Tag Archives: Health

Breast pumps are covered by insurance with no copays! (If you’re willing to do some work.)

When I was pregnant with Judah, I planned to be a 100% stay-at-home mom, so I didn’t invest in an expensive breast pump. It turned out I didn’t need one. I only pumped a handful of times, so a $300 pump would have been overkill.

However, for full-time working moms who want to breastfeed, an expensive double-electric pump is essential if you’re going to have any chance at successfully breastfeeding. That’s why the Affordable Care Act included provisions that require health insurance companies to cover breast pumps and other necessary breastfeeding supplies (and lactation consultant services!) at no cost to the insured (read: no copay). Woo hoo, right?

Well, not so fast.

I will be home full-time for the first 4 months with this baby. After that, I’ll go back to a part-time teaching schedule. As of right now, my schedule will have me on campus two hours a day, three days a week. We’re fortunate that my husband’s teaching schedule is flexible, so he’s able to stay home with the kids while I’m on campus teaching. I didn’t start teaching until after Judah stopped breastfeeding, but this time, I’d like to make sure there are bottles on hand in case baby is hungry when I’m gone. Hopefully, as long as I nurse before I go, the baby won’t need to nurse again until I’m home. But you never know! Since I’ll be away from this baby more than I was Judah, I decided to redeem my 100% covered breast pump.

Unfortunately, it’s not as simple as it sounds.

Breast pumps are sold at most big box retailers. Depending on the model and features, double-electric pumps range from $150-$400. Like all products, some are more efficient and easier to use than others. Some come with fancy features to make things more convenient for moms.

When I heard about the ACA provision, I assumed I’d be able to purchase a pump in a retail store and submit my claim for reimbursement. Wouldn’t that be so simple? That’s not how it works. At all.

First, you have to obtain a prescription for a breast pump from your OB or midwife. My midwife wrote the prescription at my last appointment, and she told me that she’d written it specifically for a double-electric pump. Apparently, if the prescription doesn’t specify “double-electric pump,” insurance companies can insist on only covering inefficient manual pumps, which are not sufficient for moms who will be pumping daily.

Once you have your prescription, you need to contact your insurance company to find an in-network durable medical equipment supplier. But here’s the catch: when I searched for a list of in-network DME suppliers in my area, I found a very short list. I called every one of them. Not a single one offered breast pumps. So I was confused.

I absolutely despise calling my insurance company (I’m always on hold forever, and they are rarely helpful). So my first call was to a lactation consultant at the hospital where I plan to deliver. My hospital is working toward baby-friendly certification, and they have an awesome lactation center that rents and sells breast pumps. I wondered if I’d be able to purchase a pump from them and be reimbursed, since they’re an in-network hospital. Unfortunately, according to the lactation consultant, they will not bill my insurance company directly, but she said I might be able to purchase it there and submit a claim for reimbursement. I’d need to call my insurance company to be sure.

After three different calls, I was given three different answers: maybe, if they’re in-network; yes, because they’re in-network; and finally, no, it would not be reimbursed because even though they’re in-network, they’re not an official DME supplier.

Since there are no DME suppliers in my area who offer breast pumps, the insurance company gave me a list of mail order DMEs that are in-network. I will need to fax or mail them my prescription and insurance information, and they will ship me a pump.

Here comes the second catch: their selection is very limited, almost always out of stock and on back-order (so order early if you can!), and their options are the bare bones models. I will be able to get a double-electric pump that will be sufficient for my needs, but it won’t include any of the extras I would get with a retail pump. I suppose I’m not surprised that’s the case, but I’m disappointed that breastfeeding moms who want to take advantage of this will be so limited in their options.

The earliest my insurance company will allow me to order the pump is 30 days before my due date. Some insurance companies won’t fulfill breast pump prescriptions until after the baby is born, so check with your in-network DME early to see if you can get a head start on the paperwork and order the pump as soon as your insurance company allows. Cross your fingers that there will be pumps in stock, and you won’t have a 6-8 week wait like I will.

