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I can't get maternity coverage

post #1 of 9
Thread Starter 
I have an individual policy and was told when I signed up two years ago that when I was ready to have a baby that I would need to add a maternity rider for 6 months before a pregnancy would be covered. I discovered I had thyroid cancer a year ago and have no thyroid now. I called to add the maternity rider and was told that I could not have it. The only way to add it would be to underwrite a new policy and any thyroid or cancer issues would be considered preexisting. My dh is in grad school and has his own individual policy. He is getting a masters in teaching but will not be done until Nov. Who knows if he will get a full time position then with a group policy(maternity would not be considered preexisting then) We are planning TTC this summer. We would like a homebirth. Our ds was induced two weeks early because of toxemia and delivered in a hospital with pitosin and epidural. I am concered because of that and needing bloodwork every month during a pregnancy to keep track of thyroid levels that we would not be able to financally pull it off. (each blood test costs$150) I do not want a company to dictate when I have a child. My ds is already three and I would not have waited this long ttc except for the tyroid issues. Does anyone have any experience with these type of things?
post #2 of 9
I don't know what they have in other states, but if you were in California there is a program called babycal that covers moms who are pregnant, and their children afterwards. Its called Baby-Cal. Maybe you can find something like that where you are? Then you could just keep your original insurance until you get pregnant (and maybe continue to keep it if you get on one of those programs, I'm not sure if they can find that out or not.... so you can have your thyroid problem not considered pre-existing by cancelling your insurance and re-instating it after baby) and have full coverage thru your pregnancy?

Its just a thought, and I hope that you can get the situation ironed out. I'd also suggest trying to speak to other people with your insurance, I've found in the past that what one person say is "impossible" can *sometimes* be doable with the right person who is helpful.

Oh also maybe you could find a job that you could get group coverage at? I'm not sure of your job situation, so that might not be an idea that would work for you at all either...

I wish you LOTS of luck getting it worked out! I had some insurance issues when I first found out I was pregnant, but those were ironed out (it was my Dh's work who was at fault), so I can commerserate with you about the worry it causes (even pre TTC)...
post #3 of 9
Oh man, that's tough.... where in Virginia are you? I had a great homebirth in Va Beach and could give you some ideas for care in that direction. Just a few ideas.... does your Ins Co have any provision for review? Maybe you could get the refusal of a pregnancy rider overturned. Sometimes basic policy is to say no at first, but that it ain't worth it in the long run. Another possibility is a dumb, deadend job for you or DH just to get into group coverage. I think Wallyworld and Target offer Ins. pretty quickly even to part-timers if you will pay. It wouldn't be cheap but even their Cobra rates might be less than your individual coverage and it could be an endrun around the whole pre-existing thing.
post #4 of 9
Every state is different, but I've been trying to get insurance in CT or MA--I am actually pregnant and overseas, but moving back to the US in two months. At first I was told that I simply *cannot* get a policy in CT as an individual. Then I found a broker who said that as long as I (or dh) call myself a business (I work freelance and dh will be exploring that route while looking for a job) and pay $100 to the CT small business fund, we can get insurance through a group policy, which in the state of CT cannot deny someone on the basis of preexisting condition. I have no idea what the laws are like in VA, but it might be worth seeing if you might be eligible for any sort of group policy (assuming they offer greater protection). In the case of small business, I was told that we don't need to have made any money and that we're eligible from the planning stage as long as we join the small business association. The cost of insurance the is also lower than individual policies. We're getting our policy in dh's name, and he, as I said, currently has no business. We called about 15 different agencies and the state insurance organization before we found this option.

MA is a little better philosophically-- insurance companies there are legally obligated to cover anyone, and some of the companies have no waiting period. Of course, you pay for it...an individual policy there would cost me $371 a month, and a family policy runs over $1000 a month.

(I'm planning a home birth, too, but don't want to be without insurance in case of emergency.)

Good luck to you, and let us know how it goes.
post #5 of 9
Thread Starter 
Thanks for the ideas and support everyone. Kama'aina mama I am in Richmond. Getting a job is not an option. I just quit working as a hairstylist and I am staying at home with my ds and gearing up to care for two other children out of my house. I had to quit working because of babysitting problems. I had wanted to be at home from the beginning but we could not afford it. I still have to generate and income out of the house . I will check into the provisions for review. I know it will all work out. I believe that everything happens for a reason and at the right time but I need to deal with this and not just leave it up to the universe.
post #6 of 9
Hi there -- Insurance while pg or ttc is a pain! My suggestion would be to call your state Department of Health and ask them about Medicaid-type programs. The Federal gov't diburses monies through the ChIP program (stands for child, infant, something....) and each state then has there own program name and rules, but most provide coverage for "unborn children" aka pregnant women, through this program. If you get WIC, the people there ought to be able to give you info, also. Good Luck!
post #7 of 9
Could you just get a midwife and plan a homebirth? Continuing to see a doctor for your thyroid doesn't mean you have to see one for the pg, too (though the doctor treating you for thyroid should know you're pregnant, of course). The two are separate issues, and as long as your thyroid levels are kept in the normal range, it shouldn't affect the pregnancy (I myself have an underactive thyroid and have been taking synthroid since I was 11).
The $150 price tag on getting your thyroid levels tested sounds like bs to me, btw. How much of that does your insurance cover, how much is actual lab fee, and how much is the doctor charging you for his time? If you're getting it checked monthly, it shouldn't be necessary to charge you for an office visit as well unless the results are too low or high and you need to see him to adjust your medication.
post #8 of 9
Thread Starter 
Ravin- we do want a homebirth but would feel better about having insurance in case I had to transport to the hospital. I have to pay $1500 out of pocket before my insurance kicks in then it pays 50% until I have paid $3000 then it starts to cover everything. I get the blood test bill from the lab. The Dr charges for the visit seperatly. I am going to see if I go streight to the lab if it will be cheaper. My OB office midwife told me I would need a blood test every month to moniter the thyroid levels. Do you know anything about that?
Gus'smama I will check with the Dept. of Health. Thanks.
I feel like I am getting ahead of myself a bit because I am not TTC yet but I need to have it all streight before so that I have as little stress during the pregnancy as possible. We feel right about having another baby and having a homebirth but when my dh's parents find out they are going to have a fit! My parents will stay more calm and positive but I know they will not be to happy about it either. It is not there choice of course but I think having this stuff all worked out beforehand will allow me to be up for all the critisizm (I can't spell) and questions
I will keep you all updated
post #9 of 9
Since you had your thyroid completely removed, monthly checks during pregnancy are a really good idea. Your doctor was right about that. I can certainly understand wanting insurance in case something goes wrong. The best thing I can tell you is read your policy very carefully w/ respect to adding maternity coverage. Adding it on shouldn't require another policy!

Another thing you can do is build up your own insurance by putting money in savings. You'd have to pay more per month for the insurance anyway. Of course, it's a bit late in the game for that strategy in this pg for you.
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