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Discussion Starter · #1 ·
Although we are not currently pregnant or TTC, I hope to be soon. I have never had a HB, but am seriously considering for #5. We currently have a high-deductible medical plan with maternity coverage ($3K deductible in-network, $6K deductible out-of-network, covered 100% after that), but we want to make some changes to our plan which may include raising our deductible, eliminating maternity coverage, or both. I am trying to figure out several things that might help us make some decisions about how to proceed.<br><br>
Just a few more details . . . We are in MO, so not MW friendly. There is at least one doctor who does HBs. We would qualify for Medicaid for pregnant women, but the HB doc is not in-network. I have no reason to believe I would need to transfer at this point. I have had 4 normal, low-risk pregnancies, with 4 uncomplicated vaginal deliveries to date.<br><br>
A couple of options I am considering:<br><ol style="list-style-type:decimal;"><li>If I could get an exception made for the HB doc to be covered as in-network, it might be worth keeping the maternity coverage and the lower deductible. That way, if I needed to transfer, additional expenses above his fee would kick the insurance into effect.<br><br></li>
<li>If we are likely to pay most of this out-of-pocket anyway, we could save quite a bit by cancelling the maternity coverage and raising our deductible. The thing that scares me about this is what it might cost if we had to transfer. So I got to thinking last night, could we use Medicaid as a safety net? I would enroll in Medicaid when the time comes, pay for our HB out of pocket and rely on Medicaid to cover any hospital expenses should we need to transfer.</li>
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So, who can help me think this through? What am I missing? Any other options I am not considering? Anyone else sign up for Medicaid as a safety-net?<br><br>
TIA!
 

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plan number 2 sounds like the best plan to me. is the HB doc covered by medicaid? if he is, medicaid should cover his services in or out of the hospital.
 

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Discussion Starter · #3 ·
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<div>Originally Posted by <strong>mbhf</strong> <a href="/community/forum/post/10807172"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">plan number 2 sounds like the best plan to me. is the HB doc covered by medicaid? if he is, medicaid should cover his services in or out of the hospital.</div>
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That's what I am leaning towards, if I can verify that I would be covered for a hospital transfer, even if I don't get prenatal care under Medicaid. Unfortunately, the HB doc is not covered by Medicaid. I am also going to call his office. Maybe they can give me some ideas and peace of mind as well.<br><br>
Thanks!
 

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Discussion Starter · #4 ·
Any other thoughts? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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I think the Medicaid-just-in-case-you-transfer plan is good. That's definitely crossed my mind several times.
 

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Discussion Starter · #6 ·
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<div>Originally Posted by <strong>notjustmamie</strong> <a href="/community/forum/post/10831565"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I think the Medicaid-just-in-case-you-transfer plan is good. That's definitely crossed my mind several times.</div>
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Thanks! The more I think about it, the more I'm thinking that's the route to go. We are considering raising our deductible (we used $0 of our deductible last year and are generally a pretty healthy family) and canceling the maternity. By doing both we will save just over $3K per year in premiums. We will then bank that money in our HSA and I will likely create a separate savings account that I can put some into in case we decide to go with a MW. Since I am in MO, I don't think I'd be able to pay a MW out of the HSA, unless the laws change b/n now and then.<br><br>
Thanks again for the input!
 

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in a similar situation, we decided to pay for HB out of pocket then use medicaid in case of transfer, and to pay for u/s if we decide to get one.
 

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Discussion Starter · #8 ·
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<div>Originally Posted by <strong>selena_ski</strong> <a href="/community/forum/post/10840431"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">in a similar situation, we decided to pay for HB out of pocket then use medicaid in case of transfer, and to pay for u/s if we decide to get one.</div>
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Congrats on the pregnancy! Thanks for posting about your plan. I was hoping for some confirmation that this sounds like a viable option. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love">
 

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I paid for my last birth out of pocket but used medicaid as a backup and for lab work (medicaid pd for prenatal lab work). If I had wanted an US, medicaid would have paid for that too.
 

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I know in TX that Medicaid covers home births as it has saved them thousands of dollars. Try checking with the Medicaid office.
 

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Discussion Starter · #11 ·
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<div>Originally Posted by <strong>mommyminer</strong> <a href="/community/forum/post/10844136"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I paid for my last birth out of pocket but used medicaid as a backup and for lab work (medicaid pd for prenatal lab work). If I had wanted an US, medicaid would have paid for that too.</div>
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Thanks! DH just asked if I had gotten any responses from anyone who had used medicaid as a backup, rather than just planned to in the future. I hadn't even thought about being able to cover lab work that way. Good to know! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"><br><br>
PS - Congrats on the LO due in June. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love">
 

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Discussion Starter · #12 ·
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<div>Originally Posted by <strong>natural&organicmom</strong> <a href="/community/forum/post/10845156"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I know in TX that Medicaid covers home births as it has saved them thousands of dollars. Try checking with the Medicaid office.</div>
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Unfortunately, I am in MO, one of the MW unfriendly states. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">: The only doctor I know of that does HBs is not on the provider list. Unless anyone knows how I can get really creative, I don't think that would fly here. But thanks for the suggestion. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up">
 

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Plan #2 sounds best and that is what we are doing right now also. Negotiating with an insurance company to accept and out of network doc as in network is impossibe...you're talking to a monster.<br><br>
We has insurance with our last HB and they reimbursed us 40% of HB cost, we had a $500 ded but paid out the butt for our coverage.<br><br>
Now we have no maternity and can't get it anyway so we are just paying out of pocket. As far as medicaid goes, they go retroactive for 3 months so you actually don't even have to go through all the paperwork. Just wait for your birth...have the baby...you'll do great and if a transport does take place you can go in 2-3 months and apply then.
 

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Discussion Starter · #14 ·
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<div>Originally Posted by <strong>iluvmyfamily</strong> <a href="/community/forum/post/10853269"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Plan #2 sounds best and that is what we are doing right now also. Negotiating with an insurance company to accept and out of network doc as in network is impossibe...you're talking to a monster.<br><br>
We has insurance with our last HB and they reimbursed us 40% of HB cost, we had a $500 ded but paid out the butt for our coverage.<br><br>
Now we have no maternity and can't get it anyway so we are just paying out of pocket. As far as medicaid goes, they go retroactive for 3 months so you actually don't even have to go through all the paperwork. Just wait for your birth...have the baby...you'll do great and if a transport does take place you can go in 2-3 months and apply then.</div>
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Thanks! We just faxed the form to cancel the maternity this morning. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin"> We also raised our deductible, and the changes will save us $3K a year in premiums. Individual coverage is sooooo expensive.<br><br>
Good to know on the medicaid. So basically, if everything goes smoothly and we don't need to transfer, we never even need to apply, unless we want to use the medicaid for testing (which I'm not sure we'll even do anyway). Sounds easy!
 
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