Pediatricians...

[lunamegn]

This has been nagging me for a while... It's kinda complicated and confusing for me so I'd appreciate any help or advice...


We are doing a homebirth. It is not covered by any insurance although I have medicaid, so we are paying out of our pockets. I became pregnant right around the time I graduated from college, so we decided to do medicaid because I did not have a job with insurance at the time and mine would be ending through my father when I graduated.

I started a job at the end of January and insurance coverage started after the 30th day I had worked for them. So now I am covered. But I'm not sure that I want to continue working for them after the baby is born. Although I have a nice maternity leave option (12 weeks) that is just not enough and the last thing we want to do is put our child in daycare. It's a last resort kinda option. So my insurance coverage with them is likely to end in about 3 or 4 months. I'm not sure if medicaid will continue covering me since I have insurance, still waiting to hear back from them.

I'm still looking into vaccinations and not sure that I'm going to vaccinate the babe at all. So at my last midwife's appointment I asked her for some recommendations for pediatricians who are friendly and understanding to mamas outside of the mainstream. These two are not covered by medicaid from what I can tell. Althogh I need to look into more. But I worry that medicaid will drop me once they varify that I have insurance... for the time being...

Now, I know some mamas who don't have pediatricians. Granted, one is very intune with her children and says that she sees a homeopathic doctor and has befriended her if anything arises she can give her a call. I've bought some books on keeping children healthy naturally (think preventative approaches)... so I'm wondering just how necessary a pediatrician is? Are there any of you who don't have one? I suppose that going to a doctor is anything is wrong and payingout of pockets would be pricey... I just don't know how necessary it is to have one if I have a community of mamas who feel confident in their ability to raise healthy children without the crutch of a doctor. I'm sort of leary and untrusting of most doctors.

I hope I've been thorough enough in my questions and concerns. Any advice would be greatly appreciated.

~ Many thanks and blessings ~

[natashaccat]

I hate Dr's myself but I'm pretty paranoid about not having insurance coverage and i know you have to be really careful when it comes to bouncing between medicaid and insurance.

One thing you really need to think about are preexhisting condition clauses. So for example, your child a develops chronic illness while you are covered under medicaid, if you later get a job that provides insurance, that insurance can exclude treatment of that condition for a year because it's a preexhisting condition and you weren't covered by another company at that time. However, if your future job offers insurance medicaid may not cover the treatment either.

[alegna]

I don't have a dr. for my dd yet. Keep meaning to go interview the one idea I have on a possibly friendly ped. but haven't gotten around to it yet. She's about 8 months old and we haven't needed a dr. yet (knock on wood!)

-Angela

[OnTheFence]

I wanted to comment on a few things.

As for the pre-existing condition clauses, if your child had prior coverage (even through the state) than the new insurance can not exclude those conditions from coverage. You may have to show your tail end about it, but those are the rules. Medicaid or a program like All Kids (which is what AL calls their insurance plan for minors who do not qulaify for medicaid but do qualify for another state funded program) can provide your insurance with a certificate of coverage.

I personally would not go without some type of insurance, whether is be private insurance, state funded insurance for children, or medicaid. You never can predict the future and shoudl your child have a condition that needs to be treated for a medical condition you may be up a creek without a paddle.

I use a pediatric group and have a designated pediatrician for my children from that group. I have done different things as far as medical care for my children. My oldest child was born with a birth defect and we did all well baby care appointments and all vaccinations but one (MMR). Because she had this birth defect we had to see specialists twice before she was 1 year old and had to have several tests done. We were glad we had insurance for this reason. With child number 2 I did a well baby appointment when we brought him home (he was adopted from birth) and I took him again when he developed a respitory infection and had labored breathing. Turns out he had RSV. He did not have another well baby appointment until he was 1. He did not have any vaccinations until he was 2 (he is fully vaccinated). I was glad to have had a pediatrician for just in case. Turns out I needed it for treatment of RSV. He also got Rotovirus at around 15m old and had to be hospitalized for 23 hours and whooping cough at 17m old. Baby number 3, I did do five well baby checkups the first year, some with and without vaccinations (I did delayed vaccinations with him). At 6 months old my son developed an ear infection that was treated homeopathicly but within three weeks he was in terrible pain and running fevers. It took three months for him to get rid of this, and three rounds of antibiotics. So I was really glad I had insurance. But one thing that really made me feel glad about having a regular pediatrician was that at around 11m old my son showed signs of slowing growth and development. He was anemic, had trouble eating food, could not crawl or pull up or anything. He had hypotonia it turns out diagnosed by our pediatrician. We sought care through Early Intervention and it was the best thing I ever did.

I personally have a great relationship with my current pediatrician. He is cooperative and understanding of my parenting. He is older and seems to be more balanced when it comes to prescribing medications and cautious about diagnosing children or treating certain things just because you brought your child into the office. He listens to me and to my children, and he has given me a lot of slack about "delayed vaccinations" and other mainstream things I don't do or delay with my kids. The one thing he is the most fixated on is vaccinating with the DTaP and Polio -- which with my last baby decided to do on schedule anyway. I am currently pregnant and due before you, I discussed with this ped my plans for the birth and how I didn't want things done to my baby, like the eye ointment or hep B shots, bathing, etc. (I do the vita K and my babies have to have their blood drawn anyway so they do PKU with that sample) He was supportive of that and the fact that I breastfeed (and longterm). I definitely think he is a "mainstream" pediatrician, just one that is older, seen a lot more and has a bedside manner that suits a mom like me!

[lunamegn]

Thank you for the advice, ladies.

Natashacat ~ You are so right about the pre-existing medical conditions. Seems like either way you'd be screwed... you could have medicaid and then have it not covered by a future employer or you could have insurance through your current insurer and then if you quit or lost it, you couldn't qualify for medicaid because of the preexisting condition... Something to consider.

