UPDATE No Maternity Insurance: Options? - Mothering Forums

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#1 of 24 Old 04-21-2004, 12:21 AM - Thread Starter
 
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OK, here's the deal . . .we have no maternity insurance at this time. (We do have health insurance.) I'm NOT pregnant, but considering TTC in the near future.

DH isn't comfortable with the homebirth route, which is OK by me, but what are my options? How do I approach a hospital to "set a rate" for me prior to becoming pregnant?

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#2 of 24 Old 04-21-2004, 12:45 AM
 
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If hubby isn't too cool with home birth, what about a birthing center instead? Much less evasive than a hospital setting, and much less expensive as well.

I seriously doubt you will get a hospital to give you a firm quote, but they can give you a rough estimate of delivery charges. My c-section was over 20k and my babies nursery bill was 3600 (not bad for her spending 6 hours total in there huh?)

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#3 of 24 Old 04-21-2004, 01:18 AM
 
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A freestanding birthing center birth with a cnm in Ohio runs about $2 or 3,000.00, including prenatal care, delivery and pp care.

HTH,
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#4 of 24 Old 04-21-2004, 02:10 AM - Thread Starter
 
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I'd love to go to a birthing center . . . but I don't know of any in Chicago . . . does anyone know of one or how to look for one?

TY so much for the replies!

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#5 of 24 Old 04-21-2004, 03:06 AM
 
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Oh, you're in Chicago!!!

There's a famous homebirth group of drs and midwives there, might be worth looking into, even if your dh is initially unsupportive of homebirth. The docs might make a difference for him (although that's what would scare me LOL.)

Can't remember the name of the group, I have it around here somewhere, if someone else doesn't come up with it first, which I'm sure they will...
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#6 of 24 Old 04-21-2004, 09:22 AM
 
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Our health insurance has no maternity benefits, either. I had to pay the same %copayment for each and every prenatal visit and for the birth. I called the insurance company to get the low-down on it all, and figured I would end up paying our out-of-pocket max long before it was all over with.

So why don't you call your insurance company?
If you pay a %, it may be much less expensive to have a homebirth, even if the midwives are out-of-network (as mine were), just because of how much less they charge than a hospital would.

My insurance wouldn't cover homebirth per se or prenatal visits unless they were at doc's office or midwife clinic. So I had my homebirth away from home, which technically counts as a freestanding birth center, and was covered by insurance as out-of-network provider. Regardless, I'd have gladly paid the full amount (and then some) in order to avoid going to the hospital to give birth again!
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#7 of 24 Old 04-21-2004, 09:39 AM
 
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I think its going to depend on where you live, but I got a bill from my doctor on her cost for a vaginal birth and for a csection. For prenatal fees, including one ultrasound at 20 weeks and her charge for attending your delivery: for a vaginal birth was $2800 and for a csection was $3600. The hospital charge for a vaginal delivery without an epidural was $1200. Nursery fees were just a few hundred dollars. My first csection cost for just the hospital were over $15000 and my second csection was a little over $8000.
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#8 of 24 Old 04-21-2004, 09:43 AM
 
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Maternity gets expensive fast if you have any complications at all. The tests, lab fees, office visits, delivery, nursery fees, even the damn witch hazel pads they give you after the birth. My pregnancies cost upwards of $100,000, but I had a severe complication in each one. Well, the same complication each time.

I would really work on your husband about the homebirth. With my last, I lived in one of the most expensive areas in the country and the going rate for the whole prenatal care and delivery was $3600. That was for everything, regardless of how many prenatals there were, etc.

Is there any chance you could be covered by Medicaid?
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#9 of 24 Old 04-21-2004, 09:56 AM
 
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depending on how much your insurer pays, I found that a small group insurance policy price was about the same as purchasing it yourself. Check with a local insurance agent (who proces several carriers) or get quotes yourself from web pages. our local Blue cross blue shield is very fast. The extra cost for a year of priovate insurnace will probably still be less than what you'd out of pocket.

In many cases, the most expensive complications are the baby, not you...so make sure your child we be covered from birth, not 30 days or after you file paperwork, blah blah.
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#10 of 24 Old 04-21-2004, 12:12 PM
 
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How much do you guys make a year? You don't have to answer that here, just in your head. Check out Social Services, they offer Medicaid just for pregnant women with no health insurance or maternity coverage. The guidelines are much less astringent than those for regular Medicaid. THey pay for everything from lab work, even epidurals (if you want one) and caesarean deliveries and baby care to your postpartum check up. In NC it will also work for the baby's first year of life no matter what, but I don't know about other states.

