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May 2016 Moms
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Cannot add maternity until November! I need it now?!

AnkupperAnkupper member
in May 2016 Moms
I'm about in tears, just called to get my list of benefits for maternity through my insurance company. I was informed that because I have had my policy with this company for over three years it was grandfathered in and they were not obligated to add maternity to my plan. I don't know the first thing about insurance but I've read so much about how the laws have changed and that maternity is included in all plans now... I guess I'm just a special case. I've been a loyal, faithfully paying customer to my insurance company for the past three years. I'm trying really hard not to panic but I have my first appointment at eight weeks scheduled on Tuesday the 29th. I've called my doctors office and explain the situation I'm waiting on a call back with the dollar amount that I will be expected to pay in full at the time of the visit for my ultrasound and first doctors appointment. My husband has insurance through work but I have a got sinking feeling this is going to be the same exact situation as he's been with the company for the past five years and never switched insurances. Apparently there are a few loopholes as far as qualifying for early enrollment however we do not qualify for any of them. I feel like I've searched every Avenue and I just don't know what else to do.

Has anyone else had this happen? And if so do you have any suggestions on how to find a loophole to help cover the next two months until open enrollment in November? As it is, even if I sign up in November coverage will not start until December in which case I will be 1/3 of the way through my 2nd trimester. Any wisdom would be greatly appreciated.
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Re: Cannot add maternity until November! I need it now?!

  • Charla1224Charla1224 member
    A friend of mine found out she was pregnant in October a few years back and with approval from her OB used Planned Parenthood twice just to ensure everything was ok. She didn't want to pay her deductible two years in a row so she put off visits with her OB until January so she could change her plan for that year anticipating the birthing cost.

    If coverage isn't an option for a couple months I'd suggest PP or other community clinics until you can schedule with your OB.
    Me: 31 | DH: 33
    DD: 05/14/16
    Baby #2 EDD: 12/23/19
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  • RanFan28RanFan28 member
    There are people who "write" medical insurance, just like car or home. I'd try to get in touch with someone who knows the ins and outs and can give you the options. You might be eligible for coverage through ACA before the open enrollment period if this is considered a life change or loss of benefits.

    Me: 31 | DH: 33

    DS1: 12.23.13 | DS2: 05.06.16

    BFP: 06.30.19 | EDD: 3.9.20

    **TW**
    TTC3: 11.18
    BFP: 02.05.19
    CP: 03.07.19
    *really traumatic recovery*



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  • mariaalenemariaalene member
    What state are you in? All have different benefits. That will help ppl give you more accurate advice
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  • mariaalenemariaalene member
    https://healthinsurance.about.com/od/healthinsurancebasics/a/Pregnant-No-Maternity-Insurance-What-Now.htm
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  • .Kelly..Kelly. member
    What PP suggested- Planned Parenthood- is an excellent suggestion. They can handle all of the early appointments until your insurance kicks in. Pay is sliding scale. 

    image image
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  • AnkupperAnkupper member
    edited September 2015
    .
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  • AnkupperAnkupper member
    mariaalene said:

    What state are you in? All have different benefits. That will help ppl give you more accurate advice


    I am in Texas :)
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  • AnkupperAnkupper member
    edited September 2015
    Thank you ladies! I didn't realize that Planned Parenthood offered prenatal care options. I suppose I thought it was more on the contrary. This is a big relief. On paper we make too much to qualify for any assistance programs, but this doesn't take into account that we bought a home and needed a new car along with a huge medical expense earlier this year. So... "On paper" is great. But it doesn't mean we have loads of money in the bank. Especially considering we had been told we were covered.

    Thank you all again! I treasure the ability to gain wisdom from those of you who know more than I! :)
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  • vampirinavampirina member
    Also, you may be able to purchase new insurance during the open enrollment period on the open exchange market if you need to do so. I would definitely consider that option. I'm pretty sure pregnancy can't be considered a "per-existing condition" for new plans (or if it is, that you can't be ineligible for insurance because of it...)  You might not be able to receive subsidies, but hopefully you'll still be able to get a plan you like and can afford. I think open enrollment is sometime in the fall so do your research!
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  • mslovesbomslovesbo member
    During your option period, you may consider adding short-term disability. It may not help immediately, but it will help a little after delivery. I know you wont receive full benefits because you are supposed to have had the policy for a full year before using it for maternity leave, but you should still be able to file a claim and they will likely provide a check for partial benefits, plus you would be covered if you got pregnant again or had any other short term disability.

    I signed up in October (1 month after finding out I was pregnant last time) delivered in June (so I had the policy for almost 9 months) and received a nice compensation check (even at partial pay). I was thrilled I went ahead and signed up knowing I wouldn't get full benefits.

    Like I said this doesn't solve your insurance coverage issue -- but a little more cash after baby arrives might help pay some of the medical bills.

    imageimage 
     
    http://media.thedailytouch.com/2013/08/lets-do-this-ucas-gif.gif


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  • NigerianHairNigerianHair member
    Wow.. I hope this works out for you. Yes, only a small percentage of Planned Parenthood services are "the contrary". Theyre awesome! Hooe that helps in the meantime.
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  • .Kelly..Kelly. member
    I was curious what services were offered at our local PP clinics, so I checked. Ours actually do not offer prenatal services beyond testing. They will do postpartum checkups though. Hopefully your local PP will have the services you are needing.

    image image
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