Hannah Novy: Insured, and Still Facing Tens of Thousands in Debt

“How does my five-day-old owe thousands of dollars already?” That was Hannah Novy’s reaction when medical bills began appearing in MyChart for her newborn daughter.

Hannah’s daughter was born prematurely after Hannah developed preeclampsia at 30 weeks and four days of pregnancy. Hannah spent three weeks in the hospital, while her daughter spent 41 days in the NICU. The family had health insurance through Hannah’s husband’s job, but their plan renewed on July 1, in the middle of their hospitalizations. Because Hannah’s hospitalization and her daughter’s NICU stay fell across two plan years, the family could face out-of-pocket costs under both. Hannah estimates that, even after insurance, the family could still owe at least $30,000.

Hannah’s pregnancy had been largely uneventful until one night, when she felt short of breath and checked her blood pressure at home. It was high, and her doctors told her to go to the emergency room. When she arrived, her blood pressure was 176 over 113, and doctors diagnosed her with preeclampsia.

Because of the severity of her condition and the possibility that her baby could be born early, Hannah needed to be transferred by ambulance to a larger hospital in St. Louis with a NICU equipped to care for premature babies. She asked whether she could leave the hospital and drive herself there, but doctors told her she could not because of the severity of her condition. “I was worried about the money from the second I got there,” she said.

Hannah spent 16 days in the hospital while doctors monitored her and tried to keep her pregnancy going. Doctors eventually confirmed that she had severe preeclampsia, and when her condition worsened, they determined she needed to deliver. Hannah ultimately had a C-section. Her daughter was born on June 13 and immediately went to the NICU, where she spent 41 days. She was born small because of problems with Hannah’s placenta and needed CPAP and several interventions for jaundice. Hannah described her daughter’s NICU stay as relatively uncomplicated overall — she primarily needed time to grow and learn to eat.

Hannah visited her daughter every day while also arranging childcare for her two sons and managing her husband’s work schedule. She said the family was scrambling to manage everything while her daughter was in the hospital.

Then the medical bills started arriving. “I just watched the numbers go up and up and up. They’re still coming and there’s no end in sight,” she said.

Hannah believes they could owe at least $30,000 after insurance. “There’s no way for me to even start paying any reasonable amount of that,” she said. For now, Hannah is largely ignoring the bills because she cannot see a realistic way to pay them. The family plans to apply for assistance and hopes it will help reduce what they owe.

The family was already facing significant financial pressures before the hospitalizations. Hannah is primarily a stay-at-home mom and does freelance writing and editing for additional income. She also has two older sons, one of whom has autism and a rare genetic syndrome requiring significant additional care. “We’re never going to be able to save money. It’s just one thing after the other,” Hannah said. “This medical stuff has really, really hit us hard.”

Hannah is also frustrated by how much her family pays for health insurance that does not seem to provide ample coverage. “We pay so much from my husband’s paycheck every two weeks. It’s like, what are we even paying for?” she said. “It doesn’t cover anything.”

The bills have made Hannah afraid of needing health care in the future. She has skipped medical care in the past because she could not afford it, including X-rays related to her rheumatoid arthritis. She also once put off a colonoscopy despite having a family history of colon cancer because her family could not afford it. “I just prayed I would be okay,” she said. But when Hannah developed severe preeclampsia, she had no choice but to seek care.

The financial uncertainty has also changed how Hannah thinks about her family’s future. “I’m lying awake because I have a newborn, but I’m also lying awake because I’m worried about finances. Will my kids have college funds? I don’t know,” she said.

For Hannah, having health insurance did not eliminate the financial barriers to care. Her family had coverage when she developed a severe pregnancy complication and when her daughter needed specialized care for more than a month. Yet they are still facing potentially tens of thousands of dollars in medical bills. “Health care should be a basic universal human right,” she said. “Nobody is choosing to hang out at the hospital or need to see a specialist.”

After everything her family has been through, Hannah worries that the cost of care could keep her from seeking it when she needs it. “I have kids who need me, and I’m scared to need any other health care because of the cost,” she said.