Health Care Rant

stephmkemp

I'm 23 and thanks to the Affordable Care Act, I'm still covered under my father's health insurance as a dependent. The insurance through my work is really expensive and not worth a damn. I will be 10w on saturday and after waiting 3 weeks for my first prenatal visit, my OB office calls today to tell me that I do not have any maternity care benefits through my insurance. Apparently the insurance companies are not required to extend maternity care benefits to dependents considered to be children. *enter big fat sigh* and to top that off, my open enrollment just passed a few weeks ago at work. So if there are any other young momma to be's on their parents insurance, make sure you check that the maternity care is extended to you as well. Oh and I don't qualify for short term disability because I got KU a month before open enrollment. Its so hard to stay positive these days. Starting to enter freak out mode!

chicorojo

My state offers pregnancy medicaid. All states are different. But we are above the poverty line and because of ins. Issues I get pregnancy medicaid. I would check there first.

MaggieN2028

I'm having an issue with my insurance too...I guess it just comes with pregnancy.  UGH.  NOT FUN.

HorseFeathers3

Do you live in CA? If so apply for MediCal. If not, do you have state funded medical coverage you can apply for?

drpayne

The reality is people pay out of pocket to have babies all of the time.  This will be the third time for me.  It sucks but it's not uncommon.

caden1206

Apply for Medicaid immediately for maternity coverage. Personally, I don't think dependents should have maternity coverage. If you are responsible enough to start having children you need to start working on providing HC coverage for yourself and children. I don't know if you get dropped from your Dad's insurance if you can apply through the exchanges. Check that out too. There are options now thanks to the ACA.

nopegoat

Also paying OOP. Talk with your OB office and they will work out a decent payment plan.

Manateearmz

One more thing to think about is the baby's insurance. Once the baby is born do you know what insurance you'll have for it? It might be good to look into short term medial coverage or go onto the exchange for ACA. Sort term might deny you due to pre existing conditions. FMLA should be good to hold your job.

erynpdx

My employer doesn't offer insurance, so I'm on my own.  LUCKILY I found out I'm KU 2 weeks before the end of open enrollment, so while my premium is HIGH, and this baby is still going to cost a LOT, at least I'm covered(ish). 

Agree with PPs, check into state benefits, if I made just a little less than I do I would have qualified for 100% coverage, and if my salary stays the same, the baby will be covered by state help so that's a little peace of mind...

stephmkemp

Thanks for all of the advice. I finished applying for state assistance today and neither denied nor accepted to give me coverage. My case has been handed off to a case specialist, so fingers crossed. My salary puts me just above the maximum for state coverage =/ also, I have thought about the babies coverage after they are born, and I was going to enroll in insurance through my work irregardless of the price. I just thought I would save a little money for the next 7 months by staying on my father's insurance.

Heorwig

Yeah I checked this before we started trying. I dropped off my mom's insurance and enrolled in my work's insurance to get the maternity coverage.

My SIL is having the same issues. She is on Medicaid now. That will probably be your best option, or pay out of pocket as PP said.

caden1206

stephmkemp said:

Thanks for all of the advice. I finished applying for state assistance today and neither denied nor accepted to give me coverage. My case has been handed off to a case specialist, so fingers crossed. My salary puts me just above the maximum for state coverage =/ also, I have thought about the babies coverage after they are born, and I was going to enroll in insurance through my work irregardless of the price. I just thought I would save a little money for the next 7 months by staying on my father's insurance.</block

The baby daddy needs to be responsible for HC coverage too.

Edit for the baby

amr196

Hmmmm that's probably why my bills have been SO DAMN EXPENSIVE! but I'm pretty sure my honey and I are going to elope this summer anyway haha main reason being.... So I can have his insurance too.

stephmkemp

@richardsj2‌ you can't use pregnancy as a qualifying event, but the birth of a child you can. In my previous reply I talked about my plans to do that, but I was hoping to save money for the next few mk the by staying on my father's insurance

sarals24

Where is the father of your baby in all this? Does he have health care? I agree with PPs, if you are old enough to start a family, you are old enough to take responsibility for your own health coverage.

stephmkemp

My husband works PT and has been actively looking for FT for half of a year, so insurance through his company isn't offered.

caden1206

stephmkemp said:

My husband works PT and has been actively looking for FT for half of a year, so insurance through his company isn't offered.

Starbucks offers insurance to full time employees.. Just saying.

AllTheTeaInChina

Maternity care is on the list of essential health benefits. How do some people have ins without maternity coverage if its required?

