Postpartum Support and Adventures in Health Care Coverage

Two things to share  regarding postpartum support:

1. First I’m happy to announce that there’s going to be a local postpartum support group in my hometown of Reston, Virginia.   When I was diagnosed with PPD almost 10 months ago, Postpartum Virginia supported two groups that met at places and at times such that I couldn’t attend.  Luckily I found a therapist who specialized in postpartum care and whose office was less than five minutes from my front door.   Since my first visit with her where I released so much pain regarding the trauma of experiencing a postpartum crisis, I feel that I am healing . . . in many ways, I feel better than my old self.  I know that my therapist has a good deal to do with how well my health improved, and I am so grateful that I found her.  Now, I feel like I can help pay it forward.  Postpartum Virginia’s founder Adrienne Griffin recently asked me to help lead the support group in my town; I have to admit, I feel mixed emotions: I’m excited to be part of a group that I think will make such a difference for so many women and their families and I’m also afraid: I want to be strong enough to listen and offer support to those women and families who are struck by PPD.  It isn’t an easy path to walk alone.  I don’t think I could have made it to where I am today without the love and support of so many many people.  Anyway, here are the details about the group:

POST PARTUM SUPPORT GROUP

Meet and talk with other pregnant and new mothers who are finding pregnancy and the postpartum weeks and months difficult and/or overwhelming.. I f you are feeling sad, anxious, angry or irritable, group support can help.  Babies most welcome.  Free childcare for older children.

Second  and  Fourth  Thursdays

10:00AM

Fairfax County Reston YMCA

12196 Sunset Hills Road
Reston, VA  20190

YMCA Phone: (703) 742-8800

The YMCA is also extending a helping hand by giving our group a space to meet in and by offering childcare for attendees.  I have to say I feel like so many prayers have been answered.

2.  Let me tell you how wonderful horrendous our insurance company, United Health Care has been since my PPD diagnosis.  While I was able to find a postpartum psychiatrist and psychotherapist who were both working so hard to help with my recovery, it was troubling to learn that neither specialist was covered as in-network providers by my insurance. What this usually means is that as clients of UHC, we are able to seek care out of network so long as we pay upfront and then seek partial (usually 50%) coverage after doctors’ appointments.  What we experience in the last ten months though indicates (to both my husband and me) that our insurance company never intended to compensate us, even partially, for my postpartum care.  Initially, a representative for UHC told me that I would be partially covered should I go out of network and she also “highly encouraged” me (I remember that exact phrasing) to seek in network coverage.  I wish that I could have done so.  Unfortunately, and as I explained to UHC, my postpartum disorder is postpartum anxiety, which, early on, meant that I could not handle making long drives, let alone with a screaming newborn.  UHC’s in network providers were all at least 45 minutes away from my home . . . a car ride that months ago I could never have completed by myself.

I credit my husband for going back and forth with the insurance company.  Both he and the HR representative where he works have made what seems like an endless number of calls to UHC regarding the lack of reimbursement for out of network visits.  The thing is, we are allowed to go out of network . . . on paper, that is.  Apparently though, new rules are discovered as we attempt to have a claim covered.  It is getting ridiculous.

So why not change care?  Why not switch to a UHC in network provider granted that I can now make 8 hour drives, am going off of my anxiety medication, and am overall feeling better than I have in years . . . my health care providers know my medical history, they know me, they have a record of giving good care.  And according to UHC, from March 2010, my visits to these providers are now “approved.”  The problem, still no reimbursement (at $100 plus dollars a session) for all prior visits.  Which adds up to a lot of money.

I’m lucky that our family had the financial resources to cover my care since our insurance company continuously fails to coherently explain why they are not delivering the service that we pay rates for each month, which is health care coverage . . . both full and partial.  I wonder where I would be today had my family been scraping by and living paycheck to paycheck, unable for me to see a doctor let alone a therapist who understands postpartum disorders.

That’s where I’ll leave off for now . . . I certainly hope that I’ll have better news to share sometime soon.