Anyone not have prenatal/pregnancy coverage w/ health insurance?

bim38106

One of my closest friends just found out she is pregnant! She was on birth control, so this was very not planned.... she recently moved to Oregon and got a new job. She has health insurance, but she just found out she is not covered for maternity and other insurances won't accept her since she now has a "pre-existing condition" (not too surprising there).

I could have sworn I'd read on the tri boards way back when about people going through the state, or some other program, when this happens, to get some coverage...anyone have to go through this or know in what direction I can point her?? The only info she was given was that w/ the new health care bill, she should shop around and she might find an insurance co. willing to take her on.... TIA!

vmm0016

Are you talking about the 6 weeks she has to take off after she has the baby?  If so, a lot of companies do not have for maternity leave.  If you are talking about insurance to cover the pregnancy...she should be okay if she has health insurance.  My company does not pay for maternity leave and I have been here for 5 years.

bim38106

vmm0016:

Are you talking about the 6 weeks she has to take off after she has the baby?  If so, a lot of companies do not have for maternity leave.  If you are talking about insurance to cover the pregnancy...she should be okay if she has health insurance.  My company does not pay for maternity leave and I have been here for 5 years.

oops, I worded that wrong didn't I. I think it's because I just read her email and that's what she wrote.. I mean prenatal care through health insurance. They won't cover anything related to the pregnancy or l&d.

vmm0016

bim38106:

vmm0016:

Are you talking about the 6 weeks she has to take off after she has the baby?  If so, a lot of companies do not have for maternity leave.  If you are talking about insurance to cover the pregnancy...she should be okay if she has health insurance.  My company does not pay for maternity leave and I have been here for 5 years.

oops, I worded that wrong didn't I. I think it's because I just read her email and that's what she wrote.. I mean prenatal care through health insurance. They won't cover anything related to the pregnancy or l&d.

That seems weird.  I know some companies have a grace period that you can not get pregnant in.  I guess I would check at what her options are through the state.  Man, that would be nerve wracking!  I hope she gets things figured out!

2BWEDN2007

In my state, all uninsured pregnant women qualify for MassHealth which is the state Medicaid program. I would highly suggest she visit her state's website to find information on how to apply.

MegDC

2BWEDN2007:

In my state, all uninsured pregnant women qualify for MassHealth which is the state Medicaid program. I would highly suggest she visit her state's website to find information on how to apply.

If she gets her insurance through her employer and they have 50+ employees, they can't deny her under HIPPA.  Only individual and small business insurance policies can deny her (HIPPA exempt).

She should contact the Oregon AG's office and ask if they have a healthcare or insurance advocate she can speak with.  She should also explore medicaid options.

karebear428

I would start with the state...my Dh and I had an opps (that ended in a mc) right after we started dating and didn't have any insurance.  We went through the state and everything would have been covered.  I do know there are income restrictions, and they asked us if we had any form of insurance, so I don't know if your friend having normal health insurance would make a difference.  Just go to the county health department and go from there, it never hurts to try.

BlueMoonMagic

I didn't have health insurance when I found out I was pregnant (gotta love oopsie babies!). I shopped around and found that Blue Cross Blue Shield would cover me, but that I would have to wait 180 days before the maternity benefits kicked in. So for me, I found out I was pregnant February 10, got insurance to start March 1, and maternity benefits started Sept 1. Lilia was born Oct 2. We were just over the 'limit' of gross income to qualify for state programs. Until my maternity benefits kicked in, my OB's office had a program for women with no health insurance with a payment plan for services needed.

bim38106

Thanks so much everyone! I will pass along the information to her. She is really stressing right now, both about this and about the unplanned pregnancy (w/ BF of 6ish months who is actually going through a divorce right now....don't even ask!)

DiscusCoach

I thought you couldn't deny for pre-existing conditions if it was a group policy.