I was incredibly frustrated, but I’m sharing my experience to let other moms know that it can be done. If you have a specific pump in mind, and the extra money to spend on it, you might want to go ahead and make the purchase on your own. Unfortunately, I suspect that’s part of why insurance companies have made the process so complicated — they hope women will just purchase a pump out-of-pocket so they can get the exact model they want before the baby arrives without all the hassle. If funds are limited, or you’re insisting that your insurance company honor the requirement on principle (I pay a lot of money in insurance premiums! If the law says they have to cover my breast pump, they’re going to cover it, dang it!), be prepared to do some research, be aware of your rights, and get the ball rolling early.

Have any of you received a breast pump from your insurance company? What was the process like for you?

Why I’m done with New Year’s resolutions

Every year on New Year’s Day I feel anxious for a fresh start. “This is the year,” I tell myself. And I really mean it. I really believe that opening a fresh new calendar will give me the motivation I need to make all the changes I failed to make the previous year.

Unfortunately, I don’t think I’ve ever followed through with a single resolution. The closest I came was the year after Judah was born when I resolved to take at least one photo a day. I made it to July before I stopped making an effort to use my camera each day. Let’s be honest, though, my success was probably more likely due to the new baby who stayed relatively still looking cute. Once he started moving, I was done playing photographer.

This year is no different. I have a whole list of things I’d like to change about myself — get in shape, be more organized, finally get to the home improvement projects we’ve been putting off, be more creative, make more time for the things I enjoy doing.

When I really started thinking about it, I started to feel really bad about myself. That’s the thing about New Year’s resolutions — most of them are pretty focused on what’s not good enough about us. As I ticked off the huge list of possible New Year’s resolutions in my head, all I could think was, “Man, I’m doing a lot of things so wrong.”

I think most of us get enough of that kind of negative self talk as it is without focusing an entire yearly tradition on what’s not good enough about us, what we need to change.

I’m not bashing self-improvement. It’s important to be healthy, take care of ourselves, and banish bad habits. However, instead of making a resolution and setting myself up for disappointment if I fail, I’m changing my perspective this year. I’m focusing on the positive. Instead of thinking about all the things I need to change about myself, I’m surrounding myself with people, things, and ideas that motivate and inspire me to take care of myself and my family in the way that we deserve.

The problem with “New Year’s resolutions” is that when we tie our motivation to a time of the year, the motivation inevitably wears off. Anyone who regularly works out at a gym is familiar with this phenomenon. Every January 1, there is a flood of new faces in the cardio room and the classes. Suddenly you’re waiting in line for a treadmill when just before Christmas 90% of the machines were empty. By Valentine’s Day, the crowds are gone. All of those people who rushed to the gym after the holiday gluttony and resolved to finally get in shape have gotten back to their busy lives.

So I decided — no New Year’s resolutions this year. If I choose to eat better, exercise more, organize more efficiently, or start a new home project, I’ll do it because I’m feeling motivated and inspired to do so in the moment — not because of the date on the calendar. I’m not going to spend the beginning of the year feeling bad about myself because of all the things I need to change.

Do New Year’s resolutions work for you? How do you motivate yourself to make positive changes?

Photo credit

Resolutions for 2012

My standard resolution for, oh, 10 years or so has been “eat healthier and lose weight.” So far I’ve only stuck with that resolution for 1 out of 10 years. Pfft. I suck.

I’m not giving up on that resolution. Lord knows I have more weight than ever to lose this year. But starting last year, I decided to focus on other things, too. Things that are easier, more fun to accomplish, and will improve my life in other ways. Here’s what I want to accomplish in 2012.

Organize paper clutter.

I have complained about the mountains of paper that stack up around our house for years. I need to finally find a way to keep them organized, keep paper off the kitchen table, and keep it out of my way. I’m working on an organizing station, and I’ll let you know what we come up with.

Start crossing off to-dos around the house.

It’s been over 6 months since we moved into our house, and we haven’t really done anything meaningful to make it our own. We haven’t painted, we haven’t begun any of the projects we’ve talked about doing, and we haven’t even hung anything on the walls yet (I know, it’s terrible). I’m not a good decorator, but I love this house, and I want to make it even better.

