Thursday 1 November 2018

Getting Your Baby an Alien Card (ARC) While They're in the NICU in Korea

NICUs in Korea are stressful enough with the majority of them only allowing you access to your baby for 20-30 minutes twice a day. Since you're a foreigner in Korea, you'll also have to worry about getting your baby a visa. You might also have to worry about getting them Korean health insurance. Below you can find out more about these two topics.

You Have 30 Days to get Korean Health Insurance
If you have Korean National Health Insurance you need to get your child an ARC within 30 days so that they are covered. For the first 30 days, they're under the mom's insurance.

You Have 90 Days to Get the Visa
If you don't have to worry about Korean health insurance, you still have to worry about the visa. You need to apply for the visa before 90 days or face a fine. Most immigration offices require you to make an appointment and there is usually a two week wait after that. If you can't make an appointment online, thanks to how horrible Korean websites are, you can go to the immigration office with the baby's passport and they will help you make an appointment.

First Things First
 The Littlest Peanut: NICU
Buy from Amazon
In order to get an ARC, you need to get your child's passport. Make sure you look at what documents you need way before the baby is born. Different countries have different requirements, however, I believe that all countries require the child to actually go to the embassy.

Of course, if your child is in the NICU, they can't leave in order to go to the embassy. They also might be there for a long time, so you can't risk waiting to get the passport.

A Simple Solution
There is a pretty simple solution and that is to bring the embassy to you. You will have to contact your embassy and ask about this. Most places are going to charge an extra fee for them to come to you and the further away you are, the more it is probably going to cost. However, it has to be done.

Once you get your child's passport, then you can get their ARC. Some countries take a long time to issue the passport. If that's the case, then you might be able to get the ARC with proof of having applied for the passport. Contact the immigration hotline on 1345 for more info.

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Monday 1 October 2018

Giving Birth on Base/Post in Korea if You're Non Command Sponsored (Non CSP)

Updated 12 September 2018

If you come to Korea non CSP (Command SPonsored), you can see by the CSP vs non CSP matrix that you don't have access to the same services as those families who come here command sponsored. Usually, if you come to Korea non CSP, you only have access to ER medical services; that means you can't get a regular appointment on base. This means that you can't even give birth on base. However, there are exceptions to the rule. Being pregnant is one of them. If you want to be seen for prenatal appointments on base and/or give birth at a military facility while in Korea, read on.

Get on Tricare Select*
Most bases/posts will have a waiting list to get on Tricare Prime. If you get on Prime, then you have the same medical services as a command sponsored family. However, don't get too excited. Some places have so many people on the waiting lists that they have closed the waiting list. Doesn't make sense to me since people are always coming and going, but that's military intelligence for you.

* Starting January 1, 2019 you will no longer be allowed to switch to Select due to pregnancy. What this means is that if you have Prime, you would need to do one of the following
  • Get a referral to get the birth you want.
  • Pay completely out of pocket (OOP).**
  • Switch during a QLE (qualifying life event, not pregnancy, but for example, a move).
  • Switch during the the annual late fall 90 day open enrollment period.
However, while being pregnant isn't a reason to switch, having a baby is a QLE. So you can switch back after the baby is born.

** Costs vary greatly if you decide to pay out of pocket. A midwife for a homebirth can be 3.5-8mil. A birthing center can be 3-15mil.

Get a Referral
Call Women's Health. Tell them that you're pregnant and they *should* help you get an appointment on base. If that doesn't work, walk into Women's Health and they will help you set up your first appointment. Currently, in Gyeonggi-do and Seoul, only the Brian Allgood Hospital aka the 121 at Yongsan is where you can give birth. You might be able to stork nest i.e. get Tricare to pay for lodging shortly before you give birth. Some other bases/posts may be able to take care of your prenatal care. It's best to ask since things are always changing.

On Base Care for Your Newborn
Your newborn will be able to be seen on base for the first 120 days. Check with the appointment line. Usually the pediatrician will reserve one day a week for appointments for non-CSP newborns. I think at Osan it was Thursday.

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Sunday 1 July 2018

What to Do If a Korean Hospital Refuses to Let You Leave

In order to leave a hospital in Korea, you will have to pay your bill in full either with cash, a debit card, or a credit card. I'm not exactly sure if that's legal since it would seem to me that they're demanding a ransom to let you go home. But just be warned that people have started GoFundMe accounts precisely for this reason.

Let's assume that you can and will pay in full but they still don't want to let you or your child leave. Let's also assume that you or your child don't have any medical issues and they're simply keeping you because of hospital protocol. If you or your child is legitimately sick and need to be in the hospital, don't expect any of the choices below to work. However, you have a few choices if everything is fine.

1. The easiest thing to do is to just stay. Wait until they discharge you and then go home. Some places don't want to discharge people on weekends since the accounting department isn't fully staffed. (It doesn't make sense to me either, they should just be able to plug numbers in). What they might do is tell you they will overcharge you and let you go home on the weekend and then you're supposed to come back on Monday and they will fix your bill.

