CHP Vs. High Deductible Pregnancy Choice - Help!

I have a friend who was on CHP with her first baby last year and loved it. I have a $1500 deductible, which I met with my ob/gyn delivering and the rest was covered at 90%, but I then four days after giving birth got a rare case of post-eclampsia and ended up in ICU for 8 days and it was a whole other ball game. Even though I had met my deductible I was still responsible for 10% until I met our family out-of-pocket maximum. So needless to say we are $13,000 in medical debt right now. You never know if something out of the ordinary is going to happen. I would check it all out and see what you can qualify for. If you can do it, you pay taxes just like everyone else and until our country can fix the health insurance crisis, do what is best for you and yours.

I had the same problem, and ended up getting pregnant before insurance would have covered it anyways, I don't know where you live- but I now go to Exempla Certified Nurse Midwives (though you can also choose to see the doctors there). Your first appointment there is with the financial adviser- who, if you qualify, will apply you for ALL state programs. I ended up qualifying for Medicaid!! If you are denied for all state programs, you go back in to the financial adviser and are put on a sliding scale with a payment plan- beginning at 500 and not exceeding $3000, I believe. I LOVE THEM!!!! WOrth a shot, at least!!! Plus- they deliver at St. Josephs, which is supposed to be the nicest place to deliver in Colorado- they did that huge renovation so it is supposed to be like a spa instead of a hospital!!! Best of Luck!

I just had my baby on 7/2 with CHP and loved it! However, you CANNOT have other insurance to be on CHP, you can for medicaid, but ot CHP. I birthed with the CFM midwives at University and it was a wonderful birth. Just to let you know too, I am a doula who works on a sliding scale to assist families with lower incomes, www.birthfirstdoula.vpweb.com.

We recently encountered a similar situation. Our COBRA benefits ended while I was pregnant and there were very few options for coverage. My husband is self-employed, so we were eligible for one plan through his business. It was a PPO plan with a high deductible. I had a scheduled C-section, so I was afraid like you that we would have to meet a deductible for me and my baby. Fortunately, I found out that with most plans you only need to meet the deductible for the mom and all costs for the baby are billed under your name. The risk is, if the baby has to stay in the hospital longer than you do, he/she will have to meet their deductible for those charges. The other option we had was through covercolorado.com. There were less expensive plans available if you qualify. We went through an insurance broker to help us make the decision. She was very helpful and didn't cost us anything. Good luck!

Sign up for CHP for your three year old NOW and for yourself as soon as you get pregnant. It is wonderful and it is for people like you whose income is on the edge.

Theresa

Once you are pregnant and have confirmation of pregnancy with due date, I would apply to Medicaid and let them know that you do have insurance but your ded is $4000 and you just can't meet it. If the rest of your finances qualify (most do b/c they are trying to have all pregnant moms get pre-natal care) they should work with your ins. Your child would get covered immediatly after birth as well.

GL and hopefully congrats!!
J.

There are multiple programs out there, call your health and welfare and talk to them, there are some programs that let you keep your insurance and the kids up until the age of 5, when you will either have to put them on medi-cade or keep them on your husbands. We have been on different programs throughout the last 10 years, we origanily kept getting denied even though according to their "amount you can make" we qualified, turns out that some of the kids had to be dropped from our insurance and as soon as I knew the date they got medi-cade, but others could have both. I never figured out their logic, really I just wanted them to pick up our deductibles and co-pay's, would have been cheaper for the state. Any ways contact the state they can tell you the best route to go 4,000 is a HUGE deductible!

During my 3rd pregnancy I had insurance through my work but still qualified for medicaid assistance. They paid my co-pay and my insurance covered the rest. This was great because I had to have several ultrasounds and we would have been in huge debt without the assistance. All my other pregancies were covered no problem by my insurance without all those high deductibles. Check with your husband's insurance about pregnancy specific coverage. For me, it was different than regular coverage. There are also usually different options. Right now we can choose covereage and deductibles that meet our needs because he has such a big group.

I think you should seriously look at your finances. Try to plan out exactly how much everything will cost (look at some of your hospital bills with your last child) and perhaps add a couple thousand for just in case. If you honestly cannot afford it and you qualify for CHP, apply for CHP. The comment that you shouldn't let tax payers pay for your children was totally rude and unfounded. The state has an interest in the welfare of ALL of its citizens, including unborn children. That is why we all pay our taxes...so we can have a healthy society. There is no shame in using CHP. CHP and other programs like it are designed to promote prenatal healthcare for mom and baby, and allow lower income families access to affordable healthcare. If you qualify for CHP, it is very likely that you cannot afford "regular" insurance anyways. If "taxpayers" really had problems with "paying for other people's baby's" they should talk to their state and federal representatives to provide a real solution to the insurance crisis, not degrade you for exploring your options.

