Oregon Health Plan Kicks Aetna's Ass!

GREAT NEWS: Today I received my approval for the Oregon Health Plan in the mail, meaning that our baby's birth will be paid for by the state -- and we will have no copays!

Aetna was really giving us the run around and it was really frustrating. First, when I contacted them to inquire about home birth benefits, they said that no home births were covered, and that they would only cover a "birth center" if it were in a hospital setting.

At some point, we had a birth center in town contact them for pre-authorization, and Aetna told THEM that they would cover their services at 80% - the out-of-network rate. So we thought that there was a chance that a midwife would be covered.

Vivante Midwifery -- our midwives -- contacted Aetna only to learn that they could not give pre-authorization and that they would only consider whether or not they would cover the home birth after you file a claim, so the out-of-pocket to us might have been about $800 or it might have been about $3,000, if the insurance wouldn't cover it. And they wouldn't tell whether or not they would agree to cover it -- which is ridiculous because the home birth would cost about a third of what a birth would cost in the hospital due to the hospital facility fee.

That's another thing -- while I am ranting about the hospital/insurance company BS: the hospital leads you to believe the cost is going to be less than it really is. They send you information about the professional services fees with a note about how other fees might apply without bothering to mention the huge other fee - the facility fee - that WILL apply and which is about $5,000. OHSU was really not up front about its costs. I specifically contacted the billing department to find out how much it would cost me to have my baby there and they quoted me the global fee they charge for the professional services, and did not mention the hospital fee, following up with the letter mentioned above that didn't mention the hospital fee either. I only learned about the facility fee from my midwife, who works for OHSU and privately with Vivante Midwifery.

So, anyhow, because I am student with little income, the Oregon Health Plan is going to cover these expenses and I don't have to worry about fooling around with Aetna. Now I just wish that I hadn't already paid the $600 to extend my private health insurance coverage through the summer, but I had to play it safe because I wasn't sure whether or not I would be approved for OHP.

This is another reason why Oregon is so awesome: the social services are excellent. Some people might not feel right about receiving social services, but I am all about it right about now - and don't see any reason why I shouldn't take advantage of it while I am incurring all of this law school debt.

I find it really interesting that OHP covers home birth and that Aetna Student Health won't offer to cover it upfront.

After all the stress over the insurance and costs, it is nice to know that it will all be paid for -- and we don't have to worry about it any more.

Sunshine ... finally!

Iris's birthday brought the sun out of hiding - finally! So, of course, I got sunburnt on my chest hanging out in the sun all day after nine months of gray skies and rain. I am going to get myself some sunscreen for future use. This happens to me every year... but it was really nice to feel some heat. I would take a photo of the aftermath - but it's kind of embarrassing.

The Obama shirt is SM's - that she offered to me (knowing that I was a Hillary fan before she conceded) to wear once I realized I was getting too much sun. SM's cat, Shug (aka Bear), kept a watch over us and batted the neighbor's dog away when he wandered over to our blanket after rolling around in a bunch of raccoon scat. It was a good day.

SM's 25th

We celebrated Sarah Marie's 25th birthday this Saturday (even though she is not officially 25 until Wednesday) by hanging out in the sunshine in the back yard, eating sundried tomato tofu dogs, and baking carrot cake. It was a really nice chill afternoon.

Saturday with SM

After the Rose Parade, we crashed Sarah's Saturday (supposed-to-be-studying-day) and hung out with her and Shug for the afternoon, since we were already on her side of town.

electric cars and compost

While Portland's weather is dreary for the overwhelming majority of the year, you gotta love a city that has electric car charging stations and a city-wide compost collection system.

It's a shame that cities like Pensacola, Florida have still not figured out how to manage a curbside recycling system or recycle its own post-hurricane wood waste. It's also a damn shame that cities like Panama City, FL not only haven't figured out how to recycle, but also throw all their plastic garbage bags into an incinerator and burn it for everybody to breathe.

SM and I were discussing this yesterday: Portland is too cloudy, gray-skied, and sunless, and FL is too behind the times and polluted... So, where will end up? SM says she is going to be a Cali girl, but I just don't know.

Rose Parade and Scales of Justice

Yesterday, we went downtown to try to catch our friends race in the dragon boat races as part of the Rose Parade festivities. We missed the race -- as we got a late start and traffic/parking was packed -- but we did catch up with some of the team - representing Lewis and Clark Law School on the "Scales of Justice."

I also snapped a pic of the "Queen of Rosario." We didn't stand through the whole parade procession - but for more pics/videos, you can go to http://blog.oregonlive.com/rosefest/

We also caught part of a push-up contest going on in the park.

Memorial Day Weekend

We headed over to our friend Todd's place for Memorial Day and Chris and Rob made some chicken and veggie kabobs, corn, pork, and more. It was a good time. And of course, Chris couldn't resist playing Rock Band.