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#11 of 24 Old 04-21-2004, 12:46 PM - Thread Starter
 
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Mamas, you don't know how comforted I am by your replies. This issue has been haunting me for the last 8 months!

copslass, I've been doing Internet searches for midwives here in Chicago . . . I haven't yet (knowingly) found the group you're referring to.

stafl- I tried calling my insurance company (we use a broker because DH is considered to be self-employed). I got vague answers when I first asked, and haven't had my phone call returned since (I need to call again). I know I'd have to get my own policy to cover maternity.

Mothra and Gr8flmom-- Medicaid might be an option. DH has only contract jobs, so when he's working, he makes too much for us to qualify for assistance. However, when he's not working, the unemployment check-- even though he gets the max-- certainly qualifies us.

Clarity-- I've looked on the Internet for a company like you've described, and have found no info. Any tips for searches? I will call our broker again, too. I've found that many companies make you wait a year before TTC (and paying through that year).

Icequeen-- I've found no freestanding birth centers here in Chicago or anywhere nearby. Too bad, because I'd really like that!

Mothra and OntheFence-- those fees are what scare me. I had a relatively uncomplicated natural birth last time (no drugs, but I did hemorrage after the birth), but who can predict the future!!

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#12 of 24 Old 04-21-2004, 02:10 PM
 
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Wow, what the heck is the point of medical insurance if it doesn't cover birthing? What a crazy country this is!

I remember reading about that group, too. I'm positive it was an issue of Mothering...would have been some time in 2002. You can check their issue archives about it. It was basically an OB/midwife practice that came to YOUR house and delivered at home.

But don't people without medical care get covered by Medicaid? I mean, do people really pay for their pregnancies and births completely out of pocket? That's so insane to me!

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#13 of 24 Old 04-21-2004, 02:39 PM
 
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Yes Piglet, people who do not qualify for Medicaid pay for pregnancy out of pocket. I worked for an OB/GYN and saw it several times. It is also the employer or the person that buys the insurance policy that decides wether or not there is maternity coverage. And if you are a small business or just a person, there is a waiting list for the maternity waiver or it just raises the cost of the insurance to be to high.

Call your insurance company and ask what are your maternity benefits. Sometimes it isn't covered, but complications of pregnancy are, it just depends on the policy.
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#14 of 24 Old 04-21-2004, 03:05 PM
 
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I went through this too before we got pg with dd. I had insurance which didn't cover pg, I looked into adding maternity benefits. They wanted me to pay an extra $150 a month for maternity coverage but would only cover 50% of the costs if I got pg within a year, after 1 year they would cover 100% if my hospital and provider were 'in network". I didn't want to want to wait a whole year to get pg. We make too much to qualify for any assistance. I pre-paid for my birth, it worked out really well for us. I paid the MW before 32 weeks and received a 15% discount for pre-payment, her fee was 23 hundred for all prenatal, postpartum care and the birth. The hospital was 25 hundred for a natural birth with no complications, I received a 10% discount for pre-payment. I ended up paying a couple hundred more for my RH- status, but overall it wasn't too bad. My MW said that some women will pre pay for an epidural if they know they want one. We never bothered to get maternity insurance, I want a home birth with my ndext pg. Our basic insurance will cover a emergency C-Section.

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#15 of 24 Old 04-21-2004, 04:25 PM
 
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Mizelenius,

I've been researching the same issue (insurance, but no maternity benefit). It looks like you are in Chicago too. According to Illinois state law, insurance, with or w/o maternity benefit, MUST COVER COMPLICATIONS OF PREGNANCY. It almost seems like it would be a waste of money to get the benefit. For me it would be an extra $4000 a year. Take a look at your plan. After I found out about the law, I looked at mine and discovered that it is all written right there. It will cover medically necessary c-sections, which was our main concern. Since we have a family plan, a newborn would be covered immediately. I've been meaning to post about this too. Here is a link: http://www.ins.state.il.us/healthInsurance/matern.htm

there is a number to call--I would call it!

Also, when I was pregnant, one of the midwives I was seeing was charging 3500 for prenatal and birth. The doctor group people are talking about is Homefirst Health services. They have a website. I've heard they're really expensive. Do a search on MDC. I think there are lots of discussions about them. Good luck! I'm getting ready to do the same as you.
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#16 of 24 Old 04-21-2004, 04:41 PM
 
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here's where we have gotten quotes before:

http://www.bcbs.org to find your area

https://www.carefirst.com/eSales/index.jsp for mine

in our state cigna and aetna are pretty big too I think. See, for us it's a little different because in MD insurers are required by law to offer maternity, it's not legal to exclude. Not practical to move, I suppose. I had not figured on individual policies also excluding maternity. If you're TTC, I would get a policy and try to get a 6 month exclusion...and ask if you get pregnant in that time does coverage kick in at the end of the window even if you're already pregnant? Look for state resource for self-employed people or through any associations you might belong to, that's another path to insurance coverage. Here, there are windows like 4 times a year where large companies take individual policies for self-employed people. Ask you DH's work HR person for suggestions...they might know an independent agent or have another creative idea.

just saw - Katja's info looks really helpful! That would really limit the maximum amount you'd have to cover to routine stuff. be prepared for a lot of paperwork and written appeals, but if you're persistant, any unusual things should be taken care of that way.
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#17 of 24 Old 04-21-2004, 09:37 PM
 
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Elena,

Here is the link to the MM article:

http://www.mothering.com/11-0-0/html...retakers.shtml

Dr. Mayer Eisenstein (sp?) is a trip. We met him at the LLLI Conf. in Chicago a few yrs. back.

