Friend Pregnant W/ No Maternity Coverage on insurance...what Can She Do?

I used to be in HR although she will be considered per-existing condition, the baby wont when he/she is born so when open enrollment comes, she needs to sign on. Also, the Medicaid program has various levels of coverage. The health department is an option - not necessarily a good one but none the less, it's free and she needs to get her prenatals. Until she gets to the Dr. she needs to start a children's multi vitamin at the least! She could contact a midwife, they are usually more understanding about affording health care. My husband works at a hospital and when the baby is born she can call for an application for financial assistance. Most hospitals have some program.

You've gotten a lot of good responses, but I thought I'd just throw this out there... First of all, they don't consider pregnancy a pre-existing condition (at least most don't). I switched jobs when I was pregnant & I changed insurance no problem (I did call the insurance companie they offered prior to accepting the job). Did they say why there was a 230 day waiting period? Has she looked into changing insurance companies all together? Ok, and then I know you said she was single, but if it's an option... does the baby's father have insurance? She could be added to his insurance. Or she could look for a new job, I know that's never fun, but it is a possibility.

I assume your friend is a resident of Nebraska.

The Kid's Connection program by the Nebraska Department of
Health and Human Services is what she needs to look into. This program covers pregnant moms /unborn baby, not just children. Call ###-###-#### to ask about this program. There is an income guideline for this program. The unborn baby is convered as One Child when you read the chart. You can find out the income guideline on their website http://www.hhs.state.ne.us/med/kidsconx.htm.
Even though the site doesn't mention covering pregnant moms, it DOES.

I was in this program when I was pregnant without medical insurance. The program paid for everything from check-ups to delivery. I didn't have to pay a penny.

My kids are still covered by this program as their sole medical insurance. It is great.

Everyone has their own hospital they want to go to, but Alegent hospitals do a good job of making sure your cost is only what you can afford. Bergan Mercy has the lowest rates for delivery and includes the epidural (anesthesiologist is extra though, because he's independent. same everywhere.). Also, most prepay plans are for a two day stay and will refund you half if you only stay one day. Hope this helps.

i fund my own insurance because I am self employed. And in researching what I need..when you go that way, most insurance companies won't add it once you're already pregnant because it's a pre-existing condition and they don't have to cover those. Her best bet is to check with her or her husband's employer because being it's a group plan they may have already jumped through most of the hoops. But they may say the same---pre-existing condition. We considered dropping maternity after our 2nd, but after checking several companies we left it on for that just in case of one of those oops times. Because if you don't have it, and are pregnant and try to add it/apply many places call it a pre-existing condition because you were pregnant already when you attempted to add/apply. There may be some places that don't, but my uncle works in insurance and said that those places are few and far between.

The office visits generally aren't too bad to pay out of pocket. the most is the hospital stay and if she chooses drugs. The epideral being the most expensive. I never had that, just the analgesic with my first and none with my 2nd and the the 2nd's bill was about 1500 less. yes, that was after insurance, but you can kind of guess how much it would be with kind of a difference.

I had the same issue. About 1 month before I was due my company got group insurance. With group they could not exclude my pregancy and there were no waiting periods. They paid maternity for me. But in Wyoming if you get indepentant insurance coverage they can give you that oh so long waiting period and it is super expensive. I also got some Aflac policies a month or so after I got pregnant. It paid about $1700 back to me when I had my son which helped cover my deductable. Hope it helps. I remember that struggle!

I agree with Jacque B, pregnancy is not considered a pre-existing condition. When I became pregnant with my first, I was in the process of getting insurance. I found a loop-hole (which your friend will have to do) and signed up for insurance through my parents company and then cancelled it in order to start the insurance program through the company I was working for, (I think it's called change of status). I made absolutely certain that pregnancy was not considered a pre-existing condition with my employer and the insurance company before switching.

Perhaps she should look into switching insurance companies; it's atleast worth a try.

Good luck to your friend!

I am guessing her due date is in January. She should have an open enrollment period in October or November where she can change her insurance plan. She will want to talk to her employer to see what options she has. Most Major Medical insurance plans cover maternity costs therefore, her situation is few and far between. I am guessing her employer chose to have a maternity rider if needed added to their policies. If she has a flexible spending account that she can utilize or start putting money into when open enrollment occurs that will help with the medical bills.
Good luck!
D.

i wouldn't use the maternity card. i almost used them, but found out they don't pay what they say they will, and they don't actually forgive the rest of the bill, even when you pay what they tell you to.

There are 3 clinics that I know of that take people on a sliding scale. One is on 24th and Lake(Creighton), another on S 36th St between L and Q (UNMC) and the other is the Renaissance Clinic (Methodist)in The Salvation Army building on Cummings and 36th.
I used to go the the Renaissance Clinic before I had insurance. Eva is a nurse practitioner and is really sweet. I don't know if she does OB, but they have pregnate girls living there, so I would guess that she does.