Get strong.

I’ve been attending a strength-training class at my gym three times a week, and I have really enjoyed it so far. I’ve never done any strength training before, so I want to stick with it this year so I can get stronger, feel better, and change my body. We’ll see what happens!

What are your New Year’s resolutions for 2012?

Photo credit

Learn first aid to save money and avoid trauma

Let me start this by saying I would never condone risking the health of yourself or anyone in your family to save money, no matter what the cost. My family’s health is our top priority, and we will spend whatever is necessary to keep all of us well.

That said, emergency room visits are outrageous. Even with good insurance, our copay is $200 for an ER visit. If we were uninsured or paying 100% out of pocket until we hit our deductible, a single trip to the ER for something simple could easily cost over $1000. Not to mention, you’ll often sit in the waiting room for hours. Before spending that kind of time and money, you need to know that the injury really does warrant a trip to the emergency room.

Last Friday while packing some glasses, Tony accidentally broke a glass in his hand, and it cut him. It was deeper than the average “put a Bandaid on it” cut, but it didn’t look deep enough to require stitches. Again, if I really thought he was seriously injured, I wouldn’t have questioned taking him to the hospital. But we just didn’t know.

Judah was already in bed, and we were in the middle of packing and moving. The last thing either one of us wanted was to sit in an ER for hours for him to be bandaged up and sent home.

Both of our moms are nurses, so I put a call in to each of them. The consensus seemed to be that based on where the cut was on his hand and the fact that it wasn’t terribly deep, he would probably be okay with some butterfly bandages.

I’d never done anything like this, and I was incredibly nervous. The last thing I wanted to do was screw it up. My husband is better at this sort of thing than me, but he couldn’t do it one handed, so it had to be me. We put pressure on it with a clean towel, and he sat with his hand elevated for about 30 minutes to stop the bleeding. We cleaned it well, applied the butterfly bandages, and put Bandaids over it to keep it clean.

I think the bandages could have been applied better by someone with more experience, but it seemed to be good enough, because a week later it’s healing well. He will probably have a scar, because I didn’t get the butterfly bandages quite tight enough. But because of where it is on his hand, it won’t be easily visibly.

Would they have given him stitches? Maybe. Now that it’s healed, it looks a bit deeper than we thought. But it seems that in most cases, the only reason a clean cut with no jagged edges or increased risk of infection would need stitches is to stop bleeding or minimize scarring. If you can get the bleeding to stop and it’s not in a place where a scar would be noticeable, a butterfly bandage will fix the problem most of the time. If you’re skilled at applying butterfly bandages, scarring can sometimes even be reduced with a butterfly bandage because there are no jagged Frankenstein lines from the stitches.

The more I thought about it, the more I realized I need to take a first aid class. Part of our problem is that we were clueless. We could tell the wound wasn’t too bad, but we still weren’t sure if stitches were necessary. I can see how that doubt and fear would be even greater if the wound had been on our young son.

I’m sure we’ll encounter many bumps and cuts as Judah gets older. I want to know more about first aid not only so I can know whether professional medical care is required, but so I can provide him with basic first aid instead of rushing to the ER for every little thing.

When I was a kid, my dad was excellent at patching us up. He was an expert butterfly bandager. When I was 7, I busted my chin on the side of a dresser when he was out of town on a business trip. He later said he probably wouldn’t have bandaged it himself, because the chin is such a tough place to heal without stitches. My mom rushed me to the ER. We waited forever, and I was panicked and scared after my sister jokingly told me they were going to stitch me up under a sewing machine. She was trying to make a joke, but I took it literally, and I was terrified.

I think in most cases, getting first aid treatment from a parent at home is less traumatic and scary for a kid than a visit to the hospital. If I can learn to provide that basic care for Judah myself, we can avoid putting him through a traumatic ER visit unless it’s absolutely necessary.

Learning first aid can also prepare you to provide first treatment for serious issues that require professional medical care. Driving to the hospital or waiting for an ambulance takes time, and it’s important to be able to take the right steps immediately after an injury.

