A few days before Christmas, Amy Jay and her family packed up everything they owned and moved to Huntsville, Ala.

They'd been living in North Carolina where her husband Mac, an Army veteran, had a good job at a small software company. They lived near family. The couple had a young daughter and Amy was seven months pregnant with their second.

But her progesterone shots - necessary to keep her pregnancy viable after a series of miscarriages - had been $200 a month. Insurance wouldn't cover it, or the blood tests her doctor said were needed.

"The insurance my husband had (through his job) deemed it all unnecessary and wouldn't pay a penny of it," Jay said. "We quickly realized this wasn't going to be a sustainable situation."

After looking at supplemental and marketplace insurance - they missed the income cutoff to get Medicaid by about $70 - they realized the only way to get the insurance benefits they needed was for her husband to find a different job.

He found a tech job in Huntsville on Redstone Arsenal. It would mean a small pay cut, but the benefits were better. The new, better insurance wouldn't kick in until Feb. 1, about two weeks before the baby was due.

They signed up to retain her husband's old insurance under COBRA, a law that protects people during a lapse in coverage. That meant they would have coverage for about a month until the new insurance kicked in.

It also meant that a hospital in Alabama would be considered "out of network" under the old insurance.

"That told us we were going to be looking at a $20,000 hospital bill, but we figured we would just get that bill, set up a payment plan and do the best we could if the baby came early," said Amy Jay. They prayed the baby wouldn't come early.

But then she did. Baby Evelyn was born unexpectedly on Jan. 16, a month before her due date.

And two months later, the Jays received a bill in the mail - for $178,000.

'My stomach dropped'

Evelyn spent two weeks in the Neonatal Intensive Care Unit at Crestwood Medical Center, struggling to breathe with lungs that were underdeveloped.

"They were so sick and fragile that a fit of crying caused a collapsed lung," said Jay. "There were times we weren't sure she was going to make it. But I can't sing the praises enough of the hospital and staff and the doctors that treated her. They were loving and compassionate and treated us like family. But it was still the most horrible two weeks of our lives."

Before Evelyn's birth, Mac Jay had called the insurance company to make sure their baby would be covered under the old insurance plan until the new one kicked in.

But in mid-March, on Amy Jay's birthday, she went to the mailbox and found a bill for the entirety of Evelyn's birth and NICU stay: $178,389. Insurance had not paid any of it.

"My stomach dropped," said Jay. "My immediate reaction was there's been some mistake. Some coding or billing error, and all we needed to do is make phone calls and it will be fine."

Mac and Amy Jay with daughter Evelyn, who was born one month prematurely. The Jay family didn't realize they had to retroactively add Evelyn to their insurance plan and were left with a $178,000 hospital bill that their insurance refused to pay. (Photo by Brekke Johnson, Wagon Wheel Photo, www.wagonwheelphoto.com)

But after weeks of phone calls with the insurance company, the Jays were told the bill could not be covered because they'd never filled out paperwork after Evelyn was born to add her to the insurance plan. Jay said nobody had told them they'd have to add her to the plan after she was born.

They asked if they could add Evelyn to the plan at that time. They were told it had to have been done within 30 days of her birth; it was too late at that point.

Jay said they were completely unprepared for the complicated world of civilian insurance. "Our experience with our first child was when we were in the military," said Jay. "She was born on an Air Force base in Japan.

"To say that this has been a nightmare is a gross understatement."

Jay said their options were bleak: a payment plan they couldn't afford, or bankruptcy.

"Because of my husband's job, either of those options makes him a security risk and he loses his job," said Jay.

They looked into taking out personal loans, but were denied repeatedly, she said.

Jay took to Facebook, asking friends in a Facebook fitness group for advice or personal experiences from others who had gone through bankruptcy or overwhelming debt, and how they managed it.

Instead, she found a community ready for action.

"They basically said, 'we're not going to accept that your family has to face financial ruin because you had a sick baby,'" said Jay. Some of the women were journalists in other states who reached out to national news outlets. Sites like Babble and The Daily Mail picked up the Jays' story.

Amy Jay's best friend started a GoFundMe.com page to help raise money to cover the medical expenses. The hospital was willing to work with the Jays, forgiving some of the debt if they could pay the rest of it in one lump sum by the end of May.

Thanks to the work of friends, the Jays have surpassed their $25,000 goal on the GoFundMe. That will pay most of Evelyn's birth and NICU bills; the rest the Jays have been able to put on a payment plan that they think will not affect their credit.

"I'm so thankful and fortunate," said Jay. "The outpouring from this community and the online community who have read our story has been awe-inspiring.

"And yet I realize we are incredibly privileged. Our story has a voice, and I know there are people in my own neighborhood going through similar things with medical debt, and there's nobody amplifying their voice."

Fighting for change

Jay said the kindness of strangers has prompted her to take action.

"The system itself is the demon in this story," she said. "It's deliberately confusing and complicated.

Evelyn Jay was born a month early and struggled to breathe due to immature lungs. The Jay family didn't realize they had to retroactively add Evelyn to their insurance plan and were left with a $178,000 hospital bill that their insurance refused to pay. (Photo by Brekke Johnson, Wagon Wheel Photo, www.wagonwheelphoto.com)

"The system benefits very few on the backs of very many, and something has to change. I'm not a policy writer; I'm a stay-at-home mom. But what I am sure of is the current system, which capitalizes and commodifies healthcare, is not sustainable."

Jay hopes to get more involved in contacting legislators and working to get policies in place that could ease the burden on Americans who carry a heavy burden of medical debt.

"There are people who are going to read this article who owe millions in medical bills," she said. "Their two choices are bankruptcy and a payment plan that will never end. I want people to know that we see how blessed we really are, by other fighting on our behalf, and I'm going to personally fight on behalf of those going through the same situation."

*Updated 5/22/2017 at 11:38 a.m. to include more information on the hospital payment plan.