Pregnant with no insurance--tips? - Mothering Forums

Pregnant with no insurance--tips?

babycatcher12's Avatar babycatcher12 (TS)
09:44 PM Liked: 22
#1 of 21
08-06-2012 | Posts: 481
Joined: Dec 2009

So I just quit my job for a relocation for DH's job. We get insurance through August from my job, DH's new job doesn't offer insurance (he's a pastor) so we'll be buying it privately. No insurance company will insure me because I am already pregnant. Right now it's either find a way to fork out the cash for COBRA (which is $555 a month for just me or $1400 for our whole family) or self pay because private insurance companies consider pregnancy a pre-existing condition in Kansas and won't cover me. We don't qualify for medicaid because in Kansas they only count the father, mother and baby in utero for family size so the income requirements are much lower than if they considered our entire family size. My children would qualify for aid because they count the whole family size in that but not for pregnant women. Basically everyone I called today said they couldn't help me and there weren't other options. :(

 

Have you ever gone through a pregnancy with no insurance? How did you do it? I have a clotting disorder (which may or may not require heparin) and just experienced 2 second trimester losses which required induction and subsequent trips to the OR for retained placenta. If I hadn't just lost 2 babies I think I would be fine planning another homebirth and living without insurance this go round, but I'm a bit nervous after my recent history. 

 

Basically I'm looking for ideas, thoughts, advice or suggestions. Anything that will help me and not make me feel so hopeless. :)

 

--Erin


cryswilkins's Avatar cryswilkins
10:07 PM Liked: 14
#2 of 21
08-06-2012 | Posts: 287
Joined: Nov 2010
I thought it was illegal for them to count pregnancy as a pre-existing condition as long as there was no gap in coverage? I know that when I was pregnant with DD and DS my DH switched jobs and the only thing I had to do to keep coverage was to pay cobra for the time between when his old insurance stopped and new insurance started.

The first time we only paid the cobra for me for the three months and the second time we had it written into DHs offer that the new employer would pay the cobra so the whole family was covered.

I hope you can find a solution.
babycatcher12's Avatar babycatcher12 (TS)
10:13 PM Liked: 22
#3 of 21
08-06-2012 | Posts: 481
Joined: Dec 2009

I did too. I called the insurance commissioner today to ask. She told me that part of the healthcare law doesn't come into effect until 2014. Employers can't count it as a pre-existing condition, but apparently when you're buying it privately they can. Several insurance companies told me they couldn't even include me on the policy because I was pregnant. The insurance commissioner did say I could be part of the "high risk" pool which is insurance for people with pre-existing conditions, but that is over $1000/month for just me and it still has a deductible and copays. She said "you basically fall in that middle class gray area". 


DelawareMom's Avatar DelawareMom
06:27 AM Liked: 22
#4 of 21
08-07-2012 | Posts: 160
Joined: May 2008

I'm sorry you're having to deal with this. We reside in the same "middle-class gray area". I currently have no health insurance and am 31 wks pregnant. We were supposed to get on DH's employer's plan; it was taking longer than we thought; and then we're *surprise* pregnant! So DH and DD have insurance, but it just would have cost too much to add the pregnant lady, so we're using a midwife and doing self-pay and holding our breath that we don't have any complications. 

I wish I had some advice to offer, but I just wanted to let you know you definitely aren't alone in this situation. I hope someone has more concrete answers for you.


faithsstuff's Avatar faithsstuff
07:10 AM Liked: 20
#5 of 21
08-07-2012 | Posts: 537
Joined: Nov 2008

Ugh, I am so sorry!  Last time I was pregnant this happened, though we were in NY and qualified for state care.  Eventually dh got a full time job with benefits.  I wish you luck.


greenemami's Avatar greenemami
07:39 AM Liked: 23373
#6 of 21
08-07-2012 | Posts: 1,797
Joined: Nov 2007

I ended up pregnant with no insurance as well.  We used a midwife (home birth but through a birth center) and paid in cash on a payment plan, and then just crossed our fingers for no complications/hospital transfer.  It made my delivery pretty stressful-things were moving along slowly and there was talk of a transfer, which freaked me out as I had no idea how I would pay for that (obvously, I would have gone and figured it out if it were truly necessary, but I wasn't willing to transfer *only* for slow labor). 

 

I don't know if any other options for you, but I hope it works out! 