Have you talked w/dh about what exactly his fears are about hb? Has he seen the safety stats vs. hospital births for second time mamas??? Planned HB is actually much safer...but I digress......

Best wishes! Keep us updated

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#18 of 24 Old 04-22-2004, 06:30 PM
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When I had my dd I had no maternity coverage but health insurance like you. What we did was approach the hospital first. They offered basically 50% of their normal package for vaginal delivery if we paid in full before we had the baby. If we ended up having a c-section they would have added this on later but at a reduced rate also. With my midwife's office after paying ont ime for a year they reduced the cost of my office visits to be equal with what they would have received on average in reimbursement from my insurance company. I don't know if your providers would be amiable to this situation but it worked for us. I think I paid a total of $3000 for all services involved...

This was all on the advice of my aunt you works in hospital administration. The hospital came up with the offer mostly because this is about the same amount they would receive from an insurance company but they get it right away. HTH!!
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#19 of 24 Old 04-22-2004, 07:02 PM
 
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there is also an alternative birthing center in Oak Park attached to a hospital. west suburban hospital, I think?
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#20 of 24 Old 04-22-2004, 10:56 PM
 
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Many birth centers (besides being cheaper anyway) do offer a discount to uninsured clients. The one in my area (that just closed, unfortunately) was 10 percent.

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#21 of 24 Old 04-23-2004, 03:10 PM
 
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Are any of these places near Chicago?
http://www.birthpartners.com/search/...1&pro=1&id=439
Home Birth & Women's Health
400 E. 22nd St. Suite F
Lombard, IL 60148
http://www.birthpartners.com/search/...1&pro=1&id=540
Naturopathic Midwifery for Woman
38W103 Kristin Drive
Elgin, IL 60123

http://www.birthpartners.com/search/...=1&pro=1&id=78
HomeBorn Health, Inc.
5120 Rotary Road
Cherry Valley, IL 61016

I dont know, I could just look by State.......these websites might have some info for you also:

http://www.iffm.lovesbaby.com/
http://www.supportucmidwives.org/

Desiree

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#22 of 24 Old 04-28-2004, 08:53 AM - Thread Starter
 
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I just wanted to thank you all again for your suggestions, as they've given me hope!

I also happened to find that the university I've been attending off/on offers insurance very cheaply ($218 per semester!) that automatically covers maternity . . .something to look into, along with all the other helpful ideas you've given me!

Thank you again!

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#23 of 24 Old 05-01-2004, 10:12 PM - Thread Starter
 
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I just wanted to THANK YOU so much again, ladies! I have found a nearby hospital that has a set rate for people without insurance . . .I'll be working with a group of 5 midwives in a birthing center within the hospital. That way both DH and I will get our way (though he still wants a doctor . . .but he's giving in). The expense is about the same as separate maternity coverage. Not cheap, but not out of the question, either, especially since it will (hopefully!) result in a BABY!

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#24 of 24 Old 05-02-2004, 12:15 AM
 
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The hospital heres have set fees for prenatal care, prenatal lab work, ultrasounds and vaginal delivery. everything else is many dollars more. My midwife was kind enough to remove everything out of my room that was not included in the package rate and even offered to go to wal-mart and get me stuff if I needed it. Unfortunately things got crazy and out bill ended up totallying $25000 for misc. specialist, NICU care, all sorts of medication (ones I ddn't take even but hey they got them ready . . . ) Insane stuff. MAdeline is 7 1/2 and we still pay ovcer $300 a month for it. intrest was 1% incurring omnthly. we weren't even paying off the intrest each month so every month our bill went up by $100. That is what happens to the uninsured It was insane.

Our last baby was unisured until a month before the birth. thankfully they covered everything. she was boirn in Dec, we hit our deductable a day after benifits started (infection that loooked a lot like preterm labor) and they were gracious enough to extend that deductable period through the next year (so that we didn't have to start over again right after meeting it. Baby was due Dec 25 It had the potential to end up costing more thanpaying out of pocket). It is crazy stuff this incurance stuff. I can't imagine insurance not covering preganacy though. that is why we have insurance. we dropped it after our policy ended. It was almost $1000 a month. crazy stuff.

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