Question re: older adult kids "boundaries"

[Clarita]

11 minutes ago, Carol in Cal. said:

I wasn't sure whether to believe this or not, and along came a snoo equivalent with studies that showed better and more lengthy sleep in a contraption that projected mom body sounds and responded somewhat to baby's stirring.  This did not convince me to buy the contraption; rather it convinced me that the folks who advocated for co-sleeping had a point.

When my husband saw the ad for the snoo he wanted one, for himself. 

I fall asleep at the drop of a hat, so it had less of an appeal to us. Plus I didn't want my kids to get used to the snoo and be disappointed with me. 

[Katy]

When fertility treatments are involved the bills get very high very quickly… but, I had more than one call from frustrated people whose hospital was charging them the amount they were contracted to write off for being in network. Technically fraud, but these billing people frequently make very little money and have very little training. I’d mention it to your sister so someone can double-check. No OOP maximum sounds ridiculous, but for some policies the max is really high, like 50k.

[TechWife]

21 hours ago, sheryl said:

As I've stated, I really don't know.  I believe my memory is correct that I heard 70 or 80K. Now I may have heard incorrectly.  I'll have to press the issue in the future to get an update.  

Unless they have been accumulated bills that they haven't paid, then you've been given some incorrect information. By law, the 2021 maximum out op pocket cost is $8,550 per individual and $17,100 for a family. So, between all three of them, for all of their medical needs, they would pay no more than $17,100 for their medical expenses for 2021. If the baby was born in 2020 and remained in the hospital into 2021, then the OOP maximum would be due for both years, but it wouldn't exceed $33,400, which is the total family OOP maximum for both 2020 and 2021 combined.

This amount does not include any non-covered care. That, they are on their own for and may include things like that bed rental, which looks like a convenience item, not a medical necessity, but I don't know for sure. It would also include any non-covered care they received - for example, if they went to a non-participating hospital in a non-emergent situation and their insurance has no provision for out of network care, then they would be on the hook for the entire amount of the hospitalization. I can't imagine $70 - 80K covering childbirth & a NICU stay, though. That would be really low unless the stay was really short. Also, the hospital would have moved very aggressively to either transfer them to an in network facility, to qualify them for Medicaid or to make sure they arrange a payment plan if they refused a transfer or didn't qualify for Medicaid. It also would not include any housing/hotel/boarding costs for parents after the mom was discharged from the hospital. That, they have to pay on their own, although hospital social workers usually get deals at area hotels if a Ronald McDonald House placement isn't available.

Here is a quick table for reference - the amounts go up a little bit in 2022:

https://www.healthinsurance.org/glossary/out-of-pocket-maximum/

[goldberry]

I had a "colicky" baby.  There were times I would have paid any amount that I did not have for anything that MIGHT stop the screaming. 😳 If we had Snoos back then I might have ordered one.   I was no longer in a logical place! 

[goldberry]

On 12/20/2021 at 8:18 AM, TechWife said:

 but it wouldn't exceed $33,400, which is the total family OOP maximum for both 2020 and 2021 combined.

 

How in the world do we (collective United States we) consider it acceptable to have a $33,400 bill WITH insurance??  Our healthcare system is insane. 😭  And how many hours work does that include just making sure the bills are correct and have been paid correctly?  100s of hours!!  

[Katy]

Guys if there were infertility treatments and they allowed them to make payments that wouldn't be covered by many insurance plans and it could easily exceed 100k. Some countries will cover one attempt at everything, like I think I read in the UK they will pay for one round of IVF, but I don't think any country covers unlimited infertility treatments.

[Jean in Newcastle]

48 minutes ago, Katy said:

Guys if there were infertility treatments and they allowed them to make payments that wouldn't be covered by many insurance plans and it could easily exceed 100k. Some countries will cover one attempt at everything, like I think I read in the UK they will pay for one round of IVF, but I don't think any country covers unlimited infertility treatments.

This was the niece that was already criticized by the OP for wanting a baby when she was overweight and "old".  I can't remember if they chose IVF but if they did (and I totally understand why people would choose that) they had to have understood the financial ramifications before starting down that road. 

[BlsdMama]

2 hours ago, goldberry said:

How in the world do we (collective United States we) consider it acceptable to have a $33,400 bill WITH insurance??  Our healthcare system is insane. 😭  And how many hours work does that include just making sure the bills are correct and have been paid correctly?  100s of hours!!  

