Coffee With Purps

Coffee Conversations with a Purple Girl

Midway Transitions

I saw this coming, but that doesn’t make it any easier, or any less annoying. I knew, when we decided to start trying for a baby the year I turned 26 that we would be dealing with switching insurances midway through a pregnancy. But then again, you never really know when you start trying. It could take years, it could take months, it could happen on the first try. You just never know. So we went ahead and here we are, working through all the transitions that come with switching insurance mid pregnancy.

For the most part, I’ve been pretty emotionally stable this pregnancy, so far. We’re slowly losing that as the weeks go on, but up until now, I’ve only had one major meltdown where I just couldn’t cope and that was when I learned I wasn’t going to stay on a Highmark plan. Highmark is crazy expensive, as it turns out, and even though we’d been told for months that I would be able to affordably be added to my husband’s work insurance, that was not the case. So that was blow number one. The second blow came moments later when Logan texted me that we would have to go with a UPMC plan because it was the most affordable. That was the big one. The final straw was checking to see if I could still extend my dad’s insurance, if only until the end of the pregnancy so I could stay with all my doctors. That offer expired the day before we found out we actually needed it. I was crushed.

For those who don’t live in Pittsburgh, you may not be aware of the whole Highmark verses UPMC thing. Basically, UPMC is a hospital system in the Pittsburgh area that also offers health care coverage. At some point they got mad at Highmark for some reason and now there’s a split between the two. If you have Highmark you can’t go to UPMC hospitals and if you have UPMC you generally can’t go to hospitals in the Allegheny health network, which only accepts Highmark and others. I don’t know all the fine details behind why they had their falling out or why things are the way they are. It’s just generally understood that most places either accept Highmark or UPMC, but almost never both.

I’ve always had Highmark insurance through my dad and it was great. I found a great OB/Gyn group that was connected with Forbes hospital, which would have been so convenient. I had a great PCP with a group that we love and I was heartbroken to think that not only would I not be able to keep my OB and have to figure out what to do for care in the middle of my pregnancy, but that I also probably would have to find a new PCP as well. I cried basically all day after our text conversation while Logan was at work. It’s the most irrationally upset I’ve been this whole pregnancy.

God’s plan is perfect, though, and what often seems like a huge trial sometimes turns out to be a blessing in disguise. For a long time I’ve been considering the Midwife Center in Pittsburgh for potential care. My biggest hesitation was the insurance thing. Like many places, the Midwife Center has UPMC leanings, but accepts Highmark as well, though they are limited in the care they can provide women with Highmark insurance plans. They partner with UPMC Mercy, where they can go and continue care there. They can transfer women to West Penn hospital, which accepts Highmark, but the midwifes can’t go with the patient to continue care. If we wanted to go to the Midwife Center for prenatal care and deliver in a hospital, we don’t know who we’d get. So we were going with the usual hospital, OB/Gyn route for this pregnancy, until I had to switch. I was heartbroken to give up the East Suburban group that had been so good to me, but with the switch to UPMC, we could go to the Midwife Center and still deliver in a hospital if we wanted.

To help ease my mind further, we checked the insurance plans accepted by our PCP and discovered that they will accept my new insurance, so I don’t have to switch PCPs as well as OBs. That was a huge comfort to me in the midst of all the other changes that were coming. We love our PCP and the other doctors in her group and have had nothing but good experiences with them. My in-laws have had to switch doctors twice in two years due to insurance issues and this last time they’ve had a really hard time finding someone they liked. I was terrified that I would have to give up this great practice for someone I didn’t care for, but thankfully, that is not the case. I get to keep my PCP and Logan and I don’t have to see different doctors.

So we began the weird process of switching to the Midwife Center as soon as I got my new insurance card. It’s been a really strange adventure, thus far. They have this whole online system where you fill out an application for care, they send you a link to set up an online health history, and once that’s filled out and approved, then you can make an appointment. You also have to do orientation to birth at the center, and they like you to have gone through that before your first appointment.

Logan and I went last Tuesday for our orientation. It wasn’t a lot of new information for me. Mostly they talked about their partnership with the hospitals and how they handle different situations. It made Logan feel a lot more comfortable with the whole idea, though, knowing that they never take risks with a patient’s health and if there is any question as to whether or not it would be better for them to be at the hospital they transfer right away. Most of their transfers happen because of minor things, like the mother deciding she wants the epidural after all. It’s always an option, no matter what, to transfer to the hospital at any time. We also got a tour of the birthing rooms, which look very cozy. They have two new rooms with free-standing tubs for water births, and hammocks, which are apparently really nice to labor in.

It took me a while to figure out which extension I needed when calling so I could make an appointment. Their calling system is a little funky that way. They have an option for “start prenatal care” which is what I wanted to do, but that goes to a voicemail that tells you to do all the online things. You need the “make an appointment” option to actually make an appointment, which might seem obvious to most people, but it took me like three times calling to figure it out. But, we have an appointment now for the end of the month and we’re on our way to being back on track.

The only thing now is, who do I go to with questions? I can’t call my old OB because they don’t take my new insurance, so that just leaves the Midwife Center, but I don’t know if they can help me yet because I haven’t had my first appointment. They also, again, have this weird online system to interact with patients. You message them through this website that has your chart and everything and they get back to you through that if it’s not an emergency. There’s part of me that’s really into it, since I feel a lot less silly emailing someone with my minor issues than calling, but there is also a part of me that kind of wants to talk to a human when I need reassurance. I’ve messaged them a couple times now with various things about starting care and where I am currently, since I’m transferring care and they are pretty prompt with their responses. I guess it’s probably okay to go to them if I need something, though hopefully I won’t need to before my first appointment.

So that’s been my weird journey through switching insurance and doctors and such mid-pregnancy. It’s been an interesting ride thus far and I’m ready for it to be over. I called East Suburban to have my records transferred to the Midwife Center and they were nothing but sweet and helpful and understanding and it made me sad all over again to leave them. If you’re looking for an OB/Gyn, I can’t recommend them enough. I am excited, though, to start care with the Midwives and to know that I’m that much more likely to have the birthing experience that I wanted from the beginning. Lord willing, things will go smoothly from here. No more adventures, please.

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