For many families, insurance can be a hassle to figure out. But for the Jay family of Alabama, insurance has made their life a living nightmare. After going through a premature delivery of their second daughter, Evelyn — already a difficult situation in itself — the family was devastated to learn that their insurance company was refusing to cover the cost of their medical bills.
Alabama Living reports that thanks to an unexpected early delivery and about a two-week gap in coverage for insurance (despite their best efforts to avoid it), the Jay family was reportedly slapped with the full charges for baby Evelyn’s delivery and subsequent NICU stay. The total bill? 178,000 dollars.
It all started when the family, made up of Amy, a stay-at-home mom, and Mac, an army veteran, were living in North Carolina. Mac worked at software company that provided benefits, but unfortunately, they weren’t enough to cover everything the growing family needed. Because she had a history of PCOS and four miscarriages, Amy required monthly progesterone shots and blood tests during her pregnancy, which ran over $200 every time. Their insurance refused to cover the shots, so they looked into what other options they had.
What they found was that they didn’t have a lot of options — they made $70 too much to qualify for Medicaid and none of the supplemental plans available for purchase would cover the shots either, so Mac accepted a new position with better health care benefits in Huntsville, Alabama. His new insurance was set to kick in on Feb 1, two weeks before the baby was due, so the family signed up for COBRA to ensure they’d be covered in the interim. Although COBRA was better than nothing, the hospital they would deliver at was “out of network,” so an early delivery would equal an expensive bill.
Baby Evelyn was born unexpectedly early in January 2017, an entire month before she was due. The insurance coverage they had under COBRA told them that if Amy did deliver early, the bill would be about $20,000. The couple resigned themselves to doing what they could with a payment plan and being thankful their daughter was OK. “She is the light of our lives,” Amy Jay said in a recent YouTube video.
But two weeks after she was born, they were shocked to open a bill for more than $178,000 instead.
“My stomach dropped,” Jay told Alabama Living. “My immediate reaction was there’s been some mistake. Some coding or billing error, and all we needed to do is make phone calls and it will be fine.”
As it would turn out, despite their best efforts, the Jays had not realized that they needed to actually add their daughter to their insurance plan once she was born. With their first daughter, who was born under military insurance, the rules were different, and the couple was devastated when they realized an oversight could cost them so much money. Despite many hours on the phone with the insurance companies, they were told there was no way to add Evelyn retroactively and they were stuck with the bill. Their options? Pay up or go bankrupt.
Desperate, Jay reached out for help on social media, including on her Instagram account, and after their story was featured in several prominent outlets, Jay says the hospital agreed to work with them on a more manageable payment plan and forgive a large portion of the bill if they could put down a lump sum by May. A GoFundme account that Jay’s best friend set up was able to raise more than $25,000, which paid the majority of the debt due.
In a YouTube video, Jay says she can never express her thankfulness for the kindness she has received and that they are still facing a huge amount of medical debt. Both she and her husband are hoping to spread awareness about the complicated rules of insurance, especially for military families transitioning to civilian life, so that no family faces what they did.
“We have a very messed up system,” Jay notes in her video. “That people going through one of the worst times in their life forget to pester an insurance company…about something…and we end up responsible for this massive bill. This isn’t right. A child that is sick should be able to get health care without financially ruining their family.”
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