MamaBookworm's Avatar MamaBookworm
09:20 AM Liked: 19
#7 of 21
08-07-2012 | Posts: 122
Joined: Jul 2012

I discovered this too, when I was shopping around for individual insurance after I quit my job. My COBRA would have been 1,600 a month, which was way too much for us. The agents told me I was "uninsurable". Then I got fifty bazillion calls from these companies that sell "discount cards" - which are NOT insurance at all. You pay like 250 a month to get pre-negotiated rates at their network hospitals. Sounded a little scammy to me, and definitely not worth it.

 

I found sort of a loophole. My husband freelances and has an LLC to run the money through. Because we are both 50% partners in the LLC, I was able to find a company that does group plans for very small businesses. Group plans are currently prohibited from excluding pre-existing conditions. I found a high-deductible HSA plan. It's still a lot of out of pocket, but preventive care is covered 100%. Not sure what the laws are like in your state, I live in PA.

 

Good luck!


camprunner's Avatar camprunner
05:29 PM Liked: 36
#8 of 21
08-07-2012 | Posts: 1,596
Joined: Oct 2003

Insurance hasn't paid anything for my last two pregnancies.  In my state, they would not have insured my husband if I was pregnant either which pretty much meant no insurance for my entire family.

 

You might check out:

 

http://www.samaritanministries.org/

 

Because you are already pregnant they will only cover up to what you pay in towards your pregnancy but they will cover most other unrelated issues in full. We use them and have been impressed.
 


crystal_buffaloe's Avatar crystal_buffaloe
11:06 PM Liked: 34
#9 of 21
08-07-2012 | Posts: 820
Joined: Apr 2010
You can let the hospital know your situation and negotiate directly with them for labor/delivery costs -- if you speak directly with billing, they can sometimes give you an 'economic hardship' or 'uninsured' price. My BIL is a physician and he says that happens sometimes with people who are uninsured who have c-sections -- the hospital would rather recoup some of the money than just have the person declare bankruptcy.

I know of one CP (Family practice, who does see pregnant patients) in my town who does not accept/bill insurance, and thus has pretty reasonable rates for people paying out-of-pocket (that would be for prenatal appointments). There might be someone similar to that in your area.
chrisa's Avatar chrisa
10:52 AM Liked: 14
#10 of 21
08-08-2012 | Posts: 75
Joined: Oct 2011
Quote:
Originally Posted by babycatcher12 View Post

I did too. I called the insurance commissioner today to ask. She told me that part of the healthcare law doesn't come into effect until 2014. Employers can't count it as a pre-existing condition, but apparently when you're buying it privately they can. Several insurance companies told me they couldn't even include me on the policy because I was pregnant. The insurance commissioner did say I could be part of the "high risk" pool which is insurance for people with pre-existing conditions, but that is over $1000/month for just me and it still has a deductible and copays. She said "you basically fall in that middle class gray area". 

That's true.

 

I'm in a similar situation, and there's not way I would risk going uninsured. I had a 1 week hospital stay for PTL at 27 weeks, and the insurance was billed more than $30,000 for that. COBRA is well worth it.

 

I would say keep the COBRA - assuming you'll be near the end of your first trimester when your job insurance runs out, 6 or so COBRA payments you will make through the rest of the pregnancy won't be more than an inexpensive midwife would cost you for a completely healthy, uncomplicated pregnancy and birth, out-of-pocket. But you'll have the piece of mind knowing that if anything outside the realm of 'normal and ideal' happens, you're covered without impacting the financial well-being of your family. ER visits and hospital stays are bankrupting uninsured people.


MamaBookworm's Avatar MamaBookworm
11:13 AM Liked: 19
#11 of 21
08-08-2012 | Posts: 122
Joined: Jul 2012

I just had the supremely frustrating experience of trying to get some estimates for office visits, delivery, etc. I called the doctor's office, the hospital, the insurance company and the billing department for the midwives I see. Not one person could even tell me how much money one prenatal visit costs. Ballpark for an ultrasound? Couldn't even give me a range.

 

So, I guess I should just assume that I'm going to spend my full 5,000 deductible. 