And Angela ~ I've always wondered if I had to have a pediatrician set up BEFORE the birth, or if I couldn't go about finding one that I liked and my baby liked after she was born.

I mean, what are pediatrician's purposes?? I bring my baby in at two weeks, a month, two months, and they tell me fine, fine, fine. And if something is wrong, I truly think that I would be able to tell.

Thanks again Ladies.... And if anyone else has anymore helpful advice on the subject I'd really appreciate it!

*** Edited after OntheFence****

We posted around the same time. I just wanted to clarify that I plan on having some sort of insurance. My boyfriend is in college and graduating in May, afterwhich he will most likely have a job with insurance, so at least one of us will have it.. if not medicaid.

[thepeach80]

We now have private insurance and the boys have Medicaid secondary. AJ's is about to run out though since we have private insurance now. Evan can keep his till 1 since I was on Medicaid while pg. Having private insurance makes no difference. I take my boys to WBC, but we do not get vaxes. I think it's important to get to know your ped and to be able to trust them when it comes to making big decisions (in case baby is every really sick) and to let them get to know you personally. Our ped is fine w/ bfing, co-sleeping, cding, and not vaxing, she has several families like this. I'm glad I like our DR b/c my boys have been sick for wks now (finally o.k. w/ the warmer weather) and we've seen her a lot. Even also has reflux and needs to go in for weight checks every once in a while as well. Good luck w/ your birth and DR search.

[Crystal_clear]

No peds for my babes, and I haven't needed one. We do see a naturopath on occasion, mostly just to cover my butt. You know, those scary situations where you're talking to someone about NFL, they decide you are completely whacko and are neglecting your children and next thing you know you've got CPS at your door. Hasn't happened but you never know, and a trip to the ND is far less stressful than an MD! She does have a relationship with a ped that she can refer to if we ever need it.

[Storm Bride]

I'm not sure if you're still checking this thread or not. But, just in case:

I'm in Canada, not the US, so the entire medical insurance structure is different. But, with respect to pediatricians, I don't know anybody who has one. Most people I know have a family doctor with a fair number of kids in their practice. If something comes up, the child is referred to a pediatrician, but we don't see them on a day-to-day basis. All my well baby checkups and such have been with my family doctor, and my 12-year-old is healthy as a horse.

[Momtwice]

We have "family physicians" in the USA too, who see adults and kids.

[ZeldasMom]

I have a family practice doc I really like. He works in a very collaborative (as opposed to a controlling) way. He is also my physician I am seeing during my pregnancy in case something would happen where I would need to transfer to medical care. I am having a home birth with a midwife and my family practice doc is comfortable with me just coming in to see him twice during the pregnancy. I think it is wise to have a doctor for your child. That way if something happens where you need medical care for the baby you can get help from someone you have chosen rather than just some random doctor.

Having a physician for your child doesn't obligate you to choose treatments/interventions you don't agree with. You are still the parent and the one whose role it is to make the ultimate decision about what is best for your child.

Also, my midwife takes medicaid! Maybe you could see if yours would look into doing this too. If she is interested in exploring this option maybe my midwife could give her some tips about working through the bureaucracy. One thing, my midwife is a CNM--I don't know if this is a medicaid requirement or not. Here is my midwife's web site:
http://www.gentlehomebirth.org/

[orangebird]

We have never had a pediatrician for any of my kids. We have a family practice doc and a naturopath that I would take them to if I needed anything. I think if I had a child born extremely premature or with multiple health issues I might get a pediatrician, but I have been happy thus far just seeing our family docs for the kids.

One thing you really need to think about are preexhisting condition clauses. So for example, your child a develops chronic illness while you are covered under medicaid, if you later get a job that provides insurance, that insurance can exclude treatment of that condition for a year because it's a preexhisting condition and you weren't covered by another company at that time. However, if your future job offers insurance medicaid may not cover the treatment either.

I don't think this is true. Or maybe it varies by state. As long as you have been covered, when you get a job and get on their group plan everything is covered right away, at least for the jobs/insurance plans DH and I have had over the years this has been the case. Again, maybe different states have different laws about this so you may be right, luckily we have never had anything said about preexisting conditions. Even though they always ask about them on the forms, they always seem to be OK with everything. The individual plans have been a little more restrictive, but group plans through work never made you wait for anything.

[2+twins]

I didn't interview peds before dd1 was born. I just found a group that was accepting new patients that my insurance covered and went to them. I took her to all her well baby checks and delayed vax until 6 months and then only did one at a time (and broke up any combo vax's) and spaced them at least 2-3 weeks apart. I also didn't choose to do them all. I didn't like the ped we saw at all. I remember him making some comment in a derogatory way like, "well I guess the natural approach does work" when he found that I simply let my baby's neck air-dry (she was chunky and got all red and smelly under there when she was an infant). He had suggested I apply corn meal or something ??? I just cleaned it and blew on it until it dried. Anyway.... with dd2 I took a different approach. I still took her to her initial well baby checks (up to 6 months) but skipped all vax's. Then I decided not to take her at all - I felt more comfortable having had experience with dd1 that I'd more likely detect a problem which required attention. Still though, I don't ditch the ped. S/he's there in case I need him/her (we don't have a specific one at this time). I like traditional medicine to be the last resort and I'll try more homeopathic remedies first. All that being said, I never would have caught that my first dd's labia was fusing shut. The ped caught that at a well baby check. But like I said, now I know, so it's all good. I'm sure they're good for some stuff but I think it's good to be selective about these things, within your comfort zone of course. Btw, my kids were both home born and I did feel most comfortable having an initial exam by a ped. I would not personally want to be w/o insurance, just in case.