Manateearmz

richardsj2 said:

Manateearmz said:

One more thing to think about is the baby's insurance. Once the baby is born do you know what insurance you'll have for it? It might be good to look into short term medial coverage or go onto the exchange for ACA. Sort term might deny you due to pre existing conditions. FMLA should be good to hold your job.

Excellent point @Manateearmz.

This may be a stupid question but @stephmkemp, can't you use the pregnancy as a "qualifying life event" and start coverage with your employer?

Edited for quote fail

As far as I know pregnancy is not a qualifying life event. It would be marriage, separation, divorce or birth of a baby.

stephmkemp

For some reason, (ACA) most companies are switching to hiring more part time employees than full time.. it incredibly difficult to find a full time position in our area

caden1206

stephmkemp said:

For some reason, (ACA) most companies are switching to hiring more part time employees than full time.. it incredibly difficult to find a full time position in our area

Not true. That is just a republican talking point that is false. I work part time and I have insurance through my employer. Your husbands company just sucks and doesn't want to provide for it's employees.

sarals24

Plus, you can get insurance through the ACA. You should look into that, as it seems you have a job that pays enough. I'm not sure why you are still on your parents' insurance if you are having babies.

caden1206

I don't give people shit until I can tell they are making excuses. Just like another PP had said they checked coverage before getting pregnant, I think OP should have done the same. This is about personal responsibility. Don't come on here bitching about how things aren't fair when you didn't take the necessary steps to protect yourself.

drpayne

AllTheTeaInChina said:

Maternity care is on the list of essential health benefits. How do some people have ins without maternity coverage if its required?

Because there are some plans that are grandfathered.  My individual policy never had it.  Honestly, I'd rather pay out of pocket than deal the ACA website nonsense, even higher premiums, etc. 

Manateearmz

Oh good call @gradschoolmom1234‌ I forgot that dropping another coverage will qualify her. OP call your HR person to verify but that'll solve the issue.

Manateearmz

gradschoolmom1234 said:

Manateearmz said:

Oh good call @gradschoolmom1234‌ I forgot that dropping another coverage will qualify her. OP call your HR person to verify but that'll solve the issue.

Yes, as long as THEY dropped her. It won't work if she voluntarily drops the insurance! 

Yep. Very important.

caden1206

gradschoolmom1234 said:

caden1206 said:

I don't give people shit until I can tell they are making excuses. Just like another PP had said they checked coverage before getting pregnant, I think OP should have done the same. This is about personal responsibility. Don't come on here bitching about how things aren't fair when you didn't take the necessary steps to protect yourself.

meh. Insurance is f*ing confusing. As long as she's taking appropriate steps now to remedy the problem, doesn't bother me. I don't know the OPs circumstances exactly, but if your pregnancy was a surprise, you probably wouldn't have checked the coverage options on this particular issue. It's a kind of shitty situation, and I don't think there's much utility in berating someone for not having the foresight to know they'd have problems with their insurance coverage once they get pregnant. 

Insurance coverage is actually one of the things that pisses me off about America the most. The way we do it is just flat dumb! These are private companies whose goal is to make a profit, not produce positive health outcomes. They have financial incentives to make sure that their policies are confusing, that you stay on them as long as possible, but that they cover as little actual medical expense as possible. 

I agree with a lot of what you said about American insurance. Personally, I think we should socialize it so everyone gets care. Just my opinion.

stephmkemp

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

MaggieN2028

Yes it does @gradschoolmom1234‌. I just found out that my ultrasounds and lab work will not be covered, just my money will go towards deductible. I looked into my insurance before hand too...ugh. Like a pp said, a lot of people have to do a lot of this out of pocket, luckily many hospitals will be willing to work out payment plans.

rachelrhodes

I thought you could if there was a life changing event. Call you hr or benefit dept tell them you're pregnant and see if you can enroll. If not try govt program or see about midwifery or birthing centers it's cheaper.

lhbird87

I'm sorry to hear about this unpleasant surprise. I would have never thought you wouldn't have maternity coverage in that situation.

I totally edited because I wrote this long post and realized it wasn't really relevant. Of course anything to do with Medicaid depends on your states specific rules, but I live in a state that barely gives Medicaid to anyone and even here if you have a baby you're usually both covered if you meet the income requirements...

Then there's maternity version of Medicaid coverage. I don't know if you can get it while you have other insurance but it sounds like other ladies are suggesting you can. So I would call ASAP to find out. Best of luck to you.

caden1206

stephmkemp said:

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

I was giving you shit because you came on here acting like it wasn't fair you didn't have maternity coverage through your Daddy's insurance. It is not unreasonable for anyone to expect a grown, married woman to be prepared. Then when your husband was mentioned you started lying about how he can't get a full time job due to employers trying to get around the ACA by only providing part time positions without benefits. It is obvious you have no respect for this bill and just wanted to complain about it instead of trying to figure out how to make it work for you.