2. Don't ask for permission to leave, instead, inform them that you're leaving. This is what I would ideally do. I remember asking if I could leave and was told no. The next day, first thing in the morning, I informed them that I was leaving that day. It took four hours, but they finally discharged us.

3. Make threats. I wouldn't resort to this unless absolutely necessary, but if you're fine and can pay and they're still refusing to let you leave, then tell them that you will call your embassy and tell them that they're holding you hostage. Full disclosure, I've never done this nor do I know anyone who has, but hopefully the threat will be enough. I would tell them you're contacting the embassy over the police, because honestly, I highly doubt the police would do anything.

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

Friday 1 June 2018

Tricare and Doulas

I talked about Tricare Overseas and home births a few months ago. Unfortunately, Tricare Overseas does not cover home births. Shame on them.

Tricare claims their "primary objectives are to optimize the delivery of health care services in the military's direct care system for all Military Health System (MHS) beneficiaries and attain the highest level of patient satisfaction through the delivery of a world-class health care benefit." How they do that by limiting the choices women to giving birth by not reimbursing women for overseas home births by a midwife is beyond me.

But let's not hold a grudge, let's talk about doulas. According to Tricare, they only cover medically necessary services. They specifically say they will not cover non-medical support during labor and delivery and mention doulas.
Sometimes Tricare Pays for Doulas
Even though Tricare says they don't reimburse for doulas, some women have had doulas covered. Most hospitals and clinics don't break down their bills into super small parts.

For example, while in the hospital, you probably interacted with a few nurses during your stay. However, when you get your bill, it's not likely that you'll be billed for each one. They often get lumped together. Or how about the secretary? You're not likely to see a fee on your bill for talking to her. Another example is your room. You are probably not billed individually for the water, electricity, or sheets that you use. There's probably just a room charge.

Some birthing facilities include doulas in their fees and when they send you their bill, the doula is simply included. Sometimes the doula may be a nurse as well, so it's understandable that Tricare would reimburse families for this fee, especially if they provide medical services during your labor and delivery. Sometimes they're not nurses and Tricare still ends up indirectly covering the cost.

HOW does this happen? Because it's included in the birthing fee.
Some places may even charge the same amount whether or not you use a doula. It's kind of like the room fee. If you take super long showers, you're going to be charged the same amount as someone who doesn't take a shower during their stay.

Bottom Line: Tricare Has Paid for Doulas
Depending on how your birthing facility breaks down their bill, Tricare may end up paying for your doula.

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

Tuesday 1 May 2018

Unassisted Births in Korea

First of all, unassisted births are legal in Korea. Babies come when they are ready. You cannot always control when or where that happens. There are two categories of unassisted births: planned and unplanned. I've know about a dozen people who have had unassisted births here.
  • Some were deliberately planned and others just happened. 
  • No one had any issues getting the proper paperwork for their baby. 
  • No one was investigated by Child Services. 
  • No one had any legal problems. 
I am no advocating for or against unassisted births. I'm simply explaining the facts of what happened.

Options Available
If you have an unassisted birth, you usually have a couple of options available. If it is not planned, then chances are you will either call the midwife (if you were planning on a home birth), the call the ambulance (119, they will transfer you to an English speaker), or go to the hospital or clinic.

Remember to keep mom and baby warm and do not cut the cord. I know that some people wait to go to the hospital, a few hours, maybe overnight. If that's the case, you need to research about cutting the cord or preserving it properly (like for a Lotus Birth) so that infection doesn't set it. It is very easy for infection to set it. The cord and placenta become a decaying organ and that's going straight to your baby's gut. Please do your research about what you should do. Here's one article and another which uses herbs and salt, and another which uses witch hazel, herbs, and salt

Paperwork and Tests Required
You and your baby will most likely have some tests done to prove that you are indeed the mother. I haven't heard of anyone needing any witnesses. The hospital will then issue you with a birth certificate. If you need to get your child a foreign passport, you're going to have to ask the embassy what you need. Do not ask me. Ask the embassy. They accept the forms, not me. You may also need to have any Korean documents translated either officially or unofficially. Some common requirements are:
  • Proof that you were pregnant (prenatal records such as ultrasounds, prescriptions, or receipts)
  • Your baby's birth certificate
  • Proof that you can pass on citizenship (ask the embassy)
  • Your ID and passport
  • A photo
  • Application form
  • Fee
  • Marriage certificate (if applicable)
  • Divorce certificates (if applicable)
  • Your partner's ID and passport (if applicable)
  • DNA tests (if applicable)
If you are planning an unassisted birth, please do so safely. There is a lot of information online as well as home birth kits and checklists of things as well as articles with useful info. I know that there are Facebook groups as well. Most are closed, some are secret. Ask around and I'm sure you can get added to them.

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