Pregnant with no maternity coverage. Questions.

[mommy2bnc]

Does anyone have experience with this?  I just found out yesterday that I'm pregnant.  We have a BCBS individual health insurance plan, which does not have maternity coverage.  I was laid off from my job last month, so I am hoping that DH and I can get on his group health insurance plan at his job since my layoff will hopefully be a "qualifying life event".  If that's the case, does anyone know if my pregnancy will be covered?  I called BCBS today and the lady said that pregnancy is NOT recognized as a pre-existing condition, but I thought that I kept reading everywhere that pregnancy IS considered a pre-existing condition.  I'm so confused. I really want to make my first prenatal appt, but have to figure all of this out first.  Anyone been through this that can shed some light?   Or maybe we should just pay out of pocket since it might only be a little more money by the time we would pay a $3,500 deductible and $3,000 co-insurance?  I would get a discounted pay out of pocket discount of $2,700 for prenatal care at my OBGYN, but not yet sure about hospital costs.  How much is blood work each time out of pocket for most places?

[RosieL]

You could consider going the MW route, which is usually much cheaper.

Also, why not wait to make the appointment? If you're reasonably sure about dating (i.e. you know your LMP or ovulation date), there isn't a lot of compelling evidence that you need to be seen very soon. My first appointment, even through I contacted my MW immediately upon testing positive, isn't until 11.5 weeks. 

Good luck getting on your DH's insurance. The insurance game isn't fun. Whichever route you go with prenatal care, you're gonna wanna get on his plan asap. 

[Autumn Breeze]

Have you thought about homebirth, if you're paying out of pocket, you might get better care than you would from out of pocket through an OB and hospital. And if you do choose to go with an OB, you can research the prenatal tests to see what you feel is necessary and what tests you can opt out of.

[Adaline'sMama]

From what I understand, pregnancy is not a preexisting condition anymore.

I second not going to the doctor until you are a little further along. Is this your first?

Its not any of my business, but if you are out of work, and you DO have another kid, and your DH isnt bringing home a huge amount of money, its likely that you would qualify for Medicaid. Feel free to PM me for more details about that.

[mommy2bnc]

Thanks ladies.  I was thinking of a homebirth, but DH is not comfortable with the idea no matter how much I've told him about it in the past.  Plus, I personally feel more comfortable getting the ultrasounds and being in the hospital setting after all that we have been through with DD having had (and BEAT!!!!) cancer last year.  I want as much screening as possible just because I'm sure I'll be paranoid throughout this pregnancy.

[bignerpie]

Group insurance at your DH's work should cover your pregnancy. It's usually considered a pre-existing condition when you are applying for individual health coverage.

FWIW, what I paid for my first with insurance is more than what I'm paying for my second without insurance. First time, I owed about $4500 out of pocket, and this time, I'm paying about $3500 without the monthly cost of insurance. (My first was a hospital c-section, and this one is a homebirth with a CPM).

I still have to get my blood work done, but I was quoted $140 without insurance. My 20 week ultrasound was just under $400. 

[Mulvah]

Yes, if you can get onto your husband's insurance, it will be covered provided his group insurance covers pregnancy (which it very likely does).

[Flor]

What others have said-- if you were trying to buy insurance yourself on the individual market, it would be a pre-exisiting condition (actually even my husband could not get insurance recently because I was pregnant-- no expentant PARENTS could even apply), but under group insurance at work it is not a pre-exisiting condition.

[mommy2bnc]

Update.  We gave DH's HR person everything they needed and we're going to be able to get on his insurance!  Yay!  Who knew me getting laid off last month would be such a blessing (since it qualifies as a life event so we can add on now instead of waiting for open enrollment).  I feel so relieved now.  DH is still in shock, and probably denial about this pregnancy, but at least now financially we'll be a little more prepared for a second child.

[lizsky]

Quote:

Originally Posted by mommy2bnc 

Update.  We gave DH's HR person everything they needed and we're going to be able to get on his insurance!  Yay!  Who knew me getting laid off last month would be such a blessing (since it qualifies as a life event so we can add on now instead of waiting for open enrollment).  I feel so relieved now.  DH is still in shock, and probably denial about this pregnancy, but at least now financially we'll be a little more prepared for a second child.

Great news!  I'm glad this will work out for you!  I also agree with PP, that there is no need to rush a 1st appointment unless you have serious worries about the pregnancy.  Plenty of women don't even realize that they are pregnant until they are towards the end of their 1st trimester.  With my 1st I had my 1st appointment at 12 weeks.  Seems like it would be easier to wait to be fully covered by your DHs plan for that 1st appointment than to deal with the extra headaches of an uncovered appointment.

[erigeron]

You might also check with the provider and plan you plan to use and see if it matters if you are uninsured now but are about to get insured. I saw two different providers for prenatal care (disliked the first one and switched) and at both offices they billed the insurance in a block for all prenatal visits. So after the baby was born I paid my share of the block at the office I ended up at. (I guess the other office just had to eat the cost of 3 prenatal visits, but they were pissy to me, so I don't really care.) I wasn't charged a separate copay at each appointment. it makes sense when you consider that some women will have more prenatal appointments than others just because something comes up, they go into labor a week or two earlier or later, etc. The office is billing for all care they've provided at once.

[Flor]

My first OB wouldn't even see anyone until they were 12 weeks.

[1love4ever]

Great, glad you got insurance!  And you can still have the ultrasounds and all the tests and everything with a midwife.  I am currently getting half my prenatal care from a midwife and half from a Dr.  I have refused almost every test, but all the tests have been offered to me by both the MW and Dr.  And you could have the birth in a birthing center or even a hospital with a MW as well.  You should have DH watch The Business of Being Born on youtube, its 1hr and 20min and its free to watch.  The book Ina Mays Guide to Childbirth is amazing, I wish I would have read it with my last pregnancy, and DH read it this time around as well and really liked it.

Also was going to tell you that many/most, if not all hospitals offer financial aid, even if you have insurance.  For example, with my last birth which was in a hospital, I still owed over $2000 after my insurance paid, so I applied for financial aid, and I got all of my care paid for by the hospital because we had such a low income and few assets.  They base qualification on your income, number of dependants, etc.  Just ask the front desk for a financial aid application, or ask where the financial aid dept is.