Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Know anything about med insurance?
OK, as many of you know, we're about 6 1/2 weeks preg. It wasn't expected, but it's a totally welcome surprise that we are extremely excited about. Bad news? I don't have insurance.
While we had planned on getting married in the spring sometime (before baby news), we decided we want to go ahead and move it up to this fall. We have always said we just want a JP thing (or a quickie in Vegas) because we both have already had the big wedding and don't feel like we need to spend (waste) the money this time around, so it's not like any dreams were dashed or anything.
SO has called his insurance company and several other private ones (his firm does not provide insurance) and found out that many do NOT provide maternity coverage anymore. Something about the new insurance laws. In fact, most maternity care is only available if you have a group plan through your employer, according to the people he's talked to. They told him that if you have private insurance and get preg they will drop maternity coverage in individual plans, but WILL reinstate it once the pregnancy is over. How do you have a child without insurance? Can you take out a loan for this stuff? (I'm only half joking!)
WHAT DO I DO???? Our primary concern is the baby!
Re: Know anything about med insurance?
I'm pretty sure that no private insurance is going to cover you or SO since you are already pregnant. When I was pregnant the first time, DH was looking to switch and was denied because I was pregnant.... something about by law, the company is required to then cover the newborn and a newborn is too risky to cover since you never know what might happen.
And yeah, maternity coverage on a private policy is pretty much non-existent.
As for how to pay for it, lots of people do it. Maybe one of the girls that has delivered without insurance can fill you in on the expenses.
Work with your doctors and the hospital, tell them your situation, setup a payment plan, etc. Make sure your doctor understands that you don't want unnecessary tests and that you are paying everything out of pocket. Some doctors give a discount if you arent filing insurance.
Good Luck.
You can apply for medicaid...(?...I think that is the one). You should qualify because you have no insurance and no access to maternity insurance at this point. You will probably have to call them or go to one of their offices because if you just look at the qualifications online, it will look like you don't qualify but, again from what I've *heard*, you should qualify for maternity coverage.
I know someone whose husband made a lot of money but because they didn't have access to insurance she was able to get medicaid for her pregnancy.
That is infuriating.
So Tasty, So Yummy
Right?!?!?
I don't even know what else to say.
Here is a link with lots of helpful info and links...
http://www.healthinsurance-help.com/maternity-health-insurance-texas.html
We are looking at that problem too (not pregnant, just trying to figure out if we are going to get medical insurance). My fiancee is an insurance agent, so he was aware of all of that.
I don't know how comfortable you would be with this, but there are a lot of good midwives in the Houston area. They are all safe and cautious, and would take you to the hospital if something were to go wrong, but, barring complications, they are only about $4000. The tricky thing is, if something goes wrong, then what? So depending on your health and if you have had an earlier, uncomplicated pregnancy, it may be the way to go. That's sort of what we are planning if we are blessed with a surprise shortly after our marriage, since I know some of them and am involved in the alternative medicine field.
I work mostly with group insurance, not individual, but I'm pretty sure you would get denied coverage anyway since you are already pregnant, but don't quote me on that. You won't get maternity coverage through private insurance.
Does your SO have group insurance through his Employer (or do you?) Once you are married, you can come on to the group and the pregnancy will be covered if they have maternity since it is not able to be excluded as a pre-existing condition.
ETA: Duh, sorry - you already answered the question about his Employer and Insurance.
Best of luck to you finding a solution!
Collin Thayne 10.11.2010
my friend was in this situation and lived in league city-- she ended up delivering at UTMB in galveston, and they had some sort of maternity program you could enroll in. you did monthly payments, and had to fulfill certain requirements (go to certain classes).
i'll ask her what it was (i don't know if it was medicaid) and get back to you.
my photography blog
appalling. damn loopholes.
I know. I was like "why is she getting medicaid?" and that's how I found out from others that it's not entirely income based when it comes to maternity coverage.
It is not income based when it comes to pregnant people. When I had Micaela, my mom could no longer cover me and my minimum wage job didn't offer insurance until you were there over a year (in fast food). I ended up getting Medicaid.... I was denied at first because I had a brand new car (my grandpa bought me a car after my first one was totaled in a wreck and paid cash for it so I had a reliable car to drive to and from school in) that I could "sell for money." I appealed their decision based on the fact that even if I DID sell the car, I still wouldn't have insurance. They covered me and they covered M until she was 1 year old. Granted, I didn't make a lot of money so it's not quite the same situation, but for maternity coverage income is not a factor.
I finally got to talk to someone helpful with the Medicaid enrollment office. It has been a very frustrating couple of days with little-to-no answers. SO's private insurance for sure won't cover me, and other private ins just for myself won't either. I'm fine not having insurance for myself right now (I hate going to the doctor), but throw a baby in the mix and that is unacceptable.
The nice helpful lady I finally talked to said that because SO's (or by that time DH's) insurance won't cover me, nor will other private insurance, the case worker (that I won't get until I am approved for medicaid in 15-45 days) will take that in to consideration about continuing my benefits throughout the preg. She did give me the direct number to the Health office in Tomball, but I'm not sure I should call them about this until everything goes through. So I think we'll start with medicaid, talk to the case worker before getting married, and go from there.
I think maternity coverage should be required by everyone. I realize that includes the druggies and people who have kids just to stay on welfare, but if these kids are going to be born they need the best start possible. I think private insurance companies are the devil to deny maternity coverage, especially to PRE-EXISTING CUSTOMERS since now-a-days so many small businesses, etc. do not provide insurance to their employees. (Please don't hate me for saying that. I'm frustrated.)
but maternity coverage doesnt do much for the baby itself... you can still have adequate prenatal care without insurance. all of the baby's expenses after birth are billed separately of yours.
I was on group so we put DS on my insurance but that would have been the case whether I'd had maternity insurance or not... we could have just as easily have added him to DH's private insurance too, it was just more expensive at the time.
i think, by law, your SO's private insurance is required to cover his child... you have 30 days to add him/her after birth and he/she is covered starting the date of birth. that is the way we understood it when we had baby #1
So Tasty, So Yummy
i can understand the whole "but you aren't indigent" argument... but for someone who works, pays taxes, etc. and is in need of some help, i don't have a huge problem with this. it's one thing if you have a normal birth, but what if something happens and there are complications?
i also think it's somewhat assuming to say that because the baby's father is an attorney, they should automatically be able to pay everything out of pocket (you really never know what's going on with other people's finances). i'd say it's pretty responsible to have some sort of assistance when there are a LOT of questions. i don't want to sit here and list out all the worst case scenarios, but there are plenty of things that could happen to make the situation very different. being prepared is the best plan.
my photography blog
So Tasty, So Yummy
I completely agree. There are way too many risks involved in child birth that could bankrupt someone that doesn't have insurance. Sure we all hope and pray for the best case scenario but you just never know.
If I've been paying into a system, then I fully expect to be able to use that system if I need it, regardless of my ability to pay for a normal/best case scenario pregnancy/birth.