[cheri78]

I live in WI and here, the adoptive parents are responsible for medical expenses not covered by insurance. When we filled out our acceptance sheet, one of the things on there was that the birthmother had to have insurance. When we met with the birthmother in May, we asked her if she had insurance and she said that she had 80/20 coverage. The social worker also asked her several times. Had she not had insurance, we would not have met with her. Well, the termination hearing took place about two weeks ago and a few days later we found out that the birthmother went "out of network" for all of her prenatal care and when she delivered and none of it is covered by insurance. We also found out that she has been getting denial letters from her insurance company since January. Does anyone know if there is anything we can do about this. We would not have met with her initially had we known that she didn't have insurance but we are also definitely not willing to give up her son. Do we have any rights legally? Should it have been the agencies responsibility to verify that the birthmother had insurance? Does anyone know if there is anything we can do? Thanks for your help.

[BrandyHagz]

It will really depend on what your contract with the agency says. What are they telling you?

WI law says that "allowable expenses" include medical - but not that you're responsible for the medical expenses...it all depends on the situation.

I would fight this, personally. While the agency likely isn't able to confirm coverage (I'm not sure, with HIPPA and all) - they should have been able to do *something*.

If this Dr. had been seeing her for 6 mos (Jan - May, at least) and she'd been getting DoB notices, its likely the clinic she was going to was aware...why were they still seeing her? I've never been to a Dr.'s office that would still see me if I had an outstanding balance, unless I paid the balance I owed.

Find out what your agency is going to do...I dunno. This, along with MANY other reasons, are why I don't believe expenses should ever be involved in adoption.

[wishing4more]

I'd advise for you to have the agency contact the hospital and Dr and try to get them to reduce their fees.

I've been in a similar situation, and while I totally embrace that is was my responsibility to pay those medical expenses related to the pregnancy, my agency was able to get the fees reduced significantly.

Hope this helps!

[cheri78]

Thank you both for your input. I will definitely contact the agency again and see if they can do anything. I sure hope they can.

[cheri78]

I just talked to our social worker and she just talked to the hospital and they are unwilling to negotiate because of the birthmom's family's outstanding bills that they already have there. Any other suggestions?

Thanks,
Cheri

[Rondidondi]

This is just my opinion, but I see the this mother as lieing or withholding information from the agency and you. Did she sign papers saying she had this insurance and that you would cover expenses AFTER insurance? Then I would think you wouldn't be liable.
I had also sign release forms for the agency to get information, did this mother sign any?
If all feel you are still liable, is there a way you can work out a payment plan with the hospital yourself?
So sorry you are in this situation. I agree 110% with Brandy - expenses should not be involved in adoption.

[cheri78]

I have to look through our paperwork and see what we signed. I know for a fact it was on our acceptance list and we signed that.

I don't believe that the birthmom signed anything because the social worker keeps telling me that that is what we understood and that is what the birthmom said when we asked. But, I don't know for sure. I could ask.

I don't think it's the birthmom who is lieing (she is 17 and doesn't know anything about the insurance) - it is her mother. And, the mother doesn't want to call the insurance company for some reason. It's just a mess right now. I'm very frustrated with the whole thing.

[Whirled_Peas]

Does your insurance cover her expenses? We live in AZ and we had 60 days after certification to contact our insurance company to inform them of our intent to adopt. They are required to cover any medical expenses for the pregnancy of the baby we adopt.

[BrandyHagz]

They are required to cover any medical expenses for the pregnancy of the baby we adopt.

Are you sure about this? I know group insurance is required to cover any medical expenses that the baby has, when you adopt - but covering an unrelated pregnant woman, that's not something I have ever heard of...

[Whirled_Peas]

Originally Posted by BrandyHagz

Are you sure about this? I know group insurance is required to cover any medical expenses that the baby has, when you adopt - but covering an unrelated pregnant woman, that's not something I have ever heard of...

We took the adoption classes through Catholic Social Services and that is what they told us. We had to send our certification to our insurance company within two months. If they were only going to cover infant expenses, I see no reason to do this.

[BrandyHagz]

I guess, all I am saying is, be 100% sure. You don't want to get bills later, that you thought would be covered. Having been involved in a number of AZ adoptions...I've never heard of this (including my own research).

Maybe its some little known law...like the county attorney being able to complete your finalization for you at no cost (above filing fees).

[Whirled_Peas]

I'll try and call our insurance agency later and find out. I'll post when I do in case the info is helpful to anyone else.

[Whirled_Peas]

I just verified with our insurance, Blue Cross of Arizona, that they WILL cover birthmom's prenatal expenses if she does not have appropriate medical coverage.

BC/BS of Arizona has the following conditions:
1. The adoptive parents must submit a copy of their certification to adopt within 2 months of the certification date to the insurance company.

2. The newborn must be listed on the medical insurance within 31 days of birth.

I didn't ask, but I assume, that TPR must have been signed and/or baby placed in adoptive home. In our state TPR can be signed after 72 hours. (Which is why I used the term bmom, not emom, above since she will be bmom at this point.)

I hope this information helps others out there.

[cheri78]

I really wish our insurance worked like that. We did find out that we are not legally obligated to pay medical expenses (which someone pointed out earlier but it never really clicked) so we agreed to pay what we originally had agreed upon.

[Whirled_Peas]

We got a letter from BC/BS of AZ today outlining what we have to do for them to cover the bmom's medical expenses.