27 answers

Lack of Health Insurance and Pregnancy

Okay ladies - need some help...or rather my sister needs some help. My sis is 24 and pregnant. We work for a company that does not carry health insurance. Her husband was recently laid off (reduction in force) so he lost his benefits. He is currently working "contract" for a company that he had worked at previously, so once again, no benefits. They do not qualify for Medicaid, because "collectively" they make too much. She works on the side for a company that does offer health but the deductible is $10,000.

Has anyone else faced this problem? Does anyone have any ideas or suggestions?

Thanks!

K.

1 mom found this helpful

What can I do next?

Featured Answers

Although we made too much too Medicaid still carried me b/c I was pregnant so I would suggest she go back and re-apply.

1 mom found this helpful

I ran into this same problem. I called around to all of my local hospitals and asked them how much would the charge be if I paid cash. I was able to work out a cash price with the OB/GYN MD as well as the hospital (UTMB) and yes, I delivered on the island. I made payments at the OB appts.
It worked out great.

If she's up for the idea a home birth with a midwife is cheaper than the hospital birth. I had 2 of my kids at home costs around $3700 each... If she's interested I can message you my midwife's information.

More Answers

How does she feel about all natural birth, with no chance for medical intervention? I would suggest either a birth center or home birth with a midwife. Midwives are usually have low cash cost. The midwife I used (at a birth center) was very reasonable and covered by our insurance, but my friend went to her too. They are self-employed and therefore do not have great insurance. They paid cash, and she was very happy - it was sooooooo much less than what she had paid for her other three hospital births.

The midwifery model of care is much more personalized care, and studies show that for normal, healthy pregnant women, a midwife birth can be just as, if not more, safe than delivery with an OB. Not having all those dangerous medical interventions adds to the safety. I chose it for this reason. The bonus was that it really did cost much less, and I believe my midwife told me that her cash price was $5500, and she offered a payment plan.

OBs might offer cash price options as well, but OUCH. The hospital is going to be pricey, too...

1 mom found this helpful

Although we made too much too Medicaid still carried me b/c I was pregnant so I would suggest she go back and re-apply.

1 mom found this helpful

I would suggest she look into midwifery care. I am a homebirth midwife and had a homebirth myself 4 years ago and I am planning on another one in April. I paid my midwife 1700.00 four years ago. That was before I was a midwife. The practice I work for currently charges 2800.00 for everything. And almost all midwives accept payment plans. Besides the lower cost, research has shown that for healthy mothers birth with a midwife is safer and healthier than with an OB at the hospital.

L.

1 mom found this helpful

I am not sure where you live, but the staff at the UTMB clinics have been wonderful. I went in, no insurance and they helped me fill out all the medicaid forms for pregnanct women. I go to the offic ein Pearland. They also have an ob-gyn package for if you o not qualify for medicaid you pay $6000 dollars fo ryour whole pregnancy and delivery. You need to put down $900 deposit and then pay the balance off by your 36th week. THis covers all your doctors visits,one scan and your hospital stay. The only downside is you have to deliver on Galveston island, but I found that it was a huge savings and I am currently on their plan and have had wonderful service from them.

Most other doctors and hospitals have some sort of cash payment plan.

1 mom found this helpful

I spoke with my OB/GYN...when we were pregnant without health insurance coverage. Their office offered a discounted rate for paying "cash". Then they also worked out a payment plan that allowed you to make a monthly payment to their office that had your prenatal and delivery paid off by the 7th month of pregnancy. This of course did not cover the hospital or anesthesiologist (if you wanted an epidural) but completely covered prenatal and delivery.

The hospital will bill you and so will the anesthesiologist. That runs about $3500...so we had to scrimp and save for that while paying the doctor month to month.

Sorry I don't have any other advice...

1 mom found this helpful

Can her husband still qualify for COBRA from his previous employer?? It's a little expensive but that's what I had to do when I was laid off at 5 month pregnant...
Best of luck

Has she actually applied for medicaid. I thought I didn't qualify either, but the criteria is different when you are pregnant. Also when we were applying the rep told me about another program through medicaid. I can not remember what it was called (like Green Star or something), but it pays partially. The rep told me they usually don't advertise it. You have to ask for it.

The CHIPS program also helps women who are pregnate. It is like Medicade but it is for those who make more than the medicade limit.

www.austinabc.com

I've given birth here and loved it! Very affordable too!

I suggest calling around to OB/GYN offices for cash discount prices.

I recently saw Dr. Jason Bradford, a new OBGYN in Corpus Christi who is trying to build his practice. He was kind, gentle, and affordable to the cash pay patient.

www.corpusobgyn.com

Hi K.,

There is a lot of advice already here, but I do have a couple additions. First, as suggested by others, you can try for CHIP (http://www.chipmedicaid.org/english/cover.htm) which does offer insurance to pregnant women. There are still requirements that must be met to qualify, but it is not as restrictive as Medicaid. Also, yes, midwives are much less expensive, and I went with a midwife for my second child and LOVED the experience. However, while they are less expensive, it is still costs around $3,000 - depending on who you go with. Also, if you go with a midwife, they are less likely to be able to let you pay long term - most we spoke with required us to be paid in full three weeks before the due date. Hospitals, on the other hand, will let you continue paying long after the birth - just FYI. If you go to your local WIC office (or call) they have resources available for free or low cost clinics in your area, too. The link to find an office is here: http://www.dshs.state.tx.us/wichd/default.shtm

I hope that helps!

If they live in Bexar County and they make too much for Medicade and they have no health insurance, they might try CareLink. It works through University Hospital, goes by a sliding scale (as far as payments) and they will give her a doctor. It is not exactly insurance; but they do receive doctors care and referrals to anyone they need to see with the exception of dentists.
It might not hurt her to try - they will cover the whole family.
She can google CareLink, San Antonio for more information. She should download the application and fill it out; take with her both her & her husband's IDs; a cable or water bill (to show residence) & all income information - check stubs etc.
Good Luck.