MichelleZB's Avatar MichelleZB
11:32 AM Liked: 3529
#12 of 21
08-08-2012 | Posts: 1,018
Joined: Nov 2011

Reading this just makes me sick. Isn't it nice that Americans have the "choice" of their own health insurance? They don't have a fucking choice at all. Universal health coverage, people. Every man, woman, and child in the country should be covered. Vote for it like your lives depend on it.


babycatcher12's Avatar babycatcher12 (TS)
08:51 PM Liked: 22
#13 of 21
08-09-2012 | Posts: 481
Joined: Dec 2009

We're at the point though that it's either COBRA for me and no insurance for the rest of the family or insurance for them and none for me. If I didn't have a clotting disorder and just had 2 second trimester losses which involved induction and trips to the OR (costing more than 15,000), I would be totally fine paying out of pocket for a HB midwife. However, because of my recent history I'm a bit scared of that option. 

 

My insurance is out at the end of this month. So it would be 8 months of COBRA payments to just insure me at $555/mo. For my whole family it's $1400/mo. 

 

Camprunner we did look at samaritanministries, but weren't sure it would meet the needs we have in regards to my pregnancy. That and I was a little put out about how they cover babies (or don't cover babies) with genetic conditions or conditions diagnosed prior to birth. We had a baby with Turner syndrome and while she died, had she lived and needed surgery she wouldn't have been covered because her diagnosis would be a "pre existing condition". I like the philosophy of organizations like that, but found that rule to be a bit offensive. 


firespiritmelody's Avatar firespiritmelody
12:56 AM Liked: 38
#14 of 21
08-10-2012 | Posts: 1,339
Joined: Oct 2005
Quote:
Originally Posted by MichelleZB View Post

Reading this just makes me sick. Isn't it nice that Americans have the "choice" of their own health insurance? They don't have a fucking choice at all. Universal health coverage, people. Every man, woman, and child in the country should be covered. Vote for it like your lives depend on it.

 

 

Because our lives DO depend on it!!


MamaBookworm's Avatar MamaBookworm
08:14 AM Liked: 19
#15 of 21
08-10-2012 | Posts: 122
Joined: Jul 2012

Watch out for high deductible plans during pregnancy. I JUST discovered that I'll basically need to meet my deductible twice, once for this calendar year, and then since I'm not due until late January, it will reset and I'll have to start paying for the deductible all over again. 


erigeron
08:33 AM Liked: 5728
#16 of 21
08-10-2012 | Posts: 2,342
Joined: Oct 2010
Quote:
Originally Posted by babycatcher12 View Post

We're at the point though that it's either COBRA for me and no insurance for the rest of the family or insurance for them and none for me. If I didn't have a clotting disorder and just had 2 second trimester losses which involved induction and trips to the OR (costing more than 15,000), I would be totally fine paying out of pocket for a HB midwife. However, because of my recent history I'm a bit scared of that option. 

 

My insurance is out at the end of this month. So it would be 8 months of COBRA payments to just insure me at $555/mo. For my whole family it's $1400/mo. 

 

Camprunner we did look at samaritanministries, but weren't sure it would meet the needs we have in regards to my pregnancy. That and I was a little put out about how they cover babies (or don't cover babies) with genetic conditions or conditions diagnosed prior to birth. We had a baby with Turner syndrome and while she died, had she lived and needed surgery she wouldn't have been covered because her diagnosis would be a "pre existing condition". I like the philosophy of organizations like that, but found that rule to be a bit offensive. 


Yikes... what a Sophie's choice! Assuming your husband and kids are healthy, I'd probably pick the insurance for you because you are more medically vulnerable right now... that totally sucks. Would your kids qualify for Medicaid or SCHIP? In my church the church is required to cover the cost of insurance for the pastor. Our pastor was covered on his wife's plan for years, until she retired, and he was actually reimbursed the cost of the premium they paid for his portion of the coverage. Won't your DH's church help him with any options? Is there a plan that insures clergy?


chrisa's Avatar chrisa
09:15 AM Liked: 14
#17 of 21
08-10-2012 | Posts: 75
Joined: Oct 2011
Quote:
Originally Posted by babycatcher12 View Post

We're at the point though that it's either COBRA for me and no insurance for the rest of the family or insurance for them and none for me. If I didn't have a clotting disorder and just had 2 second trimester losses which involved induction and trips to the OR (costing more than 15,000), I would be totally fine paying out of pocket for a HB midwife. However, because of my recent history I'm a bit scared of that option. 

 

My insurance is out at the end of this month. So it would be 8 months of COBRA payments to just insure me at $555/mo. For my whole family it's $1400/mo. 

 

Camprunner we did look at samaritanministries, but weren't sure it would meet the needs we have in regards to my pregnancy. That and I was a little put out about how they cover babies (or don't cover babies) with genetic conditions or conditions diagnosed prior to birth. We had a baby with Turner syndrome and while she died, had she lived and needed surgery she wouldn't have been covered because her diagnosis would be a "pre existing condition". I like the philosophy of organizations like that, but found that rule to be a bit offensive. 