I’m looking into first aid classes now. Even if we pay a good chunk of change to learn these skills, I think it’s valuable beyond the money we’ll save in ER visits.

Photo credit

Oh, health insurance. Why must you be so difficult?

With baby due in the next month, I finally decided to stop living in denial and start dealing with the issue of health insurance for him. Unfortunately, it’s not a simple situation. Because I’m currently covered through my former employer’s insurance on COBRA and my husband is covered by a private insurance policy, we’re trying to figure out the most affordable way to provide coverage for the new baby.

I’m waiting on a quote from my COBRA insurance, but I’m pessimistic about cost. When I first started working at the company, the cost to add only my husband to my insurance plan was over $300. That’s why he ended up with a private insurance policy. Not to mention, my COBRA coverage will run out October 2011. I’d prefer that the baby have something more stable.

My husband’s policy was due for renewal this month, so we were also able to examine his coverage and make some changes. We were paying about $175 a month for pretty comprehensive coverage with a $2,500 deductible. He’s had the policy for three years, and he hasn’t had a single claim — fortunately. However, because we have money in savings and most hospitals are willing to work out a payment plan for high medical bills, we decided that we could safely reduce his yearly deductible.

We chose a plan with a $5,000 deductible. Unfortunately, we’ll have to pay 100% of his health costs up to the deductible, but beyond that, he will be covered 100%. So our maximum out-of-pocket costs for a year will be $5,000. Preventative care such as routine physicals will be covered 100% with no deductible. This reduced his premium by $100 a month.

If we decide to add the baby to his policy, their combined premium will be $250 — an increase of only $75 a month for our total health insurance costs. Well-baby care will be covered 100% as preventative care. That means all of the baby’s check-ups and immunizations will be covered with no out-of-pocket cost, but anything beyond that we’ll have to pay up to $5,000. Between our emergency fund and the option of a payment plan for more expensive medical costs, I’m comfortable with carrying a higher deductible. I’m also much more comfortable with a $75 premium increase instead of $300 a month.

This will hopefully be a temporary fix. I’ve been unable to apply for private coverage since I left my job due to the pregnancy — most private plans don’t even offer maternity coverage, let alone coverage for an existing pregnancy. Once the baby is born, I hope to find an affordable private policy for our entire family. I’ve received some quotes for $300-$400 for comparable coverage for all three of us, but until I can actually apply I won’t know any solid numbers.

The application process for private health insurance is long and arduous, so the baby will need to be added to my husband’s policy immediately to avoid a lapse in coverage. My fingers are crossed that I’ll be approved for a private policy so I can reduce the monthly payment I’m making.


If you have a job that provides you with health insurance benefits, don’t take it for granted. My husband’s employer doesn’t provide health insurance, and I’m self-employed, so dealing with health insurance is a complete nightmare. I’m just relieved that we found a solution that will keep all of us covered without costing us a fortune.

If you’re currently uninsured, do yourself a favor and look into private coverage. Depending on your medical history, you may qualify for surprisingly affordable coverage. Unfortunately, if you have pre-existing conditions, you may have to wait until health insurance reform takes effect in 2014 to qualify for private coverage. If you’ve been uninsured for at least 6 months, though, you may qualify for health insurance through your state’s high risk pool. You can find more information on your options here.

Photo by mkmabus

Healthy eating on a budget

This is a guest post by Jennifer, who blogs about frugal and simple living at her blogs Getting Ahead and Our Suburban Homestead.

When Karen asked for guest posts to run while she was in Europe, I knew I had to help. I love her blog and find that we have many similar frugal thoughts. She covers frugality so well, that I thought I would write about something else – healthy eating on a budget. Not everyone can afford to eat all organic foods. While that is the healthiest, it can seem a little drastic. Here are some of things we do to eat a healthier diet while still staying within my $400 a month grocery budget for 6 people.

Read labels.