I am going to dispute Margarets advise about UTMB no longer delivers on the island. YES, we do. Not sure where she gets that we don't. I should know, I work there. UTMB will help you with applying for Medicaid and so forth. Not sure where you live but give it a try.

Best of luck!

Unfortunately, your sister finds herself in a predicament which is sadly, very common. Since this is the case, have her to find an OBGYN that will work with her on her costs. She will need to talk with their business office person to see about making installment payments which she can have all paid probably before the baby is due. The costs will cover her pre-natal care and post-partum follow-ups. When she talks with them, she can explain her situation and most of them have charges that they assess for patients without insurance coverage that may be even less. Tell her to check around and not to feel bad because she's not alone.

Hi K.--I am a Certified Nurse Midwife and own North Houston Birth Center. While my fees are considerably less than any hospital and physician, I don't usually have clients only for financial reasons. She and husand will have to be committed to the philosophy of out-of-hospital birth experience--satisfaction and safety.

I am happy to meet with them to tour my facility and answer all questions.
We have been open 5 years, and today had baby # 800!
thanks, Kathy

I ran into this same problem. I called around to all of my local hospitals and asked them how much would the charge be if I paid cash. I was able to work out a cash price with the OB/GYN MD as well as the hospital (UTMB) and yes, I delivered on the island. I made payments at the OB appts.
It worked out great.

She should look into the CHIP Medicaid program. Here's the website: http://www.chipmedicaid.org/. Women who don't qualify for Medicaid can still get prenatal and postpartum care through CHIP. It also covers check-ups, vaccines, and prescriptions for the child.

At her age, and assuming she is (and stays) healthy with a normal pregnancy, she could consider looking into the care of a midwife. If everything goes as planned, it can save you quite a bit of money--total pre- and post-natal care; testing; delivery at home or birth center can cost well under $6000 total.

My daughter was born at Bay Area Birth Center and it couldn't have been a better experience...well maybe a FEW less hours of labor!

Licensed, certified midwives are very good at determining how the pregnancy and labor are progressing and are alert to any potential problems that may require transfer of care to an OB.

Of course...there is no epidural...but she can do it. I was in HARD, back labor for 19 hours...and I'd do it again in a minute.

Try Harris County Hospital District, also known as the Gold Card.

Not sure if this is an option but you might try Assurant (and we were referred to them via State Farm, where whe have our house and car insurance)....we had them for temporary insurance of up to 6 months when my husband as unemployed and it was MUCH cheaper than COBRA..not sure if your sister's circumstances would apply or not but might be worth a try...Good luck.

I had a baby by C-section in Nov. My insurance only covers C-section in case of complications. I had paid the private pay rates with doc and hospital and was ready to go. I could have paid only $1500 more at the hospital for C-section as private pay and the bill would have been paid in full for me and baby. Since I used my insurance for the C-section, I still have a balance of $7000. It's ridiculous. I'd have been better off not using my insurance at all. Huge battle on my hands that's still not resolved after ten months. Needless to say when they call me to see when and how I'm going to pay the $7000, I come unglued on them. I'm totally beside myself.

So I'm guessing your sis is probably better off with no insurance as long as there aren't major complications.

Check the area where you live. Here in Odessa, we have a hospital that offers way reduced rates for people who have to pay cash for their medical services.

I was in the same situation! I could not get insurance. That is why I now support a national Health Care Plan. I prepaid my Dr. and hospital and prayed I would not have complications which could've bankrupted us. It was a serious flaw in the insurance system. Do u know I paid $1500 cash for a one night hospital stay for me and baby and if it had been billed to insurance would've been $15,000!!?? Good luck - I could not find anyone to insure me.

My girls are 22 & 20 now but we only had major medical when I was pregnant with them. We went to the drs & hospitals & some of them have a cash plan. We made payments on the plan which were due by my 7th month. I was able to get the Dr & a 24 hr stay at the hospital. No anesthesia or anything - so natural childbirth was the only option.
I don't know how much it is now. When my son was born almost 15 yrs ago we paid the same amount and that time it was with insurance.

If she's up for the idea a home birth with a midwife is cheaper than the hospital birth. I had 2 of my kids at home costs around $3700 each... If she's interested I can message you my midwife's information.

One option would be to pursue a birthing center/midwife route which is usually much less expensive (and from most people I've heard offers a WONDERFUL pregnancy care and birth experience). If you want an OB, you can usually find a practice that offers a discount to patients that are paying "cash" as opposed to going through insurance--just call and ask. For example, during my first pregnancy, my practice had a global fee of around $2500 for the entire pregnancy that covered visits, etc. She will need to at least purchase some "major medical" coverage on the side though in case anything "goes wrong" during the pregnancy or delivery. You don't want to get stuck with a $20,000 bill for a c-section. Hope this helps somewhat!

In case you were considering it, I hate to dispute Cherie's advice, but UTMB no longer delivers "on the island". UTMB is a great place for medical care. If you live on the mainland, I wouldnt suggest it.

M. :)

P.S. Also to Cherie's "downside"...I was born "on the island" (John Sealy), my daughter was born in the same hospital 36 years later.
('round these parts we call it BOI, Born on The Island:)

EDIT: Dear K., I apologize for giving you the wrong advice. It was NOT done on purpose. I truly believed what I originally wrote. Thanks to Angela R. AND HER UN-BELIEVEABLY RUDE Personal Message to me, I have been set straight. I will have to say, you catch more flies with honey. A polite note from her would have been nice. I guess that it what is wrong with the world today.....we just cant be kind to one another.
M.

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