Anyways, I'll get off my soap box. I just think after you have worked through your options and decided what is best for your family, then do what is best for your family and don't worry about what others think.

Hi, H.. Check with your husband's HR dept. about the deductible. Ususally with an HDHP (high deductible health plan) there is also an HRA or HSA that can be used to pay some of the deductible costs; often, the employer subsidizes the HRA for you. Also, there are some charges that don't apply toward the deductible and may be covered without you having to pay deductible amounts. I would really call and talk to his HR staff about the details of his health plan. I'm a benefits administrator (could you tell--hee hee), so if you have any questions after speaking with them, just let me know; I'm happy to help! Good luck with getting pregnant--woo hoo!
S.

If you think you qualify for CHP, you should apply for that, but you can also go on your husband's insurance. Essentially, what his insurance doesn't cover (deductibles and copays, etc) CHP will, so you can do both. My son was on Kid Care before my husband started his new job and then we put him on the insurance when my husband's insurance kicked in. My son isn't sick a lot, but it kept us from having to pay the two times we had to make trips to the ER. Now we are doing better financially and no longer qualify, but our deductible is only $1000, not your $4000! You might also want to consider getting on your husband's insurance just in case you DON"T qualify...since there is only certain times of the year you can change things or add people to the insurance. That way you aren't stuck with NOTHING. Good luck on your decision and trying for baby number 2!

Hello H.,
My husband is in the insurance field so I thought he might have some advice. Below is his response, good luck!

She needs to see if CHP has any exclusion’s with pregnancies, sometimes these plans work like individual insurance policies where pregnancy is not a covered benefit. If she has a baby on the HDHP she will be out of pocket 8K so I would stay away from that plan until after the baby is born. After the baby is born then I would go onto the HDHP because preventive services are covered at 100% and the premium on those plans are super cheap.

if you're ok with the high deductible, go for it. If not, get chp

I would also try CHP. I am on #3 and my $1500 deductible was met with an amnio. We have to pay 20% after up to $5000. On just me. So I'm hoping everything goes well for the baby. And I know from experience that hospitals and Dr's will take any payment for as long as it takes to pay it off. My husband has a seasonal job and I know they will take minimal payments and they will take more when he's working so don't worry on that either. They are just happy to get some money. So don't take to heart those who "poopoo" your desire to have a child so "someone else can pay". Thats just rude.

Our children have had CHP and you can receive good care through this insurance - many excellent doctors and hospitals will accept it (same is NOT necessarily true for medicaid). I would do this over the costly alternative, if it were me.
Best of luck to you.

If you can't afford the deductable how can you afford the baby? Why should the tax payers cover the cost of increasing your family size?

I don't know much about insurance, i do know that as a supplemental insurance i would try to get aflac maternity you have to have it a month before you get pregnantbut it really helps. it pays you cash after and with a c section you get like 3000 or 3500 i think i would just look into it

Check with your insurance about pregnancy and delivery coverage. All of my plans have covered the birth and baby as part of the mom's deductible until the baby leaves the hospital. An emergency c-section should cost $4000, not $8000. All of the baby's hospital vaccines and hospital stay should also come out of your deductible, not the baby's deductible. Check the same thing with CHP. It is possible that CHP will cover the baby after he leaves the hospital, but you may have to cover the c-section.

This is slightly off-topic. "Once a c-section, always a c-section" is not backed up by research. A majority of women who try VBAC (vaginal birth)are successful. The money who could spend on a good childbirth class could be worth lowering your birth costs (it's not a guarantee though). ICAN is a support group for c-section moms that could also be helpful.

You need to talk to a professional health insurance broker right away to get the facts. I highly recommend Barb Hunt - IBC Insurance Benefit Connections ###-###-####. She is very knowledgable about all the ins and outs of health insurance and can answer your questions without trying to upsell you on something. Good luck!

I never thought I would do anything like Medicaid, but we had nothing for our last (number 3) and qualified. I had a very complicated pregnancy requiring medicine that was about $1000 a month on top of multiple ultrasounds and visits to specialists. Medicaid paid for everything and I received incredibly good care. Our insurance kicked in for the baby right away, but not for me until I was out of the hospital. I would check, too, because even though insurance words it per person, there is usually a family deductible, although it would still be the $8000. GL! I hope you get pregnant soon.