 

What if you keep COBRA only for you, and get a very basic, inexpensive, high-deductible private insurance plan for the family. If they don't have ongoing health issues, you can pick a policy that would be a safety net in case of medical emergencies/ accidents. Good luck!


Mulvah's Avatar Mulvah
12:31 PM Liked: 236
#18 of 21
08-10-2012 | Posts: 1,925
Joined: Aug 2008
Quote:
Originally Posted by babycatcher12 View Post

We're at the point though that it's either COBRA for me and no insurance for the rest of the family or insurance for them and none for me. If I didn't have a clotting disorder and just had 2 second trimester losses which involved induction and trips to the OR (costing more than 15,000), I would be totally fine paying out of pocket for a HB midwife. However, because of my recent history I'm a bit scared of that option. 

 

My insurance is out at the end of this month. So it would be 8 months of COBRA payments to just insure me at $555/mo. For my whole family it's $1400/mo. 

 

Camprunner we did look at samaritanministries, but weren't sure it would meet the needs we have in regards to my pregnancy. That and I was a little put out about how they cover babies (or don't cover babies) with genetic conditions or conditions diagnosed prior to birth. We had a baby with Turner syndrome and while she died, had she lived and needed surgery she wouldn't have been covered because her diagnosis would be a "pre existing condition". I like the philosophy of organizations like that, but found that rule to be a bit offensive. 

 

What is your deductible for your COBRA plan?  Did you have good insurance?  Personally, unless it were a $10,000+ deductible, I would pay for COBRA for yourself for 8 months.  $4400 is nothing compared to what you would pay if you were uninsured and something happened.  Given your history, specifically, I don't think you can afford to forgo insurance.


babycatcher12's Avatar babycatcher12 (TS)
08:56 PM Liked: 22
#19 of 21
08-11-2012 | Posts: 481
Joined: Dec 2009
Quote:
Originally Posted by erigeron View Post


Yikes... what a Sophie's choice! Assuming your husband and kids are healthy, I'd probably pick the insurance for you because you are more medically vulnerable right now... that totally sucks. Would your kids qualify for Medicaid or SCHIP? In my church the church is required to cover the cost of insurance for the pastor. Our pastor was covered on his wife's plan for years, until she retired, and he was actually reimbursed the cost of the premium they paid for his portion of the coverage. Won't your DH's church help him with any options? Is there a plan that insures clergy?

 They do give us an "allowance" as part of his salary for insurance, but they don't cover the whole premium. It would be beneficial to them though to do so because churches get back 50% of what they pay for healthcare for clergy at tax time. The church is fairly small and can't afford to do much more than what they're already doing. 

 

Quote:
Originally Posted by Mulvah View Post

 

What is your deductible for your COBRA plan?  Did you have good insurance?  Personally, unless it were a $10,000+ deductible, I would pay for COBRA for yourself for 8 months.  $4400 is nothing compared to what you would pay if you were uninsured and something happened.  Given your history, specifically, I don't think you can afford to forgo insurance.

 

You're absolutely right which is I think what we're going to do. It is good insurance and with the last 2 losses we only paid $1000 for my admission to the hospital. My husband and kids are healthy, so we're looking into a major medical policy until we can afford something else after the baby is born. 

 

Thank you all so much for your help. It is such a predicament and it's stupid that anyone has to be in this situation. Ugh!


SunnyB1978's Avatar SunnyB1978
12:37 PM Liked: 24
#20 of 21
09-04-2012 | Posts: 36
Joined: May 2006

I ended up finding a job as a teacher assistant for the last 3 months of school.  I paid out of pocket for all of the pregnancy expenses up until then, but the birth was covered over state employee's insurance, and there is no "pre-existing condition" clause for that.  And I agree with the previous poster who said to just pay COBRA for the remaining months of your pregnancy.  $550 for 8 months is certainly less than most people pay for pregnancy and birth, and if you end up with any complications, you'll really save money.


JudiAU's Avatar JudiAU
10:07 PM Liked: 1349
#21 of 21
09-04-2012 | Posts: 3,608
Joined: Jun 2008

I think with your medical history you must continue with the COBRA coverage for yourself. $500 or so a month is nothing, nothing! compared to a hospital birth with complications. 

 

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