You’re completely right that checking billing and making calls takes insane effort and time. I’ll bet I give it 5 hours a week and I’m nowhere near the bills and time needed 4 years ago when we were doing testing. Mayo made an oopsie on mine and my insurance is telling me, “non covered expenses” for something I’ve had done about a half dozen times. They covered it 3-4 times then the bills sat pending while I had it (Botox on legs, one arm, lower back) spine twice more to the tune of $13,300 x 2. Now Mayo says I’m on the hook for it. 🤦🏼‍♀️ Medical care, coverage, and billing departments can make your head ache something awful. 

[Selkie]

1 hour ago, Katy said:

Guys if there were infertility treatments and they allowed them to make payments that wouldn't be covered by many insurance plans and it could easily exceed 100k. Some countries will cover one attempt at everything, like I think I read in the UK they will pay for one round of IVF, but I don't think any country covers unlimited infertility treatments.

What I've been told is that it is pretty difficult to get IVF covered in the UK. There are strict criteria about age and BMI, and even if you are one of the lucky ones who gets approved, the wait times can be very long. (This is according to women from the UK in a Facebook group that I'm in.)

[Katy]

2 hours ago, Jean in Newcastle said:

This was the niece that was already criticized by the OP for wanting a baby when she was overweight and "old".  I can't remember if they chose IVF but if they did (and I totally understand why people would choose that) they had to have understood the financial ramifications before starting down that road. 

Well good for her.  The debt can still feel more overwhelming than the idea of the debt did beforehand though. Especially when you tack on ADHD, sleep interruption, and all the stresses of being a teacher this year. 

[sheryl]

On 12/19/2021 at 12:50 PM, Bootsie said:

I refer to my own son and daughter as my adult children or as my kids; that is my relationship to them--they are both my children and adults.  I do not refer to my nephew who is in his late 20s as an adult kid.  I knew him when he was a kid, but he is now an adult.  Likewise I do not refer to neighbors, coworkers, grocery store clerks, or other people I meet who are in their 20s, 30s, and 40 as "adult kids"  It can be difficult to transition to an adult-to-adult relationship with people that we knew when they were a child; It can also be difficult for the younger person to transition to an adult-to-adult relationship with someone they have known as an adult when they were a child. It sounds as if the couple may be overwhelmed with a new baby and medical issues, which is understandable, which is muddying the waters even more.  I think framing it of what you are willing and not willing to do to assist adult family members/friends who are going through a stressful time might help.

Yes, I understand what you are saying.  But, somewhere this thread got rerouted to discuss acceptable topics of conversation (what is acceptable or not) and use of the word "kids".  So, yes IMO their are "young" adults such as the 20's.  Middle age is typically referred to those in 40's and so on.  The term of "kids" is used (at least by people I know) to refer to those that are of a different generation at least.  But, yes, the US Gov't defines adult legal status to those 18 and above.   I don't think I refer to our local grocery store clerks as adult kids either.   They are kids in a GENERAL SENSE.  BUT, by law they are adults.  I think college-aged kids. I don't think 18-22 yo "adults" in college.  By law they are considered adults, but in a "general speaking" sense - kids.  Surely they were and are overwhelmed.  But, family or not, one should not be disrespectful as she was.  Now, ALL of us make mistakes.  It would be nice if she would come forward to claim accountability for her attitude with us but that remains to be seen.  We all have off days but we should own them.  My daughter was diagnosed with epilepsy at 7 y 10 m.  I had NO one to help me day by day with the then new condition she was faced with.  DH worked FT outside the home.  The horror of seeing your child experience dozens of absence seizures for a period of time was overwhelming.  I did not bite people's heads off but cried instead.  

[sheryl]

On 12/19/2021 at 10:04 AM, TechWife said:

What in the world? How is one unreasonable ask a pattern? How is you not respecting your own boundaries about babysitting going to destroy your relationship with your niece? That will only happen if you let it. They are your boundaries, not hers. You can’t call someone else out for violating your boundaries when you allow them to do it. You can’t call someone out for violating your boundaries when you move them around so that they don’t know where they really are. “She said two days, but she’s done one day a few times, so she must not have meant two days or I misunderstood.”
Call yourself out, but not her. 

