Kind of freaking out/insurance question

MBush4 · October 2012

This morning I received an email from the school's HR department listing the new insurance details for 2013. We'll be switching back to our previous provider but in addition, I will be paying more than twice what I've been paying for the same plan (just under $300/m to $660/m). I don't make that much in the first place (the monetary joys of being a grad student and university employee aren't really that great) and with all of the new changes to insurance, more than half of my meager pay will be going to insurance and taxes. DH is also a student and working as an intern PT for an engineering firm, but his salary still won't make up for what all of the insurance costs will be. Any advice on what to do? I'm looking at maybe declining coverage next year and trying to find another insurance provider, but I'm not sure which ones to go with. I applied for medicaid, but who knows how long it will take them to make a decision and respond.

With LO due in February I'm kind of hyperventilating over here. Thanks for any advice!

dande2129 · October 2012

Medicaid usually doesn't take TOO terribly long to respond. I believe that when you apply, the ball automatically starts rolling and you're assigned a case worker who makes sure that all of the information needed is received.

And I'm with you--- I am a student at a major university who was behind the times and JUST switched from quarter to semester system. I have to be insured to be a student, and once I opt for the comprehensive coverage plan, I can't get out of it for the entire year. My tuition "refund" also paid the insurance per quarter, as it falls under my student fees, but I just sacrificed receiving no extra money like the other students. But, with semester system, I have to pay 2 "quarter" worth of insurance in one semester, under one tuition award. I had $1800 left over to pay OOP this semester.

My LO is also due in Feb., and we will be covered until Autumn, but I'll be looking into having the baby on FI's insurance, and Medicaid for DS and I. Because of having to pay such a high premium OOP for fall semester, and it's coming again for spring semester in January, my savings has depleted.

drpayne · October 2012

You must not not have watched the debate last night because the president said health care premiums went down. If he said it, it must be true!

Kidding aside, we are on individual policies. For my son and I it's only 240 a month. However, I don't have maternity coverage so we pay a ton out of pocket. Medicaid might be your best bet if you qualify.

ANA6 · October 2012

Sometimes Medicaid can be a pain. I have been trying to get mine change since July they keep putting me back on "family planning" and saying I didn't give them my proof of pregnancy. DD sitter told me with her first DD she had to fight them every month for 7 months they kept doing the same thing to her.

dande2129:
Medicaid usually doesn't take TOO terribly long to respond. I believe that when you apply, the ball automatically starts rolling and you're assigned a case worker who makes sure that all of the information needed is received.
And I'm with you--- I am a student at a major university who was behind the times and JUST switched from quarter to semester system. I have to be insured to be a student, and once I opt for the comprehensive coverage plan, I can't get out of it for the entire year. My tuition "refund" also paid the insurance per quarter, as it falls under my student fees, but I just sacrificed receiving no extra money like the other students. But, with semester system, I have to pay 2 "quarter" worth of insurance in one semester, under one tuition award. I had $1800 left over to pay OOP this semester.
My LO is also due in Feb., and we will be covered until Autumn, but I'll be looking into having the baby on FI's insurance, and Medicaid for DS and I. Because of having to pay such a high premium OOP for fall semester, and it's coming again for spring semester in January, my savings has depleted.

jvaeth2012 · October 2012

We had a similar situation that also forced me to apply for medicaid in our state. Here when you apply for the coverage for pregnant women they process the application within 15 business days and once everything is approved the coverage back dates to the application date. If you already know that you meet the requirements you should be okay. Believe me I know how scary and stressful it can be to think that you may be without insurance.

Allycat11 · October 2012

drpayne:
You must not not have watched the debate last night because the president said health care premiums went down. If he said it, it must be true! Kidding aside, we are on individual policies. For my son and I it's only 240 a month. However, I don't have maternity coverage so we pay a ton out of pocket. Medicaid might be your best bet if you qualify.

Yes Last year my insurance premium tripled, deductible increased and other benefits changed resulting in higher OOP costs. Sadly, what you are going through is happening all across the nation right now. Still waiting for the "affordable" part of the Patient Protection and Affordable Care Act to kick in.

But in all seriousness OP, Medicaid is probably your best bet. From what I know, typically the applications are processed quickly and it is fairly easy to qualify. If you call Department of Human Services they might be able to give you a better idea of what the income limit is. Chances are any individual plan that provides the same benefits you have now would be more expensive, especially if you need maternity coverage.

smilygrl17 · October 2012

Sagen:
Usually medicaid has somewhat of a guidline, like you can't make more than x amount, or have more than this in the bank, or that many assests. You could always call your case worker (whoever is processing your application), and ask about the guidlines to get a better feel of if you are eligable.

While this is true of regular medicaid, when you are pregnant, the qualifications and eligibility is a bit more lax.

While I do have private insurance I was able to get medicaid (not sure what the name of it is, pregnancy medicaid, family medicaid, I dunno). I filled out the application August 15th and I was approved a few weeks ago. It does take some time, however they will use an earlier date, so if your doctors will hold the bills or back bill it should be fine. They put my coverage starting August 1 (when I moved to the state). Anything pregnancy related from August 1 on would be covered. My doctors office does not back bill so I did get a bill from them for an appointment inbetween getting my approval. In the end they ended up redoing the bill and I owe nothing. From what my caseworker explained to me, Medicaid will cover anything insurance doesn't. In addition, you can remain for three months post birth, and the baby stays on for 13 months. Unless you qualify for regular medicaid then obviously it would continue. Definitely look into it.

sararn2004 · October 2012

jvaeth2012:
We had a similar situation that also forced me to apply for medicaid in our state. Here when you apply for the coverage for pregnant women they process the application within 15 business days and once everything is approved the coverage back dates to the application date. If you already know that you meet the requirements you should be okay. Believe me I know how scary and stressful it can be to think that you may be without insurance.

