The No Shots Story - The Legalities
If it were a typical 4 year well check the girls would have been slated for shots on Friday. New recommendations suggest giving the Hep A series. That is what the girls would have received.
However, my understanding after talking with our Ped on Friday is that this is a recommendation, not a "requirement". I use the term requirement to identify the way the system is handling the vaccine. We know several families who are choosing to not vaccinate, either at all or selectively. For our family, we've been following the Ped's recommended vaccine schedule.
However, there are two factors that derailed the plan. One factor is that Ellie showed signs of a low grade temp just before going to the appointment Friday afternoon. With any fever present, no shots! We had the choice to vaccinate Abby or wait. It didn't matter to me so I gave Abby the choice to get her shot that day or wait until Ellie got her shot. Abby chose to wait.
But then we discovered that the girls weren't eligible for the series of shots under our insurance. They could get the shots and our Ped would administer them, but insurance wouldn't cover it until it became "required". Oh, and essentially it isn't "required" because of $$ and the budget. Also remember that this is a series of shots and we are talking two kiddos at once.
This second factor is what I really want to write about. The girls are covered under State insurance "Kids Connection". Now, this insurance has been awesome... beyond awesome! I couldn't ever ask for any better insurance than this. I wish my insurance was this good! Heck, I wish everyone had this insurance! Except, it only covers the girls. It also does not cover recommended treatments, just those required by the government. And the government makes its requirements with the budget in mind.
And so this is where I'm sure I hear... "just be grateful you have insurance" or "I can't believe you are taking advantage of the system" or "buy your own damn insurance" or or or.... Yeah, I don't talk about this much because it is a touchy subject. Everyone has their own opinions. It doesn't matter if you are gay or straight, everyone has opinions that vary from supportive to blasphemous.
What about everyday people of society, people who have these benefits, push for people who do not have these benefits? Vast majority and numbers really make a difference as to who listens! For our family, it isn't about the term "marriage"; it is about taking care of your family and all of the benefits and resources that become available to "married" couples. Many folks have no idea what benefits become available to them when they sign that marriage certificate. A certificate produced by the government, not our Church. I would absolutely be legally married to Carie if that option existed in our normal life. Until then, we are connected spiritually! Just this past week our great state has reinstated the ban on gay marriage. This has battled back and forth since 2000. Six years and it feels like we are back to nothing.
See, not only do I have the option of having a family insurance policy through work; I actually am paying for it just like everyone else. But I do not have the option of it covering my entire family. Each enrollment period I bring it up, I ask. Nope, they have to be my "legal" dependants to be eligible. Not just dependants on my taxes (which they are) but "legal" dependants. There is a difference! Meaning Carie has no shot of being covered, until we are legally married in the state we reside, and Carie would have to sever 100% of her legal rights to the girls for me to adopt them. Oh, and aside from that being ridiculous, figure in the astronomical adoption costs so that they would still only have one legal parent. All this is legal talk, we know and more importantly they know that they have two loving parents.
Most of all because the wonderful state in which we live, heck even the Country in which we live, doesn't want to recognize that our family exits or that our children exist and thrive in such a household. Some States, more specifically some Counties allow 2nd parent adoptions. Sometimes it is as specific as to what judge you get in which County. Most people would be appalled to know what some folks have to go through to complete a 2nd parent adoption which then covers the legalities and provides benefits to the children. This is absolutely not an option in our great state, in any county within the state, or with any judge within the state. We would have to move away from family for it to become an option to us.
So... society pays. Everyone pays for that choice by families like mine who "use" the system to take care of their families. Sure, we could go get a private policy to cover Carie and the girls. Last time we looked, which has been a few years, it was extremely unaffordable and the coverage was unacceptable. Remember, at the time we were looking for independent coverage for two infants and all that went along with well child coverage. I'd much rather contribute that money towards life insurance for Carie and education plans for the girls, which we do.
Carie and I will discuss whether or not to pursue the Hep A series for the girls. We will pay out of pocket if we make that choice. We will do what we feel is best for our children. But, the point really is that the system is messed up. The hard working people of society shouldn't have to pay for my kids’ health care when I am fully willing and already am paying for it through my employer.
This is the first time this discussion has come up with our Ped. She realized/remembered that we have "Kids Connection" and therefore weren't eligible for insurance to cover the series of shots. We had a really great discussion. We've always felt accepted in that office. In the initial interview process over 4 years ago they said that they were fine with our family structure. We felt that they meant it. We have felt nothing but acceptance and normalcy every time we are there. I've never felt judged! But on this day, our Ped had a few other things to say. She shared her views about how ridiculous it is that we aren't able to be recognized as a legal family. How ridiculous it is that we have to have multiple insurance policies, which still doesn't cover all of our family members. I felt that what she said came from her heart. It was wonderful to hear that she really truly got it. Some people think they get it yet they clearly don't.