Sure.  What did I say?  I need the reference.  I hope I didn't say it would destroy my relationship with my niece.  If it does that's on her NOT me.  I'm not worried about it.  Calling myself out??  Ummm, I need for people to understand this.  I gave her the benefit more than once.   Now, that's what I chose to do to extend "grace" to her.  There is no "formula" to say after once, twice, whatever number of times it's now acceptable to call her out.  I feel HIGHLY comfortable in the fact that I gave her more than one opportunity but because there is a "pattern" or repeated history to the situation then I will kindly explain to her just that - "I know this and that but please know on x number of occasions I gave you the benefit.  But, this is where I told you I stand (have mentioned more than once) and now expect it to be enforced".   So, in more world, love gives grace.   After our definition of repeated offenses or time then accountability enforced.  I didn't expect I needed to set boundaries because she is supposed to be this middle-aged adult (experienced nearing 40) and not a young adult inexperience in 20's.

[sheryl]

On 12/19/2021 at 12:54 PM, BlsdMama said:

Exactly. I racked up several hundred thousand the year of my diagnosis, misdiagnosis, ensuing treatments, and Mayo…. My responsibility that year was about $12k and travel. 
 

@sheryl - in response to two responses, you clicked the huh?/confused. That confuses me. Do you not agree she is pretty far into the grown up kingdom to have such demanding expectations, put a guilt trip on you while renting an expensive toy and going on vacation, get manipulative and pissy… 

 

My own daughters wouldn’t demand this of me, not because I wouldn’t do it, but because they have a consciousness of personal responsibility and demands other people have in their own lives. What @sassenach is getting at is that the bigger favor to your niece here isn’t agreeing to do whatever. It’sa good lesson for a big girl who might need it spelled out for her. 

Yes, I replied as such.  At almost 40 more is expected from one that age than a young adult of say 22 or so.  The 40 yo has more life experience from which to draw, time to reflect/ponder.  In fact, I expected her to "know" better.  Unfortunately, I'm seeing now that this is a dynamic b/t my sister and niece.  My niece will be told kindly that I am not her mother and what works b/t the 2 of them will not work b/t she and I.

[sheryl]

On 12/19/2021 at 5:35 PM, HS Mom in NC said:

You're missing what people are trying to suggest to you about the big picture here.   Your struggle with boundaries is likely directly due to your extended family normalizing things like discussing medical bills which isn't normal in families with healthy boundaries. It's fairly common in families that lack boundaries. It seems you have a distorted sense of familial roles and appropriateness at different developmental stages.  Lack of boundaries doesn't come out of nowhere, it typically has strong family of origin and/or personality components. 

You're immediately arguing with answers to a problem you posted about.  You should be listening and contemplating instead of justifying. It's going to require a paradigm shift on your part.  This is major, life altering stuff. Many people good at boundaries from all walks of life and different subcultures are telling you that what's been normalized for you is generally recognized as problematic.  Let that sink in and take it seriously.  Obviously you don't have to agree, but your posts read as frantically justifying so you don't have to make uncomfortable changes.

Change will require you to tolerate emotions and conversations you seem uncomfortable with.  Take a deep breath, step back, and look at the big picture of how your family thinks and operates compared to others. It's a big daunting task, but it is doable and worth it long term if you're willing to make changes.  If you're not, this kind of stuff will continue and will get worse as the lack of boundaries continues to erode the quality of your relationships with unreasonable behaviors while the resentment builds on all sides.  Is that what you want? Choosing not to address it with healthy boundaries is a hard choice with consequences.  Choosing to address it with healthy boundaries is a hard choice with consequences. Choose your hard-there's no way to avoid hard. Familiar does not equal easier.

Well, your word choices are getting borderline here.  Firstly, you are assuming I don't understand.  Not sure where you get this unless perhaps b/c I might not agree with every nuance of what you're suggesting or others and the difference of opinion/practice is in conflict with your opinion/practice so this renders me as not understanding.   

You have one thread, one example and you are willing to apply a term of "normalizing things" to describe, in your opinion, that I struggle with boundaries.  You're welcome to your opinion.  It may look that way to you.  You will say I'm blind-sighted but imo I'm not.  I did NOT think I needed to address boundaries with my niece.  MY only fault was that I assumed she was going to behave in an almost 40 yo appropriate way.  This happened once....to me, that's a red flag.  GRACE was given.    Who here doesn't like to be given the benefit of the doubt?  Happened again and this FED EX request - well, now I'll address it.   

"It seems you have a distorted sense of familial roles and appropriateness at different developmental stages.  Lack of boundaries doesn't come out of nowhere, it typically has strong family of origin and/or personality components."  Thank you for sharing your views.  This scenario with my niece now gives license to accuse me of having a distorted sense of family roles?  Plural?  I will kindly disagree with you.  Instead of going down rabbit holes looking for issues, please stay with the issue at hand.  The thread was simply about a FED EX situation.  Like all extended families, there are challenges but I've always been grateful knowing I have a close-knit family.  

