Alabama family left with $178,000 hospital bill after insurance refused to cover birth of premature baby

A few days before Christmas, Amy Jay and her family packed up everything they owned and moved to Huntsville, Ala.

They lived in North Carolina where her husband Mac, an Army veteran, had a good job at a small software company. They lived close to family. The couple had a young daughter and Amy was seven months pregnant with their second.

But her progesterone injections – needed to keep her pregnancy viable after a series of miscarriages – had cost $200 a month. Insurance wouldn’t cover him, or the blood tests his doctor said were needed.

“The assurance my husband had (through his job) deemed it all pointless and wouldn’t pay a dime,” Jay said. “We quickly realized that this was not going to be a lasting situation.”

After looking at supplemental insurance and the market — they missed the income threshold to get Medicaid by about $70 — they realized the only way to get the insurance benefits they needed was for her husband find another job.

He found a technical job in Huntsville on Redstone Arsenal. It would mean a small pay cut, but the benefits were better. The new best insurance wouldn’t come into effect until February 1, about two weeks before the baby is due.

They signed up to keep her husband’s old insurance under COBRA, a law that protects people during a lapse in coverage. This meant they would have coverage for about a month until the new insurance kicked in.

It also meant that a hospital in Alabama would be considered “out of network” under the old insurance.

“It told us we were going to look at a $20,000 hospital bill, but we thought we’d just get that bill, set up a payment plan, and do our best if the baby comes early,” said Amy Jay. They were praying that the baby wouldn’t come too soon.

But then she did. Baby Evelyn was born unexpectedly on January 16, a month before her due date.

And two months later, the Jays received a bill in the mail – for $178,000.

“My stomach dropped”

Evelyn spent two weeks in the neonatal intensive care unit at Crestwood Medical Center, struggling to breathe with underdeveloped lungs.

“They were so sick and frail that a crying fit caused a collapsed lung,” Jay said. “There were times when we weren’t sure she was going to make it. But I can’t sing the praises of the hospital, the staff and the doctors who treated her enough. They were loving and compassionate and treated us like family. was the most horrible two weeks of our lives yet.”

Prior to Evelyn’s birth, Mac Jay had called the insurance company to ensure that their baby would be covered under the old insurance plan until the new one came into effect.

But in mid-March, on Amy Jay’s birthday, she went to the mailbox and found a bill for Evelyn’s entire birth and NICU stay: 178 $389. The insurance had paid nothing.

“My stomach dropped,” Jay said. “My immediate reaction was that there had been a mistake. A coding or billing error, and all we had to do was make phone calls and we’ll be fine.”

Mac and Amy Jay with their daughter Evelyn, who was born a month early. The Jay family didn’t realize they had to retroactively add Evelyn to their insurance plan and ended up with a $178,000 hospital bill that their insurance refused to pay. (Photo by Brekke Johnson, Wagon Wheel Photo, www.wagonwheelphoto.com)

But after weeks of phone calls with the insurance company, the Jays learned the bill couldn’t be covered because they never filed paperwork after Evelyn was born to add her to the plan. insurance. Jay said no one told them they would have to add him to the plan after he was born.

They asked if they could add Evelyn to the plan at that time. They were told this must have been done within 30 days of his birth; it was too late by then.

Jay said they were totally unprepared for the complicated world of liability insurance. “Our experience with our first child dates back to when we were in the military,” Jay said. “She was born on an air force base in Japan.

“To say it’s been a nightmare is a gross understatement.”

Jay said their options were grim: a payment plan they couldn’t afford or bankruptcy.

“Because of my husband’s job, either option makes him a security risk and he loses his job,” Jay said.

They considered taking out personal loans but were repeatedly turned down, she said.

Jay took to Facebook, asking friends in a Facebook fitness group for advice or personal experiences of others who had gone bankrupt or crippling debt, and how they handled it.

Instead, she found a community ready for action.

“They basically said, ‘We’re not going to accept that your family has to face financial ruin because you had a sick baby,'” Jay said. Some of these women were journalists from other states who contacted national news outlets. Sites like Babble and The Daily Mail picked up the Jays story.

Amy Jay’s best friend started a GoFundMe.com page help raise funds to cover medical expenses. The hospital was willing to work with the Jays, canceling some of the debt if they could pay the rest in one lump sum by the end of May.

Thanks to the work of friends, the Jays surpassed their goal of $25,000 on the GoFundMe. This will pay most of Evelyn’s birth and NICU bills; the rest, the Jays were able to put in place a payment plan that they believe will not affect their credit.

“I’m so grateful and lucky,” Jay said. “The outpouring from this community and the online community that read our story has been overwhelming.

“And yet, I realize that we are incredibly privileged. Our story has a voice, and I know there are people in my own neighborhood who are going through similar things with medical debt, and no one is amplifying their voice.”

fight for change

Jay said the kindness of strangers prompted her to take action.

“The system itself is the demon in this story,” she said. “It’s deliberately confusing and complicated.

Evelyn Jay was born a month early and had difficulty breathing due to immature lungs. The Jay family didn’t realize they had to retroactively add Evelyn to their insurance plan and ended up with a $178,000 hospital bill that their insurance refused to pay. (Photo by Brekke Johnson, Wagon Wheel Photo, www.wagonwheelphoto.com)

“The system benefits very few people on the backs of many, and something has to change. I’m not a policy writer, I’m a stay-at-home mom. But what I’m sure of is the current system, that capitalizes and commodifies health care, is not sustainable.”

Jay hopes to become more involved in reaching out to lawmakers and putting in place policies that can ease the burden on Americans who carry heavy medical debt.

“There are people who are going to read this article who owe millions in medical bills,” she said. “Their two choices are bankruptcy and a payout plan that will never end. I want people to know that we see how truly blessed we are, by other fighters on our behalf, and I will fight personally at the name of those who are going through the same situation.”

*Updated 5/22/2017 11:38 a.m. to include more information about the hospital payment plan.

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