She does "get it" and it is heartwarming.
However, my understanding after talking with our Ped on Friday is that this is a recommendation, not a "requirement". I use the term requirement to identify the way the system is handling the vaccine. We know several families who are choosing to not vaccinate, either at all or selectively. For our family, we've been following the Ped's recommended vaccine schedule.
However, there are two factors that derailed the plan. One factor is that Ellie showed signs of a low grade temp just before going to the appointment Friday afternoon. With any fever present, no shots! We had the choice to vaccinate Abby or wait. It didn't matter to me so I gave Abby the choice to get her shot that day or wait until Ellie got her shot. Abby chose to wait.
But then we discovered that the girls weren't eligible for the series of shots under our insurance. They could get the shots and our Ped would administer them, but insurance wouldn't cover it until it became "required". Oh, and essentially it isn't "required" because of $$ and the budget. Also remember that this is a series of shots and we are talking two kiddos at once.
This second factor is what I really want to write about. The girls are covered under State insurance "Kids Connection". Now, this insurance has been awesome... beyond awesome! I couldn't ever ask for any better insurance than this. I wish my insurance was this good! Heck, I wish everyone had this insurance! Except, it only covers the girls. It also does not cover recommended treatments, just those required by the government. And the government makes its requirements with the budget in mind.
And so this is where I'm sure I hear... "just be grateful you have insurance" or "I can't believe you are taking advantage of the system" or "buy your own damn insurance" or or or.... Yeah, I don't talk about this much because it is a touchy subject. Everyone has their own opinions. It doesn't matter if you are gay or straight, everyone has opinions that vary from supportive to blasphemous.
What about everyday people of society, people who have these benefits, push for people who do not have these benefits? Vast majority and numbers really make a difference as to who listens! For our family, it isn't about the term "marriage"; it is about taking care of your family and all of the benefits and resources that become available to "married" couples. Many folks have no idea what benefits become available to them when they sign that marriage certificate. A certificate produced by the government, not our Church. I would absolutely be legally married to Carie if that option existed in our normal life. Until then, we are connected spiritually! Just this past week our great state has reinstated the ban on gay marriage. This has battled back and forth since 2000. Six years and it feels like we are back to nothing.
See, not only do I have the option of having a family insurance policy through work; I actually am paying for it just like everyone else. But I do not have the option of it covering my entire family. Each enrollment period I bring it up, I ask. Nope, they have to be my "legal" dependants to be eligible. Not just dependants on my taxes (which they are) but "legal" dependants. There is a difference! Meaning Carie has no shot of being covered, until we are legally married in the state we reside, and Carie would have to sever 100% of her legal rights to the girls for me to adopt them. Oh, and aside from that being ridiculous, figure in the astronomical adoption costs so that they would still only have one legal parent. All this is legal talk, we know and more importantly they know that they have two loving parents.
Most of all because the wonderful state in which we live, heck even the Country in which we live, doesn't want to recognize that our family exits or that our children exist and thrive in such a household. Some States, more specifically some Counties allow 2nd parent adoptions. Sometimes it is as specific as to what judge you get in which County. Most people would be appalled to know what some folks have to go through to complete a 2nd parent adoption which then covers the legalities and provides benefits to the children. This is absolutely not an option in our great state, in any county within the state, or with any judge within the state. We would have to move away from family for it to become an option to us.
So... society pays. Everyone pays for that choice by families like mine who "use" the system to take care of their families. Sure, we could go get a private policy to cover Carie and the girls. Last time we looked, which has been a few years, it was extremely unaffordable and the coverage was unacceptable. Remember, at the time we were looking for independent coverage for two infants and all that went along with well child coverage. I'd much rather contribute that money towards life insurance for Carie and education plans for the girls, which we do.
Carie and I will discuss whether or not to pursue the Hep A series for the girls. We will pay out of pocket if we make that choice. We will do what we feel is best for our children. But, the point really is that the system is messed up. The hard working people of society shouldn't have to pay for my kids’ health care when I am fully willing and already am paying for it through my employer.
This is the first time this discussion has come up with our Ped. She realized/remembered that we have "Kids Connection" and therefore weren't eligible for insurance to cover the series of shots. We had a really great discussion. We've always felt accepted in that office. In the initial interview process over 4 years ago they said that they were fine with our family structure. We felt that they meant it. We have felt nothing but acceptance and normalcy every time we are there. I've never felt judged! But on this day, our Ped had a few other things to say. She shared her views about how ridiculous it is that we aren't able to be recognized as a legal family. How ridiculous it is that we have to have multiple insurance policies, which still doesn't cover all of our family members. I felt that what she said came from her heart. It was wonderful to hear that she really truly got it. Some people think they get it yet they clearly don't.
