Just found out we're pregnant...but our Insurance doesn't cover maternity care???? — The Bump
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Just found out we're pregnant...but our Insurance doesn't cover maternity care????

Ok, So we just found out this week that we are pregnant, and as I was checking my insurance to find out what's covered and not, I learned there is no maternity care on our plan.  My husband and I both work at a smaller business that doesn't provide insurance so we have our own individual plan. However it doesn't cover pregnancy. We make too much to qualify for Medicaid, but does anyone else have any suggestions to supplemental coverage, or something we could do to help cover the cost? We never imagined this would be an issue. We are in South Carolina and I just can't find any options.  I haven't been to the doctor yet about my pregnancy but do have an appointment scheduled. So I didn't know what options where out there for us

 Thanks in advance for any help. 

 

Kristen

Re: Just found out we're pregnant...but our Insurance doesn't cover maternity care????

  • Congratulations on your pregnancy!  No ideas for insurance.  For a much less expensive birth, interview a homebirth midwife.  If you stick with the hospital, hire a doula.  Unmedicated birth will be less expensive.  
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  • Congrats on your pregnancy and I'm sorry about your insurance issues, that is really a hard blow to receive if you thought you had coverage. Can you sign up for additional private insurance and pay for it out of pocket? I have BCBS of Alabama (my company HQ) and I know pregnancy is not a pre -existing condition so you can sign up even if you are already pg and everything will be covered. My OBs office has a sit down with everyone to talk about the financial aspect and we were quoted ~$3,000 for their office fees and another $11,000-20,000 in hospital bills. Of course, we will be paying much less with insurance, but that can give you an idea of what it could run. Do the math and see if paying for a private plan would be worth it. I do think hospitals and MD offices may offer discounts for those paying out of pocket without insurance if you pre-pay.

     

    Good Luck!

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  • Thanks for responding. We looked to see if there were any add on plans we could include and there isn't. Apparently when you pay for individual plans like we are they don't offer anything for maternity care.  I talked to our insurance salesman and he said that a year or so ago they changed rules for insurance companies where they are no longer allowed to put limit on maternity coverage or payout for the services, which caused insurance companies to have to pay more and that's when individual plans stopped covering it.  It's rough, but thank goodness we just moved and sold our house so we will have some extra money to cover the pregnancy. It's not exactly what we wanted to use the money we made on the house for, but at least we have something to fall back on and help with this cost.
  • I know that's a tough situation--and my husband and I are in the same boat. We are lucky enough to be able to pay upfront and every place we've gone--from OB to the dentist--has given us a 30% discount for paying cash. It saves them when they don't have to deal with insurance. 

    You may be able to use that technique for at least the smaller costs: lab work, sonograms, etc. 




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  • Some times Medicaid will cover.  They did for us and we thought we made to much according to the website.  They told us it was due to no maternity coverage on our ins. 

    Talk with you ob/midwife now and the hospital now!  I know in Greenville GHS will do a payment plan and it is allot cheaper than what the insurance is billed!  With our 2nd child I had maternity coverage but they did not cover everything.  I still owed 6k after insurance.  We got half of it paid off and GHS took care of the rest.

     They will work with you!  Good luck!

     

  • I am in the same situation, I have private insurance but no maternity coverage. I called my insurance company today to ask about adding a maternity rider, however was told that coverage wouldn't start until 12 months after the plan went into effect. So this is really no help at all. My husband and I "make too much" for Medicaid (trust me we are not by any means well-off), so now I am nervously trying to figure out what my options are. Does anyone have a ballpark figure of a homebirth by midwife, specifically Virginia? Assuming that there are no complications, pray God. I am so stressed when I should be excited. It's really disheartening to feel so let down by our health care system.
  • I would check into a birthing center. Many if them accept patients with no maternity coverage and it is SUPER reasonable. I'm in the midlands area and there is one right around the corner from one of the local hospitals that several of my friends have used with great success.
  • I am in a very similar boat. I would say first, still apply for medicaid- the max income for Pregnant women is 3x the usual, and they sometimes have some wiggle room since SC's mortality rate is embarrassing.  I know a few people who make over the limit by a bit but still qualified.

    We are also going with a birth center. In columbia, the entire prenatal, labor and delivery, and postnatal checkup are $5k. If you pay by week 35, you get $500 off of that. The only thing that doesn't include is the 2 required OB/GYN visits, but often the birth centers have OB's that come in every so often and only charge $100, plus b/w. So you're looking at about $5,500 if you can't pay it all by week 35, like us. Hope that helps! 

  • My husband sells insurance, we have a individual health insurance plan that does not cover maternity.
    However, starting in 2014 all individual insurance plans must cover maternity by law.
    When we had our first in 2011 I was working for a company and we had group insurance plan with maternity after I had him I quit work to stay home, we waited to get pregnant with our second so that the delivery would fall into 2014. This is a new law that is a part of Obamacare that will start in 2014.
  • Hi, have you truly looked into medicaid?  I assumed we made too much too, but when I looked into it it turns out pregnant women are in a higher bracket and can make a little bit more.

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