I really hate when people follow everything up with what seems like a pity story, but here's mine. 11 years ago I had the biggest surprise of my life and got pregnant with my son. I couldn't wait tables with no insurance, so I got a job with insurance. Boom, everyone now has insurance. Then my son was born premature and due to potential preexisting conditions I got stuck at the same, low paying job BC I couldn't have a gap in my insurance. I finally finagle a way via medicaid and got my son covered on that so I could finish my degree. I graduated, got a great job with benefits, and seriously a year later the ACA was passed an no preexisting conditions for children. The moral of this story is that I didn't complain about shit not being fair. I got off my ass and was proactive until shit happened and I didn't have half the luxuries the ACA affords you today. OK, I am now off my soapbox. Phew!!!!

Another thing, why are married people still allowed to have insurance through their parents? I really don't care one way or another, but I think that is weird. I know if my son gets married or has a child before 18 that my child support stops. You would think if you take those life steps you would become accountable for everything afterwards.

OP, I am seriously happy you found a solution. That must be a serious relief.

lhbird87

stephmkemp said:

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

I can't believe I scrolled over and missed this post. I'm glad you figured something out.

Heorwig

stephmkemp said:

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

Glad it worked out for you!

Heorwig

caden1206 said:

stephmkemp said:

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

I was giving you shit because you came on here acting like it wasn't fair you didn't have maternity coverage through your Daddy's insurance. It is not unreasonable for anyone to expect a grown, married woman to be prepared. Then when your husband was mentioned you started lying about how he can't get a full time job due to employers trying to get around the ACA by only providing part time positions without benefits. It is obvious you have no respect for this bill and just wanted to complain about it instead of trying to figure out how to make it work for you.

I really hate when people follow everything up with what seems like a pity story, but here's mine. 11 years ago I had the biggest surprise of my life and got pregnant with my son. I couldn't wait tables with no insurance, so I got a job with insurance. Boom, everyone now has insurance. Then my son was born premature and due to potential preexisting conditions I got stuck at the same, low paying job BC I couldn't have a gap in my insurance. I finally finagle a way via medicaid and got my son covered on that so I could finish my degree. I graduated, got a great job with benefits, and seriously a year later the ACA was passed an no preexisting conditions for children. The moral of this story is that I didn't complain about shit not being fair. I got off my ass and was proactive until shit happened and I didn't have half the luxuries the ACA affords you today. OK, I am now off my soapbox. Phew!!!!

Another thing, why are married people still allowed to have insurance through their parents? I really don't care one way or another, but I think that is weird. I know if my son gets married or has a child before 18 that my child support stops. You would think if you take those life steps you would become accountable for everything afterwards.

OP, I am seriously happy you found a solution. That must be a serious relief.

My husband and I were both on our parents' insurance before I got on my own for maternity coverage. My mom already has the "family" plan at her work so it did not cost any more money for her to include me along with my younger siblings. It cost the same whether I was on her insurance or not. It would cost me more to get my own with my work. It just made sense until DH and I decided we wanted to start trying and I researched and found that dependents do not get maternity coverage (makes sense, but i believe you can stay on your parents insurance until you are 26)

caden1206

Heorwig said:

caden1206 said:

stephmkemp said:

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

I was giving you shit because you came on here acting like it wasn't fair you didn't have maternity coverage through your Daddy's insurance. It is not unreasonable for anyone to expect a grown, married woman to be prepared. Then when your husband was mentioned you started lying about how he can't get a full time job due to employers trying to get around the ACA by only providing part time positions without benefits. It is obvious you have no respect for this bill and just wanted to complain about it instead of trying to figure out how to make it work for you.

I really hate when people follow everything up with what seems like a pity story, but here's mine. 11 years ago I had the biggest surprise of my life and got pregnant with my son. I couldn't wait tables with no insurance, so I got a job with insurance. Boom, everyone now has insurance. Then my son was born premature and due to potential preexisting conditions I got stuck at the same, low paying job BC I couldn't have a gap in my insurance. I finally finagle a way via medicaid and got my son covered on that so I could finish my degree. I graduated, got a great job with benefits, and seriously a year later the ACA was passed an no preexisting conditions for children. The moral of this story is that I didn't complain about shit not being fair. I got off my ass and was proactive until shit happened and I didn't have half the luxuries the ACA affords you today. OK, I am now off my soapbox. Phew!!!!

Another thing, why are married people still allowed to have insurance through their parents? I really don't care one way or another, but I think that is weird. I know if my son gets married or has a child before 18 that my child support stops. You would think if you take those life steps you would become accountable for everything afterwards.