She does "get it" and it is heartwarming.
Labels: Family
posted by Sonya at 11:06 AM
6 Comments:
Hey I hear ya. I had to be on state insurance while I was pregnant, and then our kid had it for a year and a half. He now can be covered on my partners insurance though, but I can't. What does the state expect if they don't allow us the rights we deserve. I am a stay at home mom doing day care in my home, and I don't have an insurance plan so I am not covered. But if I had a "husband", this would be fine because he could cover me. Well I don't, i have a partner and she can't cover me. So I go without insurance. You got to do what you got to do. Don't worry about it.
I don't agree that you are taking advantage of the system Sonya. You can't cover the girls and Carrie on your policy, but if you could, you would. Now, if you told me that you could and wouldn't, then maybe you could claim you were taking advantage of the system. We are lucky here in NYS that I can get DP benefits on Cheryl's policy and the girls are covered too because we did a second parent adoption. I wish you could too.
I don't think you are "taking advantage" - I think you are taking care of your family. Everyone had a need and a right to health care and to afford health care you MUST have insurance.
I do, however, think it sucks that the state won't cover the Hep A series. It's neglectful because in all honesty, it won't take many people contracting Hep A before that carefully constructed state budget is tossed out the window. They may think they are saving money by not paying for the vaccinations but in the end, are they really saving it if the medical costs from people who contract it exceed what it would have costs to protect people? Oh sure- they won't see that cost from this point but what about 10, 20 or 30 years down the road?
I just love the "save $10 in the short run but spend $100 later and then bitch about it" mentality of government agencies.
Grrrrrrrrrrrrrr.
Oh Sonya, this post really hit the nail on the head. It just floors me how this country likes to pretend families like ours don't exist (I recently read this quote: "Experts estimate that anywhere from 1 to 9 million children in the US have at least one gay parent"). Yeah, we must have invisible super powers.
In about a year, we will be in the same situation as you (minus twin girls LOL). I will be out of work and Jess will be our only income. She won't be able to cover me or the kid(s). Un-stinkin'-believable! And even if she could cover the kid(s), what about me? We still have to get an independent policy for me. Sucks!
I don't think you're taking advantage at all. You would cover the girls through your insurance if you could. But you have a gov't that panders to the religious right and will devalue families, your employer who could cover Carie and the kids if they chose but don't, and you have to do what you have to do. And it sucks.
And I totally agree with Wendy, the gov't is also being totally short-sighted by not covering the Hep A series.
Late to chime in here, and I will not comment on hep a vaccines.
Charlie is on medicaid. He didn't start out that way. He started out on my insurance. But when he hit his lifetime max of allowable benefits, they dropped him. At this point, my employer would have switched to any other group in order for him to still have coverage. But only United would cover him as my non legal child. So everything else was pointless. No individual policy would touch him, and HIPAA was close to four grand a month. So we decided on medicaid. The first time, we listed his entire family, including me. Two parents. Two incomes. We were denied. The second time, same thing. This time I was told I have too much equity in my home, and would need to take out another mortgage to pay for his health care, and once I exhausted my home equity, he could get covered. No. Way. In. Hell. I can't afford what this house is 'worth' (on paper at least). So finally, after encouragement from family and even from the social workers themselves, Jean applied as a single mother so Charlie could have health insurance. And, of course, she IS a single mother. But god how it tore us up to do that. We want the rights of marriage, we must accept the responsibities, right? Well, my kid needed health insurance, and $4k a month was not within reach. So she declared herself a single mother and got what she would have if only we were married.
Same thing for his WIC. He's on WIC because vivonex costs more than $50 a day. That's just a small amount (maybe 24 ounces) and not an entire day's worth of food. We don't have that money. Medicaid doesn't pay for it. But his health insurance that he had previously, and still would have if not for us not being able to be married (or something similar), would have covered it. Enteral formula- $4,000 a year. Sure we would still have to pay something (we do now- $380 a month) but not the whole cost. So, as a single mother (legally) she gets WIC, which covers his vivonex.
It sucks, and for a long time we were so upset and ashamed about it. Upset because in order to get our child the care he needs, I had to denounce him, on paper if not in spirit. And it hurt a lot.
And I imagine that if I already were paying for another child (like you're already paying for Spencer) it would piss me off even more.
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