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How Moms Are Cheated By Health Insurance Rules

Photograph by Twenty20

My head was pounding. The throbbing pain would not let up. I was down to my last pill, and I couldn't get a refill for another week.

How in the world was I supposed to be a mother like this?

I've suffered from migraines since I was 9 but went undiagnosed until I was 18. I've had MRIs, CT scans, allergy tests. I've seen an Ear, Nose and Throat doctor, gotten acupuncture, massage, chiropractic care. I've been a guinea pig for more medications than I can count.

Finally, when we moved to Seattle 10 years ago, I found relief: a combination of massage, acupuncture and chiropractic care.

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I'd dabbled in these treatments before but, because I had to mostly pay for these out of pocket, I'd never been able to fully explore them as a treatment plan. In Washington, though, alternative medicine was covered by our insurance. This was something new for me. According to U.S. News and World Report, Americans spent more than $33.9 billion out of pocket in 2007 for alternative and on alternative and complementary medicine. Sometimes it felt like the bulk of that spending had been mine.

Alternative medicine doesn't just affect those with migraines or those in need of chiropractic and massage benefits.

After several months and a switch in medications, my neurologist and I found that weekly massage and chiropractic care was key to managing my migraines. Through regular appointments, I went from 4-day long migraines several times a month to fewer than four migraines total per month. It was a completely new way of living for me, an almost pain-free existence I had never known.

It took over 15 years to get there, and I wasn't ready to let it go. Then, we moved to Maryland.

I had to medically start from scratch—all new doctors, prescription refills, etc. I also learned that the state of Washington was unique. My home state of Pennsylvania hadn't accepted alternative medicine as the norm when I was young, but I had hoped that the East Coast would have grown since the '90s. Sadly no.

I started a long battle with our new insurance company to get massage and chiropractic care covered. In addition, they fought me on my medication, saying that if I got more than eight migraines per month, I needed to be on a daily preventative.

I was trying to take less medication, not more. Didn't they understand that?

Thankfully, my insurance company didn't fight back on the chiropractic care, but the massage was a little trickier. Very few massage therapists actually take insurance in Maryland, since it is not the norm in this state. My neurologist and I finally figured out a work-around. My chiropractor had just hired a massage therapist and the insurance company said they'd cover massages through the chiropractor's office.

An easy fix, right? I could get a massage and then a chiropractic adjustment right afterwards. Nope. In order for the chiropractor to get all of her money, I needed to have two separate appointments on two different days. Why did everything have to be so difficult?

Fighting for my right to be pain-free didn't seem like something I should have to take on just because I moved to a different state.

Alternative medicine doesn't just affect those with migraines or those in need of chiropractic and massage benefits. Pregnant mothers are equally as affected, depending on the state they live in. Some have to fight for homebirths and midwifery care, a practice that is as old as human kind and was seen across the nation until about the 1930s, when births were moved from the home to the hospital.

The Midwives Alliance of North America says that Nurse-Midwives practice legally in all 50 U.S. states and the District of Columbia. Certified Professional Midwives are legally authorized to practice in only 28 states. And certified midwives practice legally in only three states.

The first two types of midwives are generally found in clinics and hospitals, while the latter generally practice in birth centers and homes. Whether your insurance covers your specific provider is up to the insurance company. Many do cover midwife-assisted births, but it has to be under the care of an OB-Gyn and the birth has to take place at a hospital or in a birth center. Not all insurance covers a birth at home, though this has been slowly changing.

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Fighting for my right to be pain-free didn't seem like something I should have to take on just because I moved to a different state. I got lucky that my doctors and I figured out a work-around relatively quickly, and I have a neurologist who will write a prescription for as much alternative medical care as I need, as long as it is working.

Not all patients are so lucky though. My migraines haven't gone away—there is no cure for these debilitating headaches. But at least I can wake up each morning knowing I can be the mom my boys need me to be.

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