14 answers

Health Insurance

My sister just found out she was pregnant w/ her first child due in June...not her first pregnancy (she had a miscarrage 6 years ago) The baby will have RH- blood type not sure if she will be high risk. Neither her or her husband have any type of medical coverage through their jobs and make to much to qualify for any state plan. Has anyone had any experience w/ being pregnant and getting insurance privatly? I checked into the cost of having the baby w/o any complications and cost is between $7,000-$26,000 I know they can't afford it and will be traveling for work untill March. They also don't live in TX.
Any advise is greatly appreciated!

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Thank you to everyone for the time to give great advise! I have given my sister all of the advice and called insurance companies for her yesterday, because she is already pregnant she doesn't qualify. I was also told by a friend who has state insurance they will cover you anywhere, so I advised her to call Mt (the state she lives in) and talk to them to see if that is the case for their state. I also told her she could go to a midwife untill she gets home in March and then go see a physician if she still wants to do that. We are so greatful for all of the advise!

Featured Answers

they could apply for Medicaid. Also Rh negative is not a big deal. She will just get a Rhogam shot, I have 2 kids that are positive and i am negative, and is not an issue. She could just go to a pregnancy clinic and do her care through them and pay a small fee for each visit.

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I didn't have insurance for either of my boys. I paid $2000 (plus 150 for circ)to my OB for each delivery. With the first child I paid $2100 to the hospital (it was reduced since we paid in full upon discharge) for my first son who was a vaginal delivery. My second son was breech so therefore I had a C-section and it was $4100 (again, 1/2 off since we paid upon discharge). Not too bad considering no insurance.

Call around to different hospitals and OBs to see what they can offer.

I wish her all the best as it isn't easy not having insurance. Thankfully we have it now.

It is my understanding that any woman who is pregnant, no matter the income level, is eligible for medicaid. You may want to get on the computer and and research the medicaid standards, because there are specialists who will take medicaid cases.

Good Luck!

I know Starbuck offers great insurance. I believe you only have to work 20 hours a week to get it. Maybe her husband can get a part-time job there until they have the baby. I've had freinds that worked there just to get the insurance, and they had a preexisting condition and still got the insurance. Hope this helps.

I wish your sister the best of luck in finding health care insurance, since she does not have any. Usually there is a preexisting clause.

One option that she could consider is going to a midwife. A midwife charges much less than a OB, and can see her as long as she stays low risk. (RH neg is really common!) This isn't taking a lesser road, just a different road. They run all the same tests, and check for all the same things, etc. THe care is much more personal though, and usually the cost is well below $5000.

If she does want to see an OB she can also get a reduced rate for paying patients, as well as with the hospital. It never hurts to ask.

Good luck finding insurance, I wish I could be of more help!

I inquired a couple of years ago about personal insurance & was told that NO individual insurance plans in Texas cover pregnancy... Now that was about 3 or 4 years ago & I was told specifically Texas... So it may be different in the State your sister lives. I would start by just calling any major insurance company to find out if the coverage is even available in their state.

I also know that paying cash installment payments throughout the pregnancy can save a lot of money. She would pay each month ~$100.00 to the hospital & ~$100.00 to the Dr. for like 7 months & your given a discount for doing it that way. (My numbers are examples - I am not sure of the true costs.)

T.,

If she is pregnant she can get on Medicaid simply because she is pregnant. If she goes to a county hospital clinic like Parkland in her area they will see her and put her on Medicaid if she has

H.

they could apply for Medicaid. Also Rh negative is not a big deal. She will just get a Rhogam shot, I have 2 kids that are positive and i am negative, and is not an issue. She could just go to a pregnancy clinic and do her care through them and pay a small fee for each visit.

Check into Maternity Card (they have a website). I think you still pay a portion (to maternity card), but it reduces the cost quite a bit or your money back. I also didn't have maternity insurance, but I was too late to get this. You have to get it at least a couple of weeks before baby is born. I waited too long! I don't know much about them, but it doesn't hurt to get some info! Good luck!

T.,

I am a licensed Health and Life insurance agent, unfortunately since your sister is already pregnant, she will not be able to get health insurance coverage until after the baby is born. Her only option, I believe, would be to go through the Texas Risk Pool. Sorry for the bad news. Most doctors/hospitals have payment plans - they give discounts if you have it paid off within the 9 months (I've heard $3,200 $3,900). Hope this helps.

We aquired our plan, fairly reasonably through www.ehealthinsurance.com. You put in your stats and it pulls up several plans, with details, pricing, etc. Hope this helps. We've been very happy with our plan through Aetna.

Hi, I had much the same experience as the other person who responded. We got huge reductions in price by paying in advance for both the hospital and doctor. I don't know if it's the same in other states than TX, though. My husband is a contractor, so we don't have insurance available from a company, and it's just too expensive to pay for individually.

Hope this helps, and best wishes to you and your sister!

D.

I do not have any experience directly but a friend recently hound out she was pregnant the day she quit her job. She priced self-insurance but they either did not cover pregnancy or the cost was incredibly high. We estimated $10,000 for her delivery (c-section) based on her last pregnancy. The premiums for 9 months of pregnancy were very close to the $10,000 which does not include labs while pregnant and coverage for the baby once he or she is born. Even though the cost was so much she chose the insurance plan that was $800 a month. Thank god she did, she was in the hospital for over a week! Good luck for you sister! And congrats too!!!

Hi T.,

I had my 2nd child 2 yrs ago without maternity coverage (we have health insurance but it doesn't cover any maternity). I looked into the cost of just maternity coverage, and it was ridiculous!!

What I did find out is that if you can plan to pay in cash before the baby is born, you will be able to get a reduced fee from the Dr and hospital. For instance, the hospital I planned on giving birth at told me that if I waited until after the birth and was billed for the delivery, it would be anywhere between $8,000 and $10,000 (that did not include the Dr fee for prenatal care). BUT, if I paid in advance, it was less than $3,000! (of course I paid in advance!!). The Dr was the same.

Another option would be giving birth at a birthing center. They are usually run by midwives, and cost around $2,000 or less for all prenatal care and delivery. If she has a healthy pregnacy and is willing to consider giving birth naturally w/out an epidural, this would also be a good choice. BTW, the RH factor would not make her high risk.

I did use a midwife for my 2nd child, but delivered in the hospital b/c my first was delivered by c-section. I loved the midwife and would definately go that route again for another pregnancy. The only thing to be careful about is to make sure the midwife is a certified nurse midwife and not a lay midwife. I'm sure you could find tons of info about midwives on the internet....definately worth checkin into!

If she can find a birthing center and decides to deliver there, I would also recommend hiring a Doula. I had one for baby #2 and she was my savior!!! I would not consider having another child without the help of a Doula!!

OK, sorry so long winded!! All I can say is research, research, research!!! There are so many options out there other than the "norm". Hope this helps!

:-) H.

T.,

Unfortunately, I can tell you that there aren't private insurance companies (that I've been able to find) that will cover pregnancy. That is usually reserved for group health plans at places of employment. Even if you are able to find something, it would likely be just a "discounted services plan" where they would reduce the cost of very basic things. If there is any high risk or complications, etc nothing would be covered...even ultrasounds, etc wouldn't be discounted...but I haven't found any of those either (at least not in Texas). Your sister's best bet is to just have the baby at a hospital system that takes patients without insurance (like a Children's Hospital here or Parkland) and then just have to pay it off over time. Legally, as long as you are paying something, anything, on the bill, they can't put it in collections, etc. So they could theoretically pay $30/mo or something (for forever I know). Anyway, I hope this helps a bit and good luck!

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