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S&P Express

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  16. Medical Insurance Coverage & Requirements

    in Looking to Adopt

    Posted

    If someone has health insurance with something other than a group health plan, maybe there is a loophole (if the company does not have to follow federal law) but I am not aware of this instance.

    Susan

    Yep - unfortunately, that was us. We tried using the info you provided Susan, but then after all this ragamarole, we were finally told something to the effect of our plan (through our state) is self funded and so was also self-regulated -- I'm fuzzy on the details now, but we were trying to argue the point of, if we are matched, we are fiscally responsible at the time of BIRTH, not PLACEMENT. We really just wanted to be protected in the case of a NICU stay prior to placement, etc. But w were told they didn't have to play by those rules.

    We did end up with coverage from placement, but ran into an insurance hassle anyway. PIWs beware: although we were covered, we were out of our coverage area (state) when we took placement. The hospital wanted the baby to be checked in a week and made an appt at their clinic. When we went to that, they also wanted the 2nd PKU test done in state, and it was 1 day too early to do that 2nd test, so we had to go back the next day. So -2 clinic appts. Well - our delirious, sleep-deprived, living-in-a-hotel-room-out-of-state brains didn't even think to ask for prior approval - so although we had coverage retro to placement, those visits weren't covered because they were out of network and we hadn't gotten prior authorization. I appealed, but it didn't help.

    Just my story and a little warning.

    Mary Helen,

    We ran into the same problem but once we got home and had a Dr they then did a referral back for those visits in Texas. This took place 9 months after the fact!! Check with your peditricians office to see if they would given a referral. We also had to go to the Dr twice when we were in Texas.

    Paula

  25. INQUIRY

    in Looking to Adopt

    Posted

    Hi, Nichole and Joe! Not to worry, there's still time to make the January orientation weekend. I don't know where you're at in the process, specifically, but I did see your inquiry on top of Angela's desk yesterday... if you're waiting on the application, you could keep busy in the meantime gathering the following supporting documents that'll be needed along the way:

    * photos of the outside and interior rooms of your home;

    * copy of last year's tax return;

    * a floor plan* showing every room in your home and noting the purpose of each;

    * an infertility letter from your doctor, verifying that you are unable to get pregnant

    * three reference letters on your behalf to be written and sent directly to Abrazo by three unrelated friends or acquaintances.

    Plus, you could begin the process of getting FBI clearances, since this sometimes takes awhile (usually your homestudy worker can help point you in the right direction on this), get pre-adoption physicals done (with labwork to include TB, HIV and hepatitis testing, required of all adult household members), and study the updated Abrazo homestudy standards (under Professionals' Corner) to ensure that your completed study, once done, meets Texas requirements if, indeed, this is where your precious new son or daughter is to be born! Hope this helps somewhat...

    * This is a new Texas licensing requirement; it appears that a homemade sketch will suffice and it need not be to scale.

    Thanks Elizabeth. I will start working on those things ASAP. I appreciate your help very much. We actually just built our home (my husband did i should say). We just moved in on December 2nd so we've got a definite floor plan done and photos. That's 2 steps done :D .

    Hope you have a wonderful weekend and thanks again for the help.

    Nichole

    Welcome Nichole and Joe! I just wanted to say hi because you have the same name as my son's birthmom and y'all spell it the same way. Of course, the goof that I am, I spelled it wrong for a year (without the "h"), and she never said anything. :o When I asked her why she didn't correct me she said it was no big deal. But I felt terrible. Spelling a person's name right was always a big deal in my family (I guess because I have a brother named Michael that hates to be called Mike, and a sister named Teresa who spells her name without an "h" (unlike Theresa).) So you think I'd have paid better attention!

    Anyway...good luck and Godspeed on your adoption journey...we'd love to learn more about you when you get the chance.

    Susan

    Hi Suebee! Thanks for the welcome. I have to laugh because nearly everyone i know spells my first name wrong. hahaha :lol: I don't correct them either!

    When did you & your husband adopt?

    Nichole

    Welcome Nichole! It's great to see another family from the Midwest!!! What part of Wisconsin are you from?

    Paula

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