I agree with this. Now I have not been on medicaid(called MediCAL in CA...not sure why, guess we think we are special or something) for 8 years so the guidelines may have changed, but the PP is right. It backdates to the application date, plus I was on it twice and it initiated pretty quickly. The only time I had an issue when when my daughter was a newborn and the paperwork had not gone through for her, but I was covered and we both had thrush(her mouth, my nipples). It was super annoying to treat us both when the doc couldn't actually treat her without charging a buttload that I didn't have.

Anyway, the guidelines back then mostly had to do with assets, they didn't ask about my income, but that may have changed.And a car was not included in the assets. I had to have less than 3000 dollars to my name to qualify.

MelissaRae1525 · October 2012

smilygrl17:
Sagen:
Usually medicaid has somewhat of a guidline, like you can't make more than x amount, or have more than this in the bank, or that many assests. You could always call your case worker (whoever is processing your application), and ask about the guidlines to get a better feel of if you are eligable.

While this is true of regular medicaid, when you are pregnant, the qualifications and eligibility is a bit more lax.
While I do have private insurance I was able to get medicaid (not sure what the name of it is, pregnancy medicaid, family medicaid, I dunno). I filled out the application August 15th and I was approved a few weeks ago. It does take some time, however they will use an earlier date, so if your doctors will hold the bills or back bill it should be fine. They put my coverage starting August 1 (when I moved to the state). Anything pregnancy related from August 1 on would be covered. My doctors office does not back bill so I did get a bill from them for an appointment inbetween getting my approval. In the end they ended up redoing the bill and I owe nothing. From what my caseworker explained to me, Medicaid will cover anything insurance doesn't. In addition, you can remain for three months post birth, and the baby stays on for 13 months. Unless you qualify for regular medicaid then obviously it would continue. Definitely look into it.

I agree with the bolded. At least in my state it seems like all pregnant women get approved. I have insurance but my OOP copay is super high, and with being due in January it would have started all over and we would have had to pay the hospital bill out of pocket. So don't count out Medicaid. Mine was also back dated it just took a while for the OB to process it.

brachysira · October 2012

It's really impossible to know if you can get any assistance until you check into it. Some places it is really difficult. You might find out that student health insurance has decent coverage at your university--mine does, and it only costs about $1200/year. You or DH might be able to get it so you both could check. Since $660/mo may be more than you'd pay if you didn't have insurance (but of course you don't want to be without in case of costly things you don't anticipate), you should definitely shop around for alt insurance if neither public or university options pan out, but make sure you ask lots of questions.

And although it sucks to have premiums go up, only one option we have thinks there's any value at all to federal programs that help women who need it (or even knows women in need exist).

areadinger · October 2012

I was under the impression that if you are offered insurance through your employer, regardless of the cost, you are not eligible for Medicaid.

traneshaph · October 2012

I'm not sure which state you are in, but I'm in Georgia and also work for the University System. For my Medicaid I went directly to the Office of Family Support (or whatever they call it in your area) and turned my application in. The case worker reviewed me right there and I had my Medicaid card within a week. It's weird that yours increased so much because we just got our new rate quotes for 2013 and 90% of our premiums HAVE GONE DOWN but our coverages have increased across all plans. (Health insurance, life insurance, dental, disability.) Thanx Mr. President! But definitely go directly to the office and turn your app in. Take your check stubs, Soc Security card and any/all supporting docs you think you'll need. It's much faster that way.

traneshaph · October 2012

areadinger:
I was under the impression that if you are offered insurance through your employer, regardless of the cost, you are not eligible for Medicaid.

I know things change from state to state but in Georgia & Louisiana (both which I have lived & received Medicaid in while working for a University System that offers health insurance) you are automatically eligible for Medicaid if you are pregnant. They have a seperate division of "Pregnancy Medicaid" and cannot deny you. It's called "Right from the Start Medicaid" in GA and "Take Charge" in Louisiana. If you make like 100 grand a year, you may have some problems. But I'm in a single household, pregnant with my first child & I make close to $40,000 annually. I still got approved. They didn't even ask about my income. They just asked for my Proof of Pregnancy letter, Driver's license and Social Security card.

traneshaph · October 2012

brachysira:

It's really impossible to know if you can get any assistance until you check into it. Some places it is really difficult. You might find out that student health insurance has decent coverage at your university--mine does, and it only costs about $1200/year. You or DH might be able to get it so you both could check. Since $660/mo may be more than you'd pay if you didn't have insurance (but of course you don't want to be without in case of costly things you don't anticipate), you should definitely shop around for alt insurance if neither public or university options pan out, but make sure you ask lots of questions.

And although it sucks to have premiums go up, only one option we have thinks there's any value at all to federal programs that help women who need it (or even knows women in need exist).

THIS! Especially the end. Very true!

ggatlanta · October 2012

If you can make it with your current insurance until after baby is born, try looking into private plans WITHOUT maternity coverage. Yes, you need to be extra careful about birth control since any maternity will be OOP with these plans, but they can be 1/4 to 1/5 what your employer's group insurance cost. My best friend insures her whole family with one of these plans for $250 a month (two kids plus mom and dad) in a state where her workplace coverage for the same benefits plus maternity cost $1100.

Want a personalized experience?

Kind of freaking out/insurance question

Re: Kind of freaking out/insurance question

Choose Another Board

Search Boards