My husband recently started a new job after being unemployed for several months. During that time our 1 yr old qualified for Medicaid, but we did not because they said we made too much money (even though we were on unemployment- go figure)...
My husband brought home the insurance information that his company offers and the plans are WAY out of our budget. So I've been looking online for other plans to get by ourselves and I've narrowed it down to 2 that are within our budget but I've hit a major problem- we've been delaying having our next baby until we could get insurance (almost 5 months now), but the only plans we can afford say that they will not cover pregnancy benefits until we've been paying for 12 months!! I am devistated and have been crying on and off the last 3 days just thinking about it...
So my question to all of you is, if we couldn't qualify for Utah Medicaid before, what would happen if I got pregnant? Is there some sort of plan for people who have insurance but that the companies won't pay for the maternity part? I thought it was against the law to deny coverage just because you're pregnant, but the contract clearly stated that they consider it a "pre-existing condition" even if we are paying customers until we've paid for 12 months!
What can I do? I looked online at Baby Your Baby and according to their income charts, we're only $100 over the income limit.
I am totally heartbroken. How can an insurance company have the right to tell you when you can/can’t have children? We obviously can’t afford to have another baby until we have some sort of coverage, whether it be thru Medicaid or having to wait another year before the insurance we apply for decides to pay benefits… but I really don’t want to put off having another baby for a year.
Written Jan 17, 2011:
In March I found a private insurance plan that offered GREAT maternity benefits (they pay $5,000 upfront each pregnancy and we take care of everything after that amount has been paid- NO deductable unless I have to be hospitalized due to C-section). Unfortunately, this insurance company no longer offers this maternity plan. We signed up just in time- one month before they stopped offering. My husband has had a few raises at his job since I asked this question and we're pretty sure we won't qualify for medicaid, but since I"m covered now it doesn't worry me.
Although we've been trying to conceive for a while now, I'm sad to say I'm still not pregnant. Hopefully soon!
Also, you might consider an out-of-hospital birth with a midwife. Our insurance would only have helped with maternity costs after a $5000 deductible, but we were able to pay for prenatal, delivery, and post-partum care for less than $2000 with a midwife at her birthing suite. It was a very pleasant birthing experience, and I understand it's not for everyone, but it is something to think about.
I am in a similar situation, and found out that the doctors office and hospital actually offer financial assistance. It pays a huge portion of the fees. I would call your ob and ask if they offer anything like that. My doctors office doesn't look at our assests, just our monthly income and how many are in our family.
Insurance companies can be so LAME!!!
Another thing to consider is getting a supplemental insurance plan through AFLAC. These are hospital coverage plans that pay cash for hospitalization. You do have to sign up before you get pregnant, like ten moths before you have the baby. You do have to pay a monthly fee but when you have the baby they pay you cash. The plans you choose will determine what you have to pay monthly. This was a HUGE help for us. We chose three different coverage options (which is optional) so we were paying 240 a month, which is a little steep but when we had the baby we got three separate checks that added up to 10,000. This totally helped us cover our expenses. Good luck. I know there are options and programs for you its just such a pain how hard it to find them.
Let me know if you would like more information about the supplemental insurance plans and I can get you the agent's number that we used. He was way helpful and we wish we would have stayed on it because I got pregnant by surprise four months after our daughter was born!
if you're pregnant in Utah, and need pregnancy coverage but are over the income limits you CAN get medicaid if you do a paydown... I think how it works is that you pay the amount that you are over the income limits to get medicaid... in your case $100. Call and talk to an eligibility worker. Also, I would look into UPP, which helps working people afford their employers health insurance premiums. They'll send you a monthly check for every person that qualifies... its $100 for every qualifying child and $150 for each adult. Also, make sure you're using a 4 person family size when looking at your charts for income eligability... the second you're pregnant you count as 2 people. Also, if you're that close to the income limits you probably qualify for CHIP for your kids. Hope you find a solution! =)
Im not sure about Utah but here in NH the income requirements are different if you are pregnant than if you are not. Id call DHHS and ask them.