When you refer your reply history you will see that topics mentioned are ones that I would consider better left unsaid.  You might not agree.  Who is right?  Some say politics, s**, family, and the list goes on should not be discussed.  Oh, yeah, religion is not supposed to be discussed, according to some.  Well, all of those have been discussed on this forum.  Have you participated in any "off" topics here?  Just an honest question.  I will now need to make an adjustment with my niece.  

 

 

On 12/19/2021 at 6:02 PM, goldberry said:

"Discussing medical bills isn't normal in families with healthy boundaries."  Boundaries look different in different families, and between different members of those families.  You're not in a position to determine that as unhealthy and a distorted sense of familial roles without WAY more information.  

Also, OP has already said she sees the need to address this issue and her boundaries in this situation.  Multiple times.

 

On 12/19/2021 at 6:56 PM, MissLemon said:

I have a relative like your niece, (about the same age, too). They make a lot of decisions that aren't well thought out. 

Inevitably, things go sideways and they're asking for help that requires a significant investment of time and/or money.  Everyone feels badly that they are (again) in a pickle, but it is also exhausting because they are always in a pickle.  You want to help them because you care and don't want to see them in a bad situation. And yet...here we go again. They don't want advice, they don't want to be told what to do (because they're an adult! 🙄), but they also just want you to fix their problem, and make it all go away, which isn't very "adult" of them.

I've been in a very similar situation: relative wanting me to take on a 6 hour long chore they failed to prepare for, so the relative could attend a social event.  I said no; if the chore is important, change your social event. If the social event is too important, then change the timing for the chore. I love you, but this isn't my problem and it's not an emergency. Relative was mad and tried to guilt trip me. They got over it and still call because they still fail to plan well and want me to take on their chores. 

Your niece has choices here, but she doesn't like them, so she's trying to bamboozle you into thinking you have responsibility for this situation. Whatever her debt situation is, you didn't cause it and you aren't worsening it. Her lack of planning is the only thing making her debt worse. Not you.

 

Agree, thanks for sharing!  Yes, sounds similar.  I am very disappointed that she "seemingly" is "using" me for her advantage.  Oh, idk.  Family members help one another out but now that this is repeated I can use that to explain it's not a single occurrence but a habit/pattern with HER that she might want to consider changing.  

[sheryl]

On 12/19/2021 at 8:06 PM, Clarita said:

FYI it wasn't a problem in my family either until we all realized people were making judgement calls and getting upset over the financial pieces they saw. and note the word pieces because it's always going to be pieces because they only see what the person has shared. Even if the person isn't trying to hide financial details from others in the household there are a lot of moving parts to a financial picture. After a near falling out with family members my mom and I decided to stop sharing/questioning and that this was unhealthy (even when everyone has the best of intentions).

Top it off hospital bills are the worst; if something went wrong there it may be fog for quite some time. I finally finished dealing with the hospital bills from giving birth to my 2 kids when my youngest daughter turned 3. My big mistake was to decide to put my kids on my husband's insurance instead of mine or having a fulltime job before my youngest. My immediate bill for my son's birth was in the 80k range for a non-emergency, pretty healthy baby vaginal birth. Then it was a lot of phone calls that only I could make and a lot of back and forth with hospital billing and insurance. A whole lot of waiting on bills and adjusted bills; and a lot of hospital billing people asking me why I'm so disorganized and taking so long with it (it takes them at least 3months to come back with each bill, all of which look identical to one of five types). I would not have acted appropriately if someone asked about my hospital bill.     

Yes, I just do NOT know here. Just repeating what I heard.  I've been told again and again they have terrible insurance.  Sure hope they don't have to pay that much.  Hopefully they are wrong and insurance will kick in.  What I don't understand is why do they carry 3 primary insurance policies?  One for husband, wife and baby.  Why not a group family plan?  They would reach deductible sooner, etc.  