OP, I am seriously happy you found a solution. That must be a serious relief.

My husband and I were both on our parents' insurance before I got on my own for maternity coverage. My mom already has the "family" plan at her work so it did not cost any more money for her to include me along with my younger siblings. It cost the same whether I was on her insurance or not. It would cost me more to get my own with my work. It just made sense until DH and I decided we wanted to start trying and I researched and found that dependents do not get maternity coverage (makes sense, but i believe you can stay on your parents insurance until you are 26)

I understand how you it works, I just was saying how I find it odd married people can be on their parents insurance. I really don't care how people are covered, I just care they have coverage.

stephmkemp

caden1206 said:

stephmkemp said:

Thank you to those who actually gave me advice instead of giving me shit about being on my parent's insurance. This pregnancy was indeed a huge surprise, so it's been a crazy past few weeks. For anyone who cares for an update, I was luckily able to contact my HR person (she was in vacation in canada for the weekend.. trust me I know this situation probably sounds made up but I swear this is all just my luck lol) and she informed me that she will squeeze me into this enrollment somehow, thank God.

I was giving you shit because you came on here acting like it wasn't fair you didn't have maternity coverage through your Daddy's insurance. It is not unreasonable for anyone to expect a grown, married woman to be prepared. Then when your husband was mentioned you started lying about how he can't get a full time job due to employers trying to get around the ACA by only providing part time positions without benefits. It is obvious you have no respect for this bill and just wanted to complain about it instead of trying to figure out how to make it work for you.

I really hate when people follow everything up with what seems like a pity story, but here's mine. 11 years ago I had the biggest surprise of my life and got pregnant with my son. I couldn't wait tables with no insurance, so I got a job with insurance. Boom, everyone now has insurance. Then my son was born premature and due to potential preexisting conditions I got stuck at the same, low paying job BC I couldn't have a gap in my insurance. I finally finagle a way via medicaid and got my son covered on that so I could finish my degree. I graduated, got a great job with benefits, and seriously a year later the ACA was passed an no preexisting conditions for children. The moral of this story is that I didn't complain about shit not being fair. I got off my ass and was proactive until shit happened and I didn't have half the luxuries the ACA affords you today. OK, I am now off my soapbox. Phew!!!!

Another thing, why are married people still allowed to have insurance through their parents? I really don't care one way or another, but I think that is weird. I know if my son gets married or has a child before 18 that my child support stops. You would think if you take those life steps you would become accountable for everything afterwards.

OP, I am seriously happy you found a solution. That must be a serious relief.

I'm sorry that you had such a rough start with your son. I didn't mean to come across as a spoiled kid stomping their feet.. The insurance was something that was discussed with my father and DH. My father has two younger children so like PP, it doesn't cost him anything extra to have me on his plan so it didn't make sense for me to spend more money when I didn't have to, especially when his plan had much better coverage. The reason I needed to "rant" was because I'm a freaked out first time mom and most of the women on here are very nice and supportive. However, it does offend me that you call me a liar when you don't know my life or my DH, nor the job market in our area. Also, there are some aspects of ACA that I do believe are good, but I don't agree with the majority of it.. but this is a pregnancy thread, not a political one.

I'm thankful for those of you who genuinely tried to help me and made suggestions.

caden1206

https://www.cbpp.org/cms/?fa=view&id=4028
https://www.factcheck.org/2013/09/obamacare-myths/

Just check some of these links out. You are right I don't know your area, but I am almost positive I could find position available with employer provided benefits.

stephmkemp

caden1206 said:

https://www.cbpp.org/cms/?fa=view&id=4028
https://www.factcheck.org/2013/09/obamacare-myths/

Just check some of these links out. You are right I don't know your area, but I am almost positive I could find position available with employer provided benefits.

I appreciate the info. I just know that my husband works with a bank, and when he was hired before ACA he worked 30-35 hours and since ACA was enacted they cut him to 20-25. But I'm not ignorant to information, so I'll check out those links. We all develop opinions based on our personal experiences.. mine with ACA and my husband's job just happened to be a bad one.

JunkieBrewster

This is considered a life change. You can get on at work regardless of enrollment periods, I believe.

JunkieBrewster

I did not have insurance when I got pregnant with my son eight years ago because I was supposedly infertile. My work was small and did not offer insurance at the time. I could not get on my husbands because 8 years ago they could use pre existing conditionS against you. We ended up having to pay for the entire pregnancy.
on top of that. My gallbladder went bad and they claimed it was pregnancy related and refused to pay for that too. We had to put the $10,000 surgery on a credit card before they would even perform it.