“If you’re having a mental health crisis, please hang up and call your PCM …” the robotic voice for my prior insurance trailed off, and I began to wonder whether I actually was having a mental health crisis.
Every time I’ve spoken to this insurance company, it’s left me feeling worse and more hopeless than before: Answers seem to be scarce, and the unenthusiastic voices of their “customer service” associates on the other end don’t convince me that anyone is looking very hard for those answers on my behalf.
I looked down at my half-crumpled bill again, seeing the itemized version of thousands of dollars owed for complications from a miscarriage that happened two years earlier. Complications that are being denied by health insurance.
This insurance plan is the one I’d had while my husband was still in the Army. We’d never received a bill for anything before this, thank God, but when I had to be transferred to a civilian hospital to be seen by doctors there, it got expensive very quickly.
I went to the hospital nearly a month after my miscarriage was considered complete due to continued bleeding, dizziness, and lethargy that was unshakeable, no matter how much rest I got.
Sonograms. Blood tests. An ambulance ride. A pelvic exam. They were all encouraged by a doctor I’d never met before, and who more or less dismissed the idea that I was enduring complications from my miscarriage. (I would find out later that I indeed was ― the miscarriage took five months to run its course in total.) She told me I’d need another ultrasound ― the fourth performed since the loss that showed that yes, indeed, my uterus is empty ― and that their sonographer had left for the day. It was 3:30 in the afternoon, and it was decided that I would go to the local hospital and be treated there.
The bill that arrived neatly addressed in my mailbox threatened the next one would come from collections. Since this was the first we’d heard in over two years, I’d mistakenly believed it had been handled long ago. I opened the bill, dropped my keys on the table, and sank into a kitchen chair, feeling like I was whisked back to 2016 as I dialed the insurance company’s number to deal with this, telling myself they must have made a mistake.
Why is it we were just now receiving a bill that promised to financially kick us while we were down? Why weren’t they covering it? When I finally spoke to a manager from our insurance, she told me they needed more proof.
Proof. They needed more proof. That I didn’t just wake up on a day in February 2016 and declare, “Gosh! It might be fun to spend 10 hours in the emergency room today. I hope they’ll fail to find a vein so I get stuck like a pincushion!”
They needed proof. They had already received my medical records. They’d already gotten my file from that hospital in Florida that said, yes, a spontaneous abortion. And oh, how I abhorred that language. Spontaneous speaks of decisions and risks to me, and boy was I risky: I was in the Florida Keys weighing shrimp, so I knew how much shellfish was safe for me to eat over the span of our vacation while pregnant. Proof.
Laughing at dinner the night before my birthday, soaking in the salt air and the breeze, and watching drunk middle-aged people dancing to “Kokomo.” My gut suddenly lurching and stinging and, yes, cramping. Proof.
I ran to the bathroom, breathlessly praying to not find what I did. Blood. Proof.
We went back to where we were staying, the lovely guesthouse of our best friends’ aunt. I laid down, called the Army’s nurse hotline, and kept my feet elevated. Proof.
I woke up to my husband pulling the covers off of me to discover I’d bled into their mattress. He helped me to the shower, where I found proof. I stood up, and the baby was born into this world approximately 28 weeks too early. Proof.
I let out a guttural scream and my best friend and husband rushed in to get me dressed and to the hospital. We arrived at midnight to the Key Largo emergency room, all the while joking it was a miracle to be the only people waiting and receiving five-star care, despite being surrounded by drunken tourists and old folks the whole night.
They ran their tests, and discussed sending me to Miami because I’d lost two liters of blood and needed a transfusion. My uterus was swollen, but empty. Proof.
My blood pressure sank to 70/38. The nurse rushed out and grabbed the doctor, and he said, “This is the one afraid of needles, right?” He talked about injections and shots and pricking me again to see if it would help. They checked again: 90/72. Proof. I was sent home after being advised to stay hydrated, to rest, and to call a number if I felt depressed or suicidal.
I never called. The paperwork that would come with me to the ensuing doctor and hospital visits showed the proof of that loss. Two years after the miscarriage, I didn’t think we needed all of that paperwork anymore, as it felt like that chapter was closed.
We’d moved away from that Army base, came home to North Carolina, and had our rainbow baby: caesarean section, no complications. Proof my body worked in the way I longed for it to the first time. Proof. We were billed for that surgery, happily obliging to bring this baby home, healthy, alive, happy, our proof.
I never imagined it would cost us more to lose a baby than bring one home, yet here we were.
“Hello? Mrs. Ramirez?” I’d forgotten I was on hold. Twenty-seven minutes of my lunch break, gone.
“Yes, I’m here,” I begrudged. I gave her the information she asked for, and was briefly placed on hold again.
“Yes ma’am, I’m back,” she said. “It looks like we need a letter from the doctor who sent you from the Army hospital to the civilian one stating the services rendered were needed. We just need more proof.”
Proof. I’m still actively seeking this proof ― contacting every hospital I was seen at, tracking down doctors who had long ago been moved by the military, and scouring through my own files to see if I can appease them long enough to stop my account from being sent to collections. I’d never realized just how expensive it is to be a woman, but now know in real time that it may cost you both emotionally and financially, and that sometimes someone will still have the audacity to ask you for more proof.
The insurance company is saying they need more proof that I had a miscarriage. I’m saying the trauma of this experience was heavy enough; I never intended to carry proof of my loss with me wherever I went.
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Before You Go
