance. so we're only talking about 10 days (day 30 to 40), but you should not have incurred any medical bills between those ten days.
call them up (your HR i mean). and document document document.

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Omg... Hugs!
Maybe contact an atty that specializes in accidents and see if you can get a consult.
Please let us know what the outcome is. I hate our insurance in America, it's horrible!!!! I have Blue Shield too and they are not easy to work with.
I think you might be able to plead "hardship" since all the tragedy was going on at enrollment time?

I am soooo sooo sorry for your loss... and now the added stress of the insurance and money stress. I don't know very much about your particular situation, however this is yet another example of our failing health care crisis in this country. I pay out of pocket for health insurance, however little did I know that private health insurance does not cover pre-natal care or Labor and delivery/hospital costs. And, we don't qualify for state subsidized programs, because as surprised as most people are about this, if you are pregnant and have no insurance (or insurance that doesn't cover), you still have to meet income guidelines (which are higher than typical, but still very very low if you ask me).... All of these medical expenses are coming out of our pocket... including our insurance premiums we pay every month for nothing! So... we take care of our own quite well don't we?? It's a shame. What I have found (and it has also been a frustrating process) is the hospital should be able to help out some. Our hospital has a fee scale based our our income (they still haven't figured it out yet)... but it will be between 20-60% off our total bill due to them... and they will work out payment plans. At the end of the day, as long as you pay $5/month to try to pay the hospital bill, they can not turn you in to collections... so worse case scenerio, do what you can to not let this affect your credit (not that that means anything anymore).... Don't be surprised if your insurance doesn't cover. They will do everything they can to not cover a bill. They do not work for you, unfortunately... they don't care about you or what you are going through. It is just a really really sad reality :-( I do, however hope I am wrong... and that you get these things taken care of... but if you don't... you will be okay. Focus on what is important and don't let this take you to a deep dark place... it is just not worth it. You'll be in my thoughts and prayers.

first of all I just want to say how sorry I am for your loss. This is a horrible time for your employer to be putting you through all of this turmoil. My understanding is that children are ALWAYS covered under their mothers insurance for the first 30 days - you do not have to enroll them for that to work. I just had a baby 3 months ago, and added the baby onto my husbands insurance, but my insurance still charged me for one month because she was automatically covered under my insurance for the first 30 days and they paid the bills on it. I think that if I were you I would try to get a hold of the insurance commission in your state and find out if there is any law, and also read your insurance coverage paperwork and find out if your child is supposed to be covered under your insurance for the first 30 days automatically. My heart goes out to you and I will keep you and your family in my prayers. <3

I worked also for AAA michigan so I know what you are going through with them. you are covered for the first 30 days. the law states that you have to enroll for covereage AFTER that 30 days is up. I would contact blue cross about the coverage for the hospital bills that you have. They are the ones you know what you are and are not covered for. AAA does not know that information. I could tell you stories of what they have done to me, and they won't apologize at all. they think they are right and will tell you that you are wrong, even when you aren't. In this case, they are wrong. You have coverage on your daughter and for all of the bills. So again skip them, and talk right to blue cross about the bills. unfortunatly she didn't make it so you don't have to worry about adding her on so you don't have to mess with AAA.

I had heard the stories about doing this to others as well. When i had my daughter, I had sent me an email with the copy and pasted link so i could get into everything and add her on to the policy. Plus i searched for the numbers and kept a copy of them at home, since i know how hard it is to find anything. Some advice, if you are ever needing them, and don't have their outside number, just call someone in your office or the 800 number and they can transfer you to that department that you need.

Sounds like AAA is not listening to you and doesn't give a flip about PEOPLE - they're trying to do everything by the book and forgetting that this is someone's LIFE they're toying with. Fight this. I wish I had more for you. Call the person refusing you every single day until they make it happen for you. Be a nag. Be strong and forceful in your voice. Go down there if you have to and sit face to face with them.

First my heart goes out to you on the loss of your daughters. Be comforted in knowing we now have two more angels to watch over us.

I have used the Investigative reports at WXYZ tv station numerous times with great success. They don't cost a thing and believe me AAA would not want bad publicity. AAA should be empathetic to your situation especially since they are an insurance agency.

I'm not sure where Jenison, MI is and the tv station I am referring you to is in Detroit.

I've gone to www.wxyz.com. If you don't see it on the home page, do a search for investigative reporter.

Now you may not hear directly from the news station, but the problem will be resolved.

Many blessings.