Reading labels is not hard exactly, but it can seem tedious. Grocery shopping will take longer at first, but once you figure out the items that fit into your new ideals you can just check the label every now and then to make sure nothing has changed. I started reading labels when my daughter was diagnosed with a dairy and egg allergy, so I have been doing it for 9 years now. The things I look for have changed over time. At this point we avoid artificial colors, high fructose corn syrup, dairy and eggs. Yes, even with all those restrictions we still have plenty of options out there. Most people don’t think they have options, but they really do. Cutting out the fake stuff like HFCS and artificial colors is one of the best things you can do for your health. And it only requires buying a different brand many times.

Get back to the basics.

I was somewhat forced into this because of the food allergies, but cooking basic foods with common, basic ingredients is a great way to save money. All those fancy boxes that make a meal are off limits for us. But I can create great meals myself. For instance a dinner might consist of grilled chicken, cous cous and a salad. Another night we might have spaghetti (whole wheat noodles and homemade sauce) and green beans. The fancier a meal is the more it costs.

The fewer ingredients the better.

This goes back to reading labels. If the ingredient list takes up half the box the chances are higher that it has fake stuff. For example Club Crackers have a dozen or so ingredients. Triscuits have 3 or 4. Triscuits stick to the basics in their products. The price is virtually the same.

Grow your own food.

We have a garden at our house and this year I also have a community plot as well. I can or freeze the excess produce to eat all year. That spaghetti and green bean meal from above was made from tomatoes and green beans from my garden. Even if you don’t have a ton of space, you can usually grow something. Container gardening and square foot gardening both provide lots of fresh veggies in a small amount of space. The cost is less and the produce is more nutritious.

Pick your battles.

This is why we avoid HFCS and artificial colors. I could have picked other things, or more things, but I feel pretty good about being able to avoid these while still getting foods that my daughter can eat. If we didn’t have to work around her food allergies I could avoid other things too, but it becomes really difficult at the moment. For me this means that many things I have to buy organic if I am going to buy it all. Many things I just don’t buy. Who needs all that processed junk food anyway? Your battles will probably look different from mine and that is fine.

Look for alternative sources.

I found a great local farm that sells farm fresh eggs for $2 a dozen. You can’t beat that and they are delicious. I have also found a great CSA we are joining this year that will provide organic veggies, fruits, meats, milk, bread and cheese. Check out Eat Local for local sources in your area. If you buy in bulk you can frequently get the good foods for the same price as the grocery store foods.

Stock up when things go on sale.

Organic food items go on sale too. They won’t be free, but they are much cheaper than full price this way. So when the organic ketchup went on sale for half price in February, I bought four bottles. This saves me money in the long run.

By combining these methods I am able to feed my family better foods for less money. We are eating healthier than ever before and thriving because of it. Take the time to figure out a plan for your family and you can too.

Indulgences that are killing your diet & your budget

If you’re trying to lose weight and cut expenses, it’s no secret that the first place to look is your shopping cart. The idea that healthy eating is expensive is a myth. In fact, those pricey convenience foods driving up your grocery costs are probably sabotaging your diet, too. Next time you’re at the grocery store, check your cart and swap these no-nos for healthier, more frugal alternatives.


Sodas are not only expensive — they’re also full of sugar, artificial flavors, and empty calories. Studies show that even diet sodas can lead to weight gain. Considering its negative effects on your health, the cost of soda is outrageous. Just one 12-pack per week is likely to add $12-$20 a month to your grocery expenses. Instead of drinking soda, invest in a water filtration system like Brita or Pur. If you miss flavor, drink unsweetened tea with lemon instead.


If wine, beer or liquor are weekly staples on your grocery list, it’s time to take a serious look at how much it’s costing you — not just in dollars but also in calories. Alcohol is one of the least nutritious, most caloric things you can consume. Removing it from your grocery list and your diet is a must.

Fruit Juice

Fruit juice is full of nutrients, and it’s not an inherently unhealthy drink to consume. However, when you’re trying to lose weight, it’s not a good idea to drink your calories. A glass of fruit juice is likely to have as many calories as a small snack, but it will leave you feeling unsatisfied and craving more food. Considering most fruit juices cost around $3 for a half gallon, you’re better off sticking to tea and water. Fresh fruit offers the same health benefits as juice, but an apple is a more satisfying snack than a glass of apple juice.