[sheryl]

On 12/19/2021 at 10:56 PM, sassenach said:

Oh, of course I have. I meant that you seem to think of/treat them as children that need your rescuing and your language reflects that. Like when my 24yo gets in a jam, I understand that part of the problem is inexperience and lack of adult maturity. The 24yo will ask me to bail her out (I even posted about this recently). However, my 36yo adult cousin doesn't ask for those types of bail outs, even though we are close family members who are available for emergencies and such. The 24 asks because on the spectrum of kid to adult, she still leans to the kid side. My cousin doesn't because she is a fully functioning adult who has a grasp on reasonable vs unreasonable expectations.  With my 24yo, sometimes I have to teach her to own her own adult problem by not jumping in to rescue her. It's uncomfortable, but necessary for her growth into full adulthood. So I think my point was that language can be quite telling and you seem to be leaning toward treating them more like kids and less like independent adults (it sounds like that's a pattern for your sister, too?). 

This probably just stood out because I literally just had to tell my 24yo that she was asking for us to do something unreasonable to bail her out of a situation that she was responsible for. When I said no, I too was told how stressed she was, that she would lose money, and might have to cancel plans. However, at no point did I feel responsible for those outcomes. It was frankly, not a hard boundary to hold because it was a ridiculous ask. Your niece's expectation strikes me as equally unreasonable. 

 

I replied to similar replies above.  

[sheryl]

On 12/19/2021 at 11:59 PM, Jean in Newcastle said:

Exactly. She is an adult niece, not an adult “kid”. The relationship is that of niece. It adequately explains the generational difference and doesn’t infantilize her 

Oh my word YES!  THIS!

[Frances]

Did I miss it? What was the resolution? Did your niece get it picked up from your house?

[sheryl]

On 12/20/2021 at 10:18 AM, TechWife said:

Unless they have been accumulated bills that they haven't paid, then you've been given some incorrect information. By law, the 2021 maximum out op pocket cost is $8,550 per individual and $17,100 for a family. So, between all three of them, for all of their medical needs, they would pay no more than $17,100 for their medical expenses for 2021. If the baby was born in 2020 and remained in the hospital into 2021, then the OOP maximum would be due for both years, but it wouldn't exceed $33,400, which is the total family OOP maximum for both 2020 and 2021 combined.

This amount does not include any non-covered care. That, they are on their own for and may include things like that bed rental, which looks like a convenience item, not a medical necessity, but I don't know for sure. It would also include any non-covered care they received - for example, if they went to a non-participating hospital in a non-emergent situation and their insurance has no provision for out of network care, then they would be on the hook for the entire amount of the hospitalization. I can't imagine $70 - 80K covering childbirth & a NICU stay, though. That would be really low unless the stay was really short. Also, the hospital would have moved very aggressively to either transfer them to an in network facility, to qualify them for Medicaid or to make sure they arrange a payment plan if they refused a transfer or didn't qualify for Medicaid. It also would not include any housing/hotel/boarding costs for parents after the mom was discharged from the hospital. That, they have to pay on their own, although hospital social workers usually get deals at area hotels if a Ronald McDonald House placement isn't available.

Here is a quick table for reference - the amounts go up a little bit in 2022:

https://www.healthinsurance.org/glossary/out-of-pocket-maximum/

Short answer - repeating what I heard. I just do NOT know. 

[sheryl]

On 12/22/2021 at 3:14 PM, Jean in Newcastle said:

This was the niece that was already criticized by the OP for wanting a baby when she was overweight and "old".  I can't remember if they chose IVF but if they did (and I totally understand why people would choose that) they had to have understood the financial ramifications before starting down that road. 

Well, Jean, thanks for that. Very insightful.  I'm overweight.  I think you mentioned you are (maybe I'm wrong).  No shame.  There is overweight and then there is overweight.  Another bunny trail which really had no business being brought back up but that's ok.  She is severely overweight which landed her in early labor to begin with (according to her medical group - see, this is getting dicey because people aren't supposed to talk medical issues/health issues, according to some).  She isn't old but nearing 40 for a baby is getting on the older side.  Reading literature over the years regarding age and pregnancy might offer more insight to all issues pregnancy from full term to medical conditions of mother/baby, etc.  It's a known fact that fertility rates drop the older one becomes.

[sheryl]

8 minutes ago, Frances said:

Did I miss it? What was the resolution? Did your niece get it picked up from your house?

No, not yet.  They are still up north and will return home next week.  I have no clue as I did not spend the day at their house.  They may have made other arrangements.  IDK.

[Clarita]

14 hours ago, sheryl said:

What I don't understand is why do they carry 3 primary insurance policies?  One for husband, wife and baby.  Why not a group family plan?  They would reach deductible sooner, etc.  

Because it's not always cheaper to have a group family plan, especially if the insurance is part of a benefits package from work. When I was working it has never been worth it to be on the same insurance as my husband, even when I was on a high deductable plan.