From what I know about it, major medical will not cover the pregnancy office visits, but it will cover any complications related to the pregnancy or delivery. The 230 waiting period applies to before she gets pregnant I think and since that is almost the same length as a pregnancy and she is already pregnant, it won't work for her. The only way for her to be covered by insurance now since she is already pregnant is to be accepted by a group policy through her or her husband's work. Even individual policies will require a waiting period and may consider pregnancy a pre-existing condition.
The only thing I can see right now for her to do is pay the doctor fee. She will have to pay up front; when this happened to me, my doctor expected a check for $3,500 on the day of my first appointment. From the way I understand major medical insurance plans, office visits for anything are not covered, but hospital stays should be covered after the deductible is met.
This will be very expensive for her but she can get through.

You can go to the Nebraska health and human services website which is www.hhs.state.ne.us and there is a program which is called kids connection. Kids connection is what they would put her on being pregnant, it covers and protects the unborn child, along with her prenatal needs. The income guidline for a family of 2 (the unborn baby counts as a person) is $25,322 annually. She should really look into this program for the sake of her unborn baby along with her health. When they figure your income, they do take into account your household bills. I really think she would qualify if she go into contact with them. Hope this helps!

I agree with Mary G about getting on the pre-natals and Omega 3s ASAP. A children's multi ain't gonna cut it though.

My wife and I had insurance but chose to go with a midwife. Financed on the monthly plan. Most midwifes will let you make payments. We ended up with twins born at home. A boy and a girl. We finally got the boy payed for when he was about 6 months old.

When I became pregnant with my first child my husband and I had just been married, and we moved from Wyoming to Idaho. With the move we lost our insurance, because in switching jobs we had a 3 month waiting period. I found out I was pregnant 2 months after the move, but when I called around and tried to find insurance not one company would insure myself or my husband. The sad truth was they wouldn't even cover my husband, because once the baby was born they would have to cover the baby as well, because of dependency laws. We tried to receive help from the state, because I had a hard pregnancy and was put on bed rest 4 1/2 months into the pregnancy. With just my husband's income we still did not qualify and they don't care what bills you have. All they see is the amount of money coming in. At that time my husband only made 18,000 a year, and we still didn't qualify. My daugter is 5 today, and we just finished paying off the doctor bill for her in January. We could not find any help, and therefore our bills were above $15,000. That was for everything. The sad truth is that if you know how to milk the system you can find help, but for people that really need the help and are willing to work and try to make a living you can't.

A couple of friends of mine had kids after me and they saw what my husband and I went through, so they dropped their hours until they qualified for state aid, because you only have to qualify once, and then once they were on state aid they went back to work and made a living. It just depends on what your friend is willing to do to find help.

Sorry I can't be more optimistic, but my first pregnancy was difficult and very expensive. This time around I have double coverage, and no stress about money. Good Luck!! I hope she can find a way to receive help. From my experience most insurance companies have a 10 month waiting period on any prenatal care. I looked into changing some things around and finding a new company, and they said there was a waiting period. I kept my insurance, because I was already pregnant, Keep in mind that I am also covered under my husband's and they still wouldn't cover me as a second policy. I hope she can figure something out.
A.

I only had major medical as well through my husbands blue cross and we did not add or change anything it should be covered since you have insurance already. I just had a baby April 5th and it coverd all of the hospital but $326 and all of the doctor but $347 so you should be good. Hope this helps!

Hi, First of all she needs to maybe talk to a social worker through the Hospital on all options to help her out, I work for Iowa health Physicians, I highly suggest that you call and request financial applications, for the physicians part of your bill and the Hopital part of the bill, If you are going through Iowa Health Systems we have a program called FINA, that has high guidelines, I do all the physicians billing. Also keep in mind that at the time of service through our company you can ask for discount, as long as you are paying at the time of service, a 20% discount, anymore questions feel free to email me, good luck, the help is out there, do not give up :)

She should try to see IF she qualifys for Medicaid.

C.

I just had a baby (OK, two since it was twins), and I also did not have maternity in my insurance plan, nor did I qualify for state assistance. All the hospitals have a plan she can do- she pays $1500, they match it and that covers the entire hospital portion of having the baby (aside from anasthesioligist- but the epidural is covered). Most doctors also have that type of plan. Not the most affordable way to go, but, better than nothing.

She can get on medicade, it covers alls medical bills during and after the pregnancy and she can also get the baby on it. If she likes to not have bills this is what i would definately suggest.

I don't know the Nebraska laws, but here in Montana, pregnancy is excluded from a waiting period. Your pregnancy is covered from the day you buy a policy, even in her stituation. She needs to look into the laws & see what they are in her state.
Also, she could seek out a local planned parenthood clinic for prenatal care, and some hospitals offer a midwife clinic for the income sensitive. Just some other ideas for her to explore.

Check with UNMC. When I had my first daughter there was a program for mothers in situations like your friend's.