“Low calorie” or “fat free” snacks foods

These convenience foods not only cost a fortune, but they may not be helping you lose weight. Not only are they full of artificial ingredients and sweeteners, studies show that you’re likely to eat larger portions of “fat free” and “low cal” foods, which may cancel out their benefits. Instead of buying snack foods, opt for fresh produce. Choose fruits and vegetables that are currently in season for the lowest prices. If produce prices are too high, canned fruits and vegetables are the next best thing.

Photo by B Tal

I wasn’t even being chased

This morning I finally ran a 5K after four months of training.

My first accomplishment was actually getting to the race and starting. I was convinced that it was too soon, and that I wasn’t ready. I almost backed out at the last minute.

But I made it there, and I ran the race. I’m not going to lie to you — it was hard. Today wasn’t just my first race — it’s the longest I’ve ever run in my life. I’d never run longer than a mile and a half in one stretch.

When I came to mile 1, it felt like I’d already been running for an hour. I made the mistake of training indoors on a treadmill, and running outside was a whole different experience. My lungs were burning with the chilly morning air. My legs ached as they hit the hard concrete. Several times during the race, I wondered if I could actually finish. I considered stopped, cutting through, and walking back to the car without finishing. But I kept going.

I was hoping I’d get a second wind as I hit mile 3. Instead, I just felt exhausted. I wondered how I’d actually get over the finish line.

At that moment, you’ll never believe what song randomly started playing on my iPod shuffle: “Eye of the Tiger.” I almost couldn’t believe it myself. I was going to finish my first 5K to “Eye of the Tiger”? It was too perfect. So I picked up the pace, pushed myself a little further, and I crossed the finish line.

My goal was to finish the race in under 40 minutes. I came in at 41:35. That’s roughly a 13:45 minute mile. My fastest speed is about 12:30 minutes per mile, but considering the fact that I’ve never run a full three miles, I’m cutting myself some slack for endurance.

I may have been slow by a seasoned runner’s standards, but I still crossed the finish line feeling like Rocky.

Photo by Tony, who was so proud when I crossed the finish line that he actually got misty eyed. :)

Losing the battle, winning the war

I write about this topic a. lot. It’s because after years of working on it, I still spend way too much time beating myself up when I have to let things go.

This week I announced that I’ll be updating this blog a little less frequently for the next few weeks as we head into the final weeks before our move. I put a lot of thought into the decision, and I know it’s the right thing to do if I want to maintain my to-do list and my sanity. But knowing it’s the right decision wasn’t enough to keep me from feeling defeated when Tuesday passed with Monday’s post on the homepage.

I’m running my first 5K this Saturday after months of training. The last week in February, my training was going really well. My times were up, my endurance was strong, and I felt like I would surely be ready by the end of March. Then I came down with a brutal cold in the second week of the month that kept me out of the gym for over a week. The endurance and speed that I worked so hard to build flew right out the window. My lungs are still recovering, and my body is still weak from what was a pretty nasty virus. This week I can barely make it a mile before I have to slow down and walk.

My difficult runs aren’t a product of laziness, and I can’t control it. Still I can’t help but my kick myself as I consider the strong possibility that I won’t reach my goal on Saturday. I may not be able to run all 3 miles without walking, and my time will likely be much slower than I hoped.

I know I’m not alone in this endless struggle to convince myself that obstacles are not necessarily failures. I know that you can lose the battle without losing the war, but I still have trouble getting over even the smallest of defeats.

I think a lot of women (and men for that matter) waste too much energy beating themselves up instead of building themselves up. Unfortunately, I’m proof that recognizing the problem isn’t enough to solve it. I can tell myself over and over that it’s okay to take a step back, the important thing is to keep going. Yet I still end up here — beating myself up for obstacles that I can’t control and feeling defeated prematurely. Of course, that attitude isn’t very motivating, and I end up sabotaging myself with negativity in the end.

It’s a vicious cycle that I hope to someday overcome. In the meantime, I just have to keep reminding myself that each setback makes me stronger, brings me one step closer to my goals, and teaches me a valuable lesson in how not to